Alkhaldi Sarah, Aldousari Hussah, Alfaresi Shaikhah, Alqabandi Sarah, Khafagi Walaa, Sheha Marwa, Sanhoury Marwa, Gomaa Alshaimaa, Elshony Sahar, Alenzi Farah, Eltawansy Marwa
Public Health, Kuwait Ministry of Health, Farwaniyah, KWT.
Cureus. 2024 Jul 19;16(7):e64910. doi: 10.7759/cureus.64910. eCollection 2024 Jul.
Introduction Hepatitis B virus (HBV) is a highly infectious disease affecting the liver, causing life-threatening acute and chronic hepatitis. It poses a significant global public health burden and is a major occupational risk for healthcare workers (HCWs) due to transmission through blood and blood products. Given their increased risk compared to the general population, vaccination is crucial in limiting the spread of HBV and protecting HCWs. This study aims to measure the anti-HBs titers of HCWs in the Farwaniyah Health District in Kuwait after completing three doses of the HBV vaccine. Methods This cross-sectional study was conducted in the Farwaniyah Health District of Kuwait between May and July 2023. We collected data from 556 participants from various departments, including physicians, nurses, and laboratory technicians, chosen through simple random sampling. Inclusion criteria included the completion of three doses of the HBV vaccine (Engerix-B recombinant vaccine, GlaxoSmithKline Biologicals, Brentford, UK). Demographic data were collected, and blood samples were tested for hepatitis B surface antigen antibody titers using fourth-generation enzyme-linked immunosorbent assay. Participants were categorized based on sex, age, specialty, and time since the last vaccine dose. The chi-square test and Fisher's exact test assessed differences in categorical variables, with a p-value of <0.05 considered statistically significant. Results The study included 556 participants, with 304 (54.7%) women and 252 (45.3%) men. Participants were assigned into two age groups: 294 (52.9%) were 18 to 40 years old and the remainder (262) were over 40. Most participants were nursing staff (n=392; 70.5%), followed by physicians (n=110; 19.7%) and technicians (n=54; 9.7%). A high proportion (n=340; 61.2%) received their last vaccine dose within the last five years. Overall, 375 (67.4%) HCWs developed sufficient anti-HBs titers of ≥100 mIU/mL while 181 (32.6%) had levels below 100 mIU/mL. Age between 18 and 40 years and receiving the vaccine within the last five years were significantly associated with protective titer levels, while sex was not. Nurses had significantly higher immunity levels compared to doctors and technicians. Conclusions HCWs in the Farwaniyah area of Kuwait generally responded positively to the HBV vaccine. Younger HCWs and those who received the vaccine more recently were more likely to have a protective immune response. Nurses demonstrated higher rates of seroconversion compared to doctors and technicians. These results suggest that HBV vaccination programs should prioritize timely booster doses, especially for older HCWs and those vaccinated long ago. Monitoring antibody levels is crucial to ensure ongoing protection, particularly in high-risk groups such as nurses. Implementing these measures can enhance the effectiveness of HBV vaccination programs, reduce HBV incidence among HCWs, and contribute to a safer healthcare environment. Post-vaccination testing is essential to ensure the safety of all HCWs against HBV.
引言 乙型肝炎病毒(HBV)是一种极具传染性的肝脏疾病,可引发危及生命的急性和慢性肝炎。它给全球公共卫生带来了重大负担,并且由于通过血液和血液制品传播,对医护人员(HCWs)构成了重大职业风险。鉴于医护人员相较于普通人群感染风险更高,接种疫苗对于限制HBV传播和保护医护人员至关重要。本研究旨在测量科威特法瓦尼亚健康区的医护人员完成三剂HBV疫苗接种后的抗-HBs滴度。
方法 这项横断面研究于2023年5月至7月在科威特法瓦尼亚健康区开展。我们通过简单随机抽样从各个科室收集了556名参与者的数据,这些科室包括医生、护士和实验室技术人员。纳入标准包括完成三剂HBV疫苗接种(安在时重组疫苗,葛兰素史克生物制品公司,英国布伦特福德)。收集了人口统计学数据,并使用第四代酶联免疫吸附测定法检测血样中的乙型肝炎表面抗原抗体滴度。参与者根据性别、年龄、专业以及最后一剂疫苗接种后的时间进行分类。卡方检验和Fisher精确检验评估分类变量的差异,p值<0.05被认为具有统计学意义。
结果 该研究纳入了556名参与者,其中304名(54.7%)为女性,252名(45.3%)为男性。参与者被分为两个年龄组:294名(52.9%)年龄在18至40岁之间,其余(262名)年龄超过40岁。大多数参与者为护理人员(n = 392;70.5%),其次是医生(n = 110;19.7%)和技术人员(n = 54;9.7%)。很大一部分(n = 340;61.2%)在过去五年内接种了最后一剂疫苗。总体而言,375名(67.4%)医护人员产生了≥100 mIU/mL 的足够抗-HBs滴度,而有181名(32.6%)的滴度水平低于100 mIU/mL。18至40岁以及在过去五年内接种疫苗与保护性滴度水平显著相关,而性别则不然。与医生和技术人员相比,护士的免疫水平显著更高。
结论 科威特法瓦尼亚地区的医护人员对HBV疫苗总体反应良好。较年轻的医护人员以及最近接种疫苗的人员更有可能产生保护性免疫反应。与医生和技术人员相比,护士的血清转化率更高。这些结果表明,HBV疫苗接种计划应优先考虑及时接种加强针,特别是对于年长的医护人员和很久以前接种疫苗的人员。监测抗体水平对于确保持续保护至关重要,尤其是在护士等高风险群体中。实施这些措施可以提高HBV疫苗接种计划的有效性,降低医护人员中HBV的发病率,并有助于营造更安全的医疗环境。接种疫苗后检测对于确保所有医护人员免受HBV感染的安全性至关重要。