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柬埔寨公共部门医护人员对乙肝和丙肝的知晓情况、态度、行为及流行率以及乙肝疫苗接种覆盖率

Knowledge, attitudes, practices and prevalence of hepatitis B and C and hepatitis B vaccination coverage among public sector healthcare workers in Cambodia.

作者信息

By Youlet, Le Linh-Vi, Suy Sovanthida, Chou Monidarin, Chan Po-Lin, Heng Kanika, Phou Socheata, Ny Chanthou, Deng Serongkea, Phoeung Chan Leakhena, Mam Sovatha, Ferradini Laurent, Babin François-Xavier, Saphonn Vonthanak

机构信息

University of Health Sciences, Phnom Penh, Cambodia.

Fondation Mérieux, Phnom Penh, Cambodia.

出版信息

Glob Health Med. 2024 Apr 30;6(2):108-116. doi: 10.35772/ghm.2023.01097.

Abstract

Healthcare workers (HCWs) are a key population at high risk for hepatitis B (HBV) and hepatitis C (HCV) infections. We aim to study HBV vaccination coverage, seroprevalence, knowledge, attitudes, and practices towards HBV and HCV infections among HCWs in public sector in Cambodia. A nationally representative cross-sectional study was implemented in 2019, among Cambodian HCWs. A standardized questionnaire was administered to randomly selected HCWs whose blood was then sampled. We used univariate and multivariate regression to determine predictors of outcomes. Among 755 participants, we found 4.9% positive HBsAg and 2.3% positive anti-HCV Ab. HBV vaccination coverage was 59.3%. Lack of knowledge was found on the route of transmission, HBV vaccination, diagnosis and treatment of HBV and HCV. 67% of HCWs thought that all patients should be screened for HBV and HCV and about 30% of them would refuse to take care of infected patients. 58% of HCWs always recapped the needle after use. In univariate analysis, older age-group (> 50 years) is more likely to have positive anti-HCV (OR: 9.48; 95% CI: 2.36-38.18). HCWs who were younger, female or having higher education or having ever been tested, were more likely to have gotten HBV vaccinated. Multivariate analysis reconfirmed these predictors of getting vaccinated. Study findings indicated an urgent need of a national policy for Cambodian HCWs given the high prevalence of hepatitis among this group. Policy should include an effective in-service training program to improve knowledge and practices, a testing and vaccination program for HCWs and it should emphasize stigma intervention towards people living with HBV/HCV.

摘要

医护人员是感染乙型肝炎(HBV)和丙型肝炎(HCV)的高危重点人群。我们旨在研究柬埔寨公共部门医护人员中HBV疫苗接种覆盖率、血清流行率、对HBV和HCV感染的知识、态度及行为。2019年在柬埔寨医护人员中开展了一项具有全国代表性的横断面研究。对随机抽取的医护人员发放标准化问卷,随后采集其血液样本。我们采用单变量和多变量回归分析来确定结果的预测因素。在755名参与者中,我们发现HBsAg阳性率为4.9%,抗-HCV抗体阳性率为2.3%。HBV疫苗接种覆盖率为59.3%。在HBV和HCV的传播途径、疫苗接种、诊断和治疗方面存在知识欠缺。67%的医护人员认为所有患者都应接受HBV和HCV筛查,其中约30%的人会拒绝护理感染患者。58%的医护人员使用后总是回套针头。单变量分析显示,年龄较大组(>50岁)抗-HCV阳性的可能性更高(比值比:9.48;95%置信区间:2.36-38.18)。年龄较小、女性、受过高等教育或曾接受过检测的医护人员接种HBV疫苗的可能性更高。多变量分析再次证实了这些疫苗接种的预测因素。研究结果表明,鉴于该群体中肝炎的高流行率,柬埔寨迫切需要为医护人员制定一项国家政策。政策应包括有效的在职培训计划以提高知识和行为水平、针对医护人员的检测和疫苗接种计划,并且应强调对HBV/HCV感染者的消除污名化干预措施。

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