Nakiggala Joana, Lwenge Mathias, Nakalembe Doreen, Tamale Bridget Nagawa, Nalugya Aisha, Galiwango Jovan, Wejuli Junior Mike, Tebandeke Kenneth, Isunju John Bosco, Mugambe Richard K, Ssekamatte Tonny
Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
SWEEM Health Consults Limited, Kampala, Uganda.
BMC Public Health. 2024 Dec 5;24(1):3380. doi: 10.1186/s12889-024-20917-8.
Hepatitis B is a significant health problem worldwide, particularly among high-risk groups such as female sex workers (FSWs). In Uganda, it is highly recommended that FSWs receive the hepatitis B vaccine. However, there is limited evidence of the level of uptake of the hepatitis B vaccine and associated factors among FSWs in Uganda. This study aimed to assess hepatitis B vaccine uptake and associated factors among FSWs in Kampala district, Uganda.
We conducted a cross-sectional study using data from 400 FSWs in Kampala, Uganda. We utilized a researcher-developed digitized semi-structured questionnaire and employed multistage sampling to enroll participants. Data analysis was performed using STATA version 14.0. Continuous data were expressed as mean and standard deviation whereas categorical data were reported as frequencies and proportions. We employed Modified Poisson regression analysis to assess the relationship between predictor variables and the uptake of the hepatitis B vaccine.
A total of 400 respondents (98.5% response rate) were surveyed. Close to half, 49.8% of the respondents had ever heard about hepatitis B, and only 16.5% had received at least a hepatitis B vaccine dose. Individual factors significantly associated with hepatitis B vaccine uptake included spending more than four years in sex work (APR: 1.06, 95% CI: 1.01-1.12), previous screening for hepatitis B (APR: 1.49, 95% CI: 1.38-1.61), and having work conditions that allowed time to seek HBV services (APR: 1.13, 95% CI: 1.04-1.22). Health system factors significantly associated with vaccine uptake included the presence of hepatitis B outreach programs in residential areas (APR: 1.17, 95% CI: 1.03-1.33) and receiving information about hepatitis B from peers (APR: 1.07, 95% CI: 1.05-1.31).
The study revealed a low prevalence of hepatitis B vaccine uptake among FSWs, with less than a tenth completing the three-dose schedule. Therefore, enhancing screening programs, expanding outreach initiatives, and tailoring services to accommodate nontraditional work hours while leveraging peer networks can significantly improve vaccine uptake and reduce hepatitis B transmission in this high-risk population.
乙型肝炎是全球一个重大的健康问题,在女性性工作者(FSW)等高危人群中尤为突出。在乌干达,强烈建议女性性工作者接种乙型肝炎疫苗。然而,关于乌干达女性性工作者乙型肝炎疫苗接种水平及其相关因素的证据有限。本研究旨在评估乌干达坎帕拉地区女性性工作者的乙型肝炎疫苗接种情况及其相关因素。
我们采用乌干达坎帕拉400名女性性工作者的数据进行了一项横断面研究。我们使用了研究人员开发的数字化半结构化问卷,并采用多阶段抽样方法招募参与者。使用STATA 14.0版本进行数据分析。连续数据以均值和标准差表示,分类数据则报告为频率和比例。我们采用修正泊松回归分析来评估预测变量与乙型肝炎疫苗接种之间的关系。
共调查了400名受访者(应答率为98.5%)。近一半(49.8%)的受访者听说过乙型肝炎,只有16.5%的人至少接种过一剂乙型肝炎疫苗。与乙型肝炎疫苗接种显著相关的个体因素包括从事性工作超过四年(调整后风险比:1.06,95%置信区间:1.01 - 1.12)、既往进行过乙型肝炎筛查(调整后风险比:1.49,95%置信区间:1.38 - 1.61)以及工作条件允许有时间寻求乙肝服务(调整后风险比:1.13,95%置信区间:1.04 - 1.22)。与疫苗接种显著相关的卫生系统因素包括居民区存在乙型肝炎外展项目(调整后风险比:1.17,95%置信区间:1.03 - 1.33)以及从同伴那里获得有关乙型肝炎的信息(调整后风险比:1.07,95%置信区间:1.05 - 1.31)。
该研究显示女性性工作者中乙型肝炎疫苗接种率较低,不到十分之一的人完成了三剂次接种计划。因此,加强筛查项目、扩大外展举措并调整服务以适应非传统工作时间,同时利用同伴网络,可以显著提高疫苗接种率并减少这一高危人群中的乙型肝炎传播。