埃塞俄比亚西南部吉马大学医学中心医护人员的乙肝和丙肝病毒感染：患病率、知识、态度、行为及职业暴露情况
Hepatitis B and C Viral Infection: Prevalence, Knowledge, Attitude, Practice, and Occupational Exposure among Healthcare Workers of Jimma University Medical Center, Southwest Ethiopia.
作者信息
Hebo Habtemu J, Gemeda Desta H, Abdusemed Kedir A
机构信息
Department of Epidemiology, Public Health Faculty, Institute of Health, Jimma University, P.O. Box 378, Jimma, Ethiopia.
Department of Medical Laboratory Sciences and Pathology, Health Sciences Faculty, Institute of Health, Jimma University, P.O. Box 378, Jimma, Ethiopia.
出版信息
ScientificWorldJournal. 2019 Feb 3;2019:9482607. doi: 10.1155/2019/9482607. eCollection 2019.
BACKGROUND
Blood-borne infections have been recognized as an occupational hazard for nearly 50 years. Current treatment for hepatitis B virus (HBV) is very expensive for individuals in developing countries and cannot clear infection after it progresses to the chronic stage. Thus, early screenings of people who are at higher risk like healthcare workers and vaccination and awareness creation on standard precautions (SP) to prevent transmission are mandatory. This study determined seroprevalence of HBV and hepatitis C virus (HCV) among healthcare workers of Jimma University Medical Center (JUMC).
METHODS
An institution based cross-sectional study was conducted from Nov 2015 to Jan 2016. The lottery method was used to select 240 healthcare workers. Data were collected by a self-administered questionnaire. Five to ten milliliters of whole venous blood was collected from each participant. The blood samples were analyzed (tested) for hepatitis B surface antigen (HBsAg) and anti-HCV antibody using automated Enzyme-Linked Immunosorbent Assay (ELISA). Data were entered into EpiData 3.1 and analyzed by SPSS 23.
RESULTS
The positivity of HBsAg was 2.5% (6/240; 95% CI: 0.52-4.48%) and that of anti-HCV antibody was 0.42% (1/240; 95% CI: 0.0-1.23%). Most participants had good knowledge of HBV (73.9%), HCV (60.9%), and SP (82.2%) and positive attitude towards SP (88.7%), but only 42.6% had a good practice of SP. More than half (60%) and nearly half (43%) had a history of ever exposure and exposure in the last one year before the survey, respectively. Females were at lower risk of both having ever exposure (95% CI: (0.241, 0.777)) and exposure in the last one year before the survey (95% CI: (0.297, 0.933)) compared to males.
CONCLUSION
The prevalence of HBV was intermediate according to the endemicity classification by WHO. The practice of SP was poor in most participants and, thus, occupational exposure was high. Therefore, regular screening and vaccination of healthcare workers, regular provision of basic or refresher training and availing logistics, and regular motivation of healthcare workers on the practice of standard precautions are recommended.
背景
血源性感染已被确认为近50年来的一种职业危害。对于发展中国家的个人而言，目前的乙型肝炎病毒（HBV）治疗费用非常昂贵，且在疾病进展至慢性阶段后无法清除感染。因此，对医护人员等高风险人群进行早期筛查以及开展预防传播的标准预防措施（SP）疫苗接种和宣传教育是必不可少的。本研究确定了吉姆马大学医学中心（JUMC）医护人员中HBV和丙型肝炎病毒（HCV）的血清流行率。
方法
于2015年11月至2016年1月进行了一项基于机构的横断面研究。采用抽签法选取240名医护人员。通过自填问卷收集数据。从每位参与者采集5至10毫升全静脉血。使用自动酶联免疫吸附测定（ELISA）对血样进行乙型肝炎表面抗原（HBsAg）和抗HCV抗体分析（检测）。数据录入EpiData 3.1并使用SPSS 23进行分析。
结果
HBsAg阳性率为2.5%（6/240；95%可信区间：0.52 - 4.48%），抗HCV抗体阳性率为0.42%（1/240；95%可信区间：0.0 - 1.23%）。大多数参与者对HBV（73.9%）、HCV（60.9%）和SP（82.2%）有良好的认知，对SP持积极态度（88.7%），但只有42.6%的人有良好的SP实践。超过一半（60%）和近一半（43%）的人分别有既往暴露史和在调查前最后一年的暴露史。与男性相比，女性既往暴露（95%可信区间：(0.241, 0.777)）和在调查前最后一年暴露（95%可信区间：(0.297, 0.933)）的风险较低。
结论
根据世界卫生组织的地方性分类，HBV的流行率处于中等水平。大多数参与者的SP实践较差，因此职业暴露风险较高。因此，建议对医护人员进行定期筛查和疫苗接种，定期提供基础或复习培训并提供后勤保障，以及定期激励医护人员践行标准预防措施。
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