埃塞俄比亚血液透析终末期肾病患者的乙型肝炎疫苗接种状况：一项多中心横断面研究。
Hepatitis B vaccination status among patients with end-stage kidney disease on haemodialysis in Ethiopia: a multi-center cross-sectional study.
机构信息
College of Medicine and Health Science, School of Medicine, Department of Internal Medicine, Addis Ababa University, Gastroenterology & Hepatology Unit, Addis Ababa, Ethiopia.
College of Medicine and Health Science, School of Medicine, Department of Internal Medicine, Addis Ababa University, Nephrology Unit, Addis Ababa, Ethiopia.
出版信息
BMC Nephrol. 2024 Sep 3;25(1):288. doi: 10.1186/s12882-024-03703-x.
BACKGROUND
Chronic kidney disease patients, especially those on hemodialysis, are at increased risk of developing hepatitis B virus (HBV) infection. Guidelines suggest that all patients with chronic kidney disease patients should be vaccinated against HBV, but these guidelines are sub-optimally implemented. Notably, there is a lack of studies in Ethiopia examining the hepatitis B vaccination status among patients with end-stage renal disease.
OBJECTIVE
To assess the vaccination status of hepatitis B and associated factors among people with end-stage renal disease who were on hemodialysis.
METHODS
A multi-center cross-sectional observational study was conducted in six randomly selected dialysis centers in Ethiopia, from May 2023 to September 2023. Logistic regression analysis was used to evaluate factors associated with vaccination status. A person is considered to be vaccinated against hepatitis B if he/ she has taken at least one dose of HBV. Vaccination status was determined by patient's recall and verification from medical record.
RESULTS
Only 16% of patients with end-stage renal disease on hemodialysis were vaccinated against hepatitis B virus (16.6%; with CI = 12.18, 21.83), of which 30% had received one dose, 57.5% had two doses, 12.5% had three doses, and only five had a booster dose. Post-secondary education (AOR = 5.47; 95% CI = 1.41, 21.2; P < 0.014) and dialysis for more than three years (AOR = 19.75; 95% CI = 4.06, 96.1; P < 0.001) were significant factors associated with having received hepatitis B vaccination.
CONCLUSION
Only a small minority of Ethiopian hemodialysis patients have received hepatitis B vaccination. The level of education of patients and the duration of time on dialysis were significant associated factors that affected the vaccination status of patients with end-stage renal disease. So, strong intervention is needed according to the identified factors to raise the vaccination status of patients.
背景
慢性肾脏病患者，尤其是血液透析患者，感染乙型肝炎病毒（HBV）的风险增加。指南建议所有慢性肾脏病患者都应接种乙型肝炎疫苗，但这些指南的实施并不理想。值得注意的是，在埃塞俄比亚，没有研究检查终末期肾病患者的乙型肝炎疫苗接种状况。
目的
评估血液透析的终末期肾病患者的乙型肝炎疫苗接种状况及相关因素。
方法
这是一项在埃塞俄比亚六个随机选择的透析中心进行的多中心横断面观察性研究，时间为 2023 年 5 月至 2023 年 9 月。采用逻辑回归分析评估与接种状况相关的因素。如果患者至少接种了一剂 HBV，则认为其接种了乙型肝炎疫苗。接种状况通过患者的回忆和从病历中验证来确定。
结果
仅有 16%的血液透析终末期肾病患者接种了乙型肝炎病毒疫苗（16.6%；置信区间 = 12.18，21.83），其中 30%接种了 1 剂，57.5%接种了 2 剂，12.5%接种了 3 剂，仅有 5 人接种了加强针。接受过中学后教育（优势比 = 5.47；95%置信区间 = 1.41，21.2；P < 0.014）和透析时间超过 3 年（优势比 = 19.75；95%置信区间 = 4.06，96.1；P < 0.001）是与接种乙型肝炎疫苗相关的显著因素。
结论
只有少数埃塞俄比亚血液透析患者接种了乙型肝炎疫苗。患者的受教育程度和透析时间是影响终末期肾病患者接种状况的显著相关因素。因此，需要根据已确定的因素采取强有力的干预措施，提高患者的接种率。
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