Internal Medicine Department, Kilimanjaro Christian Medical Center, P.O.Box3010, Moshi, United Republic of Tanzania.
Institute of Public Health, Community Health Department, Kilimanjaro Christian Medical University College, P.O.Box2240, Moshi, Tanzania.
BMC Infect Dis. 2018 Sep 21;18(1):474. doi: 10.1186/s12879-018-3376-2.
Hepatitis B virus infection is a global health problem with the highest prevalence in East Asia and Sub-Saharan Africa. The majority of infected people, including healthcare workers are unaware of their status. This study is aimed to determining seroprevalence of hepatitis B virus infection and associated factors among healthcare workers in northern Tanzania.
This cross-sectional study included 442 healthcare workers (HCWs) from a tertiary and teaching hospital in Tanzania before the nationwide hepatitis B vaccination campaign in 2004. Questionnaire- based interviews were used to obtain detailed histories of the following: demographic characteristics; occupation risks such splash and needle stick injuries or other invasive procedure such as intravenous, intramuscular or subcutaneous injections; history of blood transfusion and surgeries, as well as HCWs'knowledge of HBV. Serological markers of HBV were done using Laborex HBsAg rapid test. Serology was done at zero months and repeated after six months ( bioscienceinternational.co.ke/rapid-test-laborex.html HBsAg Piazzale-milano-2, Italy [Accessed on November 2017]). Chi-square (χ) tests were used to compare proportion of HBV infection by different HCWs characteristics. Multivariable logistic regression was used to determine factors associated with HBV infection.
A total of 450 surveys were sent out, with a 98.2% response rate. Among the 442 HCWs who answered the questionnaire, the prevalence of chronic hepatitis B virus infection was 5.7% (25/442). Only 50 (11.3%) of HCWs were aware of the HBV status. During the second HBsAg testing which was done after six months one participant sero-converted hence was excluded. Adjusted for other factors, history of blood transfusion significantly increased the odds of HBV infection (OR = 21.44, 95%CI 6.05, 76.01, p < 0.001) while HBV vaccine uptake was protective against HBV infection (OR = 0.06, 95%CI 0.02, 0.26, p < 0.001). The majority of HCWs with chronic HBV infection had poor to fare knowledge about HBV infection but this was not statistically significant when controlled for confounding.
Prevalence of HBV among health care workers was 5.7% which is similar to national prevalence. Although the response rate to take part in the study was good but knowledge on HBV infection among HCWs was unsatisfactory. History of blood transfusion increased risks while vaccine uptake decreased the risk of HBV infection. This study recommends continues vaccinating HCWs together with continues medical education all over the country. We also recommend documentation of vaccination evidence should be asked before employment of HCWs in order to sensitize more uptakes of vaccinations. Although we didn't assess the use of personal protective equipment but we encourage HCWs to abide strictly on universal protections against nosocomial infections.
乙型肝炎病毒感染是一个全球性的健康问题,在东亚和撒哈拉以南非洲地区最为普遍。大多数感染者,包括医护人员,都不知道自己的感染状况。本研究旨在确定坦桑尼亚北部医护人员中乙型肝炎病毒感染的血清流行率及其相关因素。
这是一项横断面研究,纳入了坦桑尼亚一所三级和教学医院的 442 名医护人员(HCWs),时间在 2004 年全国乙型肝炎疫苗接种运动之前。采用问卷调查的方式,详细了解以下内容:人口统计学特征;职业风险,如飞溅和针刺伤,或其他侵入性操作,如静脉、肌肉或皮下注射;输血和手术史,以及 HCWs 对乙型肝炎病毒的了解。采用 Laborex HBsAg 快速检测法检测乙型肝炎病毒的血清学标志物。零个月时进行血清学检查,并在六个月后(bioscienceinternational.co.ke/rapid-test-laborex.html HBsAg Piazzale-milano-2, Italy [Accessed on November 2017])重复检查。采用卡方(χ)检验比较不同 HCWs 特征的乙型肝炎病毒感染比例。采用多变量逻辑回归确定与乙型肝炎病毒感染相关的因素。
共发放 450 份调查问卷,应答率为 98.2%。在回答问卷的 442 名 HCWs 中,慢性乙型肝炎病毒感染的患病率为 5.7%(25/442)。只有 50 名(11.3%)HCWs 知道自己的乙型肝炎病毒状况。在六个月后的第二次 HBsAg 检测中,有 1 名参与者血清学转换,因此被排除在外。调整其他因素后,输血史显著增加了乙型肝炎病毒感染的几率(OR=21.44,95%CI 6.05,76.01,p<0.001),而乙型肝炎病毒疫苗接种则对乙型肝炎病毒感染具有保护作用(OR=0.06,95%CI 0.02,0.26,p<0.001)。大多数慢性乙型肝炎病毒感染的 HCWs 对乙型肝炎病毒感染的了解很差或很差,但在控制混杂因素后,这并不具有统计学意义。
医护人员中乙型肝炎病毒的流行率为 5.7%,与全国流行率相似。尽管参与研究的应答率很高,但 HCWs 对乙型肝炎病毒感染的知识仍不尽人意。输血史增加了风险,而疫苗接种降低了乙型肝炎病毒感染的风险。本研究建议继续为 HCWs 接种疫苗,并在全国范围内持续开展医学教育。我们还建议在雇用 HCWs 之前,要求提供疫苗接种证据,以提高更多的疫苗接种率。虽然我们没有评估个人防护设备的使用情况,但我们鼓励 HCWs 严格遵守针对医院感染的普遍防护措施。