Black Antony P, Vilivong Keooudomphone, Nouanthong Phonethipsavanh, Souvannaso Chanthasone, Hübschen Judith M, Muller Claude P
Institute of Immunology, Luxembourg Institute of Health (former Centre de Recherche Public de la Santé)/Laboratoire National de Santé, Luxembourg, Grand-Duchy of Luxembourg; Lao-Lux Laboratory, Institut Pasteur du Laos, Vientiane, Lao PDR.
Lao-Lux Laboratory, Institut Pasteur du Laos, Vientiane, Lao PDR.
PLoS One. 2015 Apr 14;10(4):e0123647. doi: 10.1371/journal.pone.0123647. eCollection 2015.
Healthcare workers (HCW) have an increased risk of exposure to infectious diseases and are a potential source of infections for their patients. The Lao People's Democratic Republic (Lao PDR) has no national policy regarding HCW vaccinations and routine vaccination coverage is low within the general population. This cross-sectional serostudy determines the level of exposure and risk of infection in Lao HCW against 6 vaccine preventable diseases and hepatitis C.
1128 HCW were recruited from 3 central, 2 provincial and 8 district hospitals. Sera were tested by ELISA for the presence of antibodies and antigens to hepatitis B, hepatitis C, measles, rubella, varicella zoster, tetanus and diphtheria.
Only 53.1% of the HCW had protective anti-hepatitis B surface antigen antibodies (anti-HBs) with 48.8% having anti-hepatitis B core antibodies (anti-HBc), indicating previous exposure and 8.0% were hepatitis B surface antigen carriers. 3.9% were hepatitis C seropositive. Measles and rubella antibodies were detected in 95.4% and 86.2% of the HCW, with 11.9% of females being unprotected against rubella. Antibodies against varicella zoster, tetanus and diphtheria were detected in 95%, 78.8% and 55.3%, respectively. Seroprevalence varied according to age, gender and number of children.
An unacceptably high proportion of Lao HCW remain susceptible to infection with hepatitis B, diphtheria, tetanus and rubella. Furthermore, a high number of healthcare workers are chronically infected with hepatitis B and C viruses. These data emphasize the need for a robust HCW vaccination policy in addition to increased awareness within this subpopulation.
医护人员接触传染病的风险增加，并且是其患者感染的潜在来源。老挝人民民主共和国（老挝）没有关于医护人员疫苗接种的国家政策，而且普通人群的常规疫苗接种覆盖率较低。这项横断面血清学研究确定了老挝医护人员针对6种疫苗可预防疾病和丙型肝炎的接触水平和感染风险。
从3家中心医院、2家省级医院和8家区级医院招募了1128名医护人员。通过酶联免疫吸附测定法（ELISA）检测血清中是否存在针对乙型肝炎、丙型肝炎、麻疹、风疹、水痘带状疱疹、破伤风和白喉的抗体及抗原。
只有53.1%的医护人员具有保护性抗乙型肝炎表面抗原抗体（抗-HBs），48.8%的人具有抗乙型肝炎核心抗体（抗-HBc），表明既往有接触史，8.0%为乙型肝炎表面抗原携带者。3.9%的人丙型肝炎血清学呈阳性。95.4%和86.2%的医护人员检测到麻疹和风疹抗体，11.9%的女性对风疹无免疫力。分别在95%、78.8%和55.3%的医护人员中检测到水痘带状疱疹、破伤风和白喉抗体。血清阳性率因年龄、性别和子女数量而异。
老挝医护人员中对乙型肝炎、白喉、破伤风和风疹仍易感的比例高得令人无法接受。此外，大量医护人员长期感染乙型和丙型肝炎病毒。这些数据强调除了提高这一亚人群的认识外，还需要制定强有力的医护人员疫苗接种政策。
