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尼日利亚东南部埃努古一家三级医疗机构卫生保健工作者中乙型肝炎疫苗接种及其决定因素的研究。

Uptake of hepatitis B vaccination and its determinants among health care workers in a tertiary health facility in Enugu, South-East, Nigeria.

机构信息

Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria.

Department of Chemical Pathology, College of Medicine, University of Nigeria, Enugu Campus, Nigeria.

出版信息

BMC Infect Dis. 2018 Jun 28;18(1):288. doi: 10.1186/s12879-018-3191-9.

Abstract

BACKGROUND

Hepatitis B vaccination is the most effective method of prevention for hepatitis B virus infection. It is a major public health problem in Nigeria, and health workers are at increased risk. This study determined the uptake of hepatitis B vaccination and assessed its determinants among health care workers (HCWs).

METHODS

A hospital-based cross-sectional study was conducted between July and August, 2016 using self-administered structured questionnaires among 3132 HCWs in University of Nigeria Teaching Hospital, Enugu, South-East, Nigeria. Data was analysed using SPSS version 22. Binary logistic regression analysis was used to identify factors that influenced uptake of vaccination. Ethical clearance was obtained from the Research Ethics Committee of the health facility.

RESULTS

The uptake of hepatitis B vaccination was 14.2% (n = 445). The number of doses received were: 3 doses (218/3132, 48.9%), 2 doses (71/3132, 16.0%), and one dose (156/3132, 35.1%). The reasons for non-uptake of vaccination included: cost of vaccine 48 (10.8%), 'did not believe they could be infected' 28 (6.6%), long vaccination schedule, and lack of time 150 (35.1%). The Odds for uptake of hepatitis B vaccination were 22% lower among nurses compared to doctors (AOR = 0.78, 95% CI = 0.54-0.98, P = 0.037). It increased with increasing age (AOR = 1.30, 95% CI = 1.08-1.59, P <  0.001), increasing duration of work in the hospital (AOR = 1.19, 95% CI = 1.09-1.32, P = 0.032), and was about twice higher among those that had tertiary education than others that had less education (AOR = 1.96, 95 CI = 0.76-5.07, P = 0.164).

CONCLUSIONS

The uptake of hepatitis B vaccination was low among HCWs in Enugu, Nigeria. Age, staff category, and duration of work in the hospital, were independently associated with hepatitis B vaccination. Provision of adequate hepatitis B surface antigen screening facilities and vaccination sites where the cost of vaccination is subsidized for all HCWs is recommended.

摘要

背景

乙肝疫苗接种是预防乙肝病毒感染的最有效方法。在尼日利亚,乙肝疫苗接种是一个主要的公共卫生问题,卫生工作者面临着更大的风险。本研究旨在确定医护人员(HCWs)对乙肝疫苗接种的接受程度,并评估其决定因素。

方法

2016 年 7 月至 8 月,在尼日利亚东南部埃努古大学教学医院进行了一项基于医院的横断面研究,对 3132 名 HCWs 使用自我管理的结构化问卷进行了调查。使用 SPSS 版本 22 进行数据分析。采用二元逻辑回归分析确定影响疫苗接种的因素。该卫生机构的伦理审查委员会获得了伦理批准。

结果

乙肝疫苗接种率为 14.2%(n=445)。接种的疫苗剂量为:3 剂(218/3132,48.9%),2 剂(71/3132,16.0%)和 1 剂(156/3132,35.1%)。未接种疫苗的原因包括:疫苗费用 48 美元(10.8%)、“不相信自己会被感染”28 美元(6.6%)、疫苗接种时间表长和缺乏时间 150 美元(35.1%)。与医生相比,护士接种乙肝疫苗的几率低 22%(AOR=0.78,95%CI=0.54-0.98,P=0.037)。随着年龄的增长(AOR=1.30,95%CI=1.08-1.59,P<0.001)和在医院工作时间的增加(AOR=1.19,95%CI=1.09-1.32,P=0.032),接种率也会增加,而接受过高等教育的人比接受过较少教育的人接种乙肝疫苗的几率高近两倍(AOR=1.96,95CI=0.76-5.07,P=0.164)。

结论

在尼日利亚埃努古,乙肝疫苗接种在 HCWs 中的接种率较低。年龄、员工类别和在医院工作的时间与乙肝疫苗接种独立相关。建议为所有 HCWs 提供充足的乙肝表面抗原筛查设施和接种点,并补贴疫苗接种费用。

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