School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, United Kingdom.
Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Vaccine. 2018 Aug 6;36(32 Pt B):4851-4860. doi: 10.1016/j.vaccine.2018.06.043. Epub 2018 Jun 30.
To estimate full hepatitis B vaccination coverage (uptake of ≥3 doses of vaccine) among health-care workers (HCWs) in Africa.
We systematically searched the PubMed®, Embase®, CINAHL and Psych-Info databases for studies published from January 2010 to October 2017 that reported full hepatitis B vaccination coverage among HCWs in Africa. A random effects meta-analysis was conducted to determine pooled estimates of full vaccination coverage.
Of the 331 articles identified, 35 studies from 15 African countries met the inclusion criteria and were included in the review. The estimated full hepatitis B vaccination coverage was 24.7% (95% CI: 17.3-32.0). Regional coverage was highest in northern Africa (62.1%, 95% CI: 42.5-81.7) and lowest in central Africa (13.4%, 95% CI: 4.5-22.3). Doctors were more likely (OR: 2.6, 95% CI: 1.8-3.7) to be fully vaccinated than Nurses with estimated pooled estimates of 52.4% (95% CI: 31.1-73.8) and 26.3% (95% CI: 9.7-42.9), respectively. Also, HCWs with 10 or more years of experience were more likely to be vaccinated than those with less than 10 years of experience (OR: 2.2, 95% CI: 1.5-3.3). The common reasons identified for non-vaccination of HCWs were unavailability of vaccine 50.5% (95% CI: 26.5-74.4), busy work schedule 37.5% (95% CI: 12.6-62.4) and cost of vaccination 18.4% (95% CI: 7.1-29.7).
The evidence available suggests that many HCWs in Africa are at risk of Hepatitis B infection as only a quarter of them were fully vaccinated against Hepatitis B virus. This study highlights the need for all African governments to establish and implement hepatitis B vaccination policies for HCWs.
评估非洲卫生保健工作者（HCWs）的乙型肝炎完全疫苗接种覆盖率（接种≥3 剂疫苗）。
我们系统地检索了 PubMed®、Embase®、CINAHL 和 Psych-Info 数据库，以获取 2010 年 1 月至 2017 年 10 月期间发表的报告非洲 HCWs 乙型肝炎完全疫苗接种覆盖率的研究。采用随机效应荟萃分析来确定完全疫苗接种覆盖率的汇总估计值。
在 331 篇文章中，有 35 项来自 15 个非洲国家的研究符合纳入标准并纳入了综述。估计的乙型肝炎完全疫苗接种覆盖率为 24.7%（95%CI：17.3-32.0）。北部非洲的覆盖率最高（62.1%，95%CI：42.5-81.7），中部非洲最低（13.4%，95%CI：4.5-22.3）。与护士相比，医生更有可能（OR：2.6，95%CI：1.8-3.7）完全接种疫苗，估计的总体接种率分别为 52.4%（95%CI：31.1-73.8）和 26.3%（95%CI：9.7-42.9）。此外，拥有 10 年或以上工作经验的 HCWs 比工作经验少于 10 年的 HCWs 更有可能接种疫苗（OR：2.2，95%CI：1.5-3.3）。未为 HCWs 接种疫苗的常见原因包括疫苗无法获得（50.5%，95%CI：26.5-74.4）、工作繁忙（37.5%，95%CI：12.6-62.4）和疫苗费用（18.4%，95%CI：7.1-29.7）。
现有证据表明，非洲许多 HCWs 有感染乙型肝炎的风险，因为只有四分之一的人完全接种了乙型肝炎病毒疫苗。本研究强调了所有非洲政府都需要为 HCWs 制定和实施乙型肝炎疫苗接种政策。
