Rate of Full Hepatitis B Vaccination and its Associated Factors among Medical Workers in Jinja Regional Referral Hospital Jinja District, Eastern Uganda
Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.
Hepatitis stands for “inflammation of the liver” and five types of viruses can cause viral hepatitis. Hepatitis B virus (HBV) is a virus that only can infect humans and today 240 million people are infected by chronic HBV in the world. The infectious agent in HBV is transmitted with body fluids such as blood, vaginal fluids, semen, saliva, and mucous membranes. This study was carried out to determine the rate of full hepatitis B vaccination and its associated factors among medical workers at Jinja Regional Referral Hospital, Jinja District, Eastern Uganda. A cross-sectional study design using unbiased descriptive qualitative and quantitative approaches was done to determine the rate of full hepatitis B vaccination and its associated factors among medical workers at Jinja Regional Referral Hospital, Jinja District, Eastern Uganda. A sample of 245 medical workers was recruited for the study. Majority 125(51.0%) were aged 18-35 years, 109(44.5%) were Basoga by tribe, many 92(37.6%) were catholic, many 105(43.8%) were of diploma level of education, and lastly majority 157(64.1%) were married. Only 22 (9.0%) adhered to hepatitis B vaccination i.e. got all 3 doses while 223(91%) did not adhere i.e. get the 3 doses of hepatitis B vaccination. It was found that none of the socio-demographic factors has a p-value less than 0.2. Thus, no socio-demographic factor proceeded to the multivariate analysis. The study found that family support, friends support and partner support had a p-value less than 0.2. Thus, proceeded for multivariate analysis showed family support and partner support were significantly related to full hepatitis B vaccination. Participants who were supported by their partners were 24.55 times more likely to complete the hepatitis B vaccination dose compared to those not supported by their partners. Finally, participants who were not supported by their families were 2% less likely to complete the hepatitis B vaccination dose compared to those supported by their families. The rate of full Hepatitis B vaccination was established to be low (only 9.0% adhered to full vaccination against Hepatitis B ) while a substantial number of respondents (91% did not adhere to full Hepatitis B vaccination as per the guidelines) among medical workers at Jinja Regional Referral Hospital. This reflects a potential danger to medical workers who could accidentally acquire HBV infection. Therefore, the study drew recommendations that the vaccination policy on HBV should be strengthened and implemented, and follow-up strategies for those vaccinated to ensure full dose completion. There is a need to increase the availability of personal protective gear and usage by health workers for protection during contact with patients.
Keywords: Hepatitis B virus, Vaccination, Inflammation, Liver disease, medical workers, Family support.
Hepatitis B infection is an ancient disease from the times of the Bronze Age. It had been suspected as an agent of infection in the 50s which was later reported first as an Australian antigen in the 60s and subsequently discovered under the electron microscope in the 70s. Vaccination for hepatitis B was introduced in the 80s. Hepatitis B is a major public health problem [1, 2]. Based on the prevalence of hepatitis B surface antigen (HBsAg), different areas of the world are classified as having high (≥8%), intermediate (2%–7%), or low (<2%) HBV endemicity. Among healthcare workers (HCWs), seroprevalence is two to four times higher than that of the general population. They remain at risk of acquiring HBV infection mainly through percutaneous or mucosal exposure to infected blood or body fluids. The risk might be even greater if the HCW is a trainee, intern, or just a student as they have a lack of experience, insufficient training, or plain carelessness [3, 4]. Hepatitis B infection transmission chain can be interrupted through vaccination, using safety precautions while handling infectious material, proper sterilization of medical equipment, and legit waste handling. However, the studies have indicated that there is a clear gap in knowledge among trainees of the health profession regarding the risks of occupational exposure to HBV infection [5, 6]. Hepatitis stands for “inflammation of the liver” and five types of viruses can cause viral hepatitis. Hepatitis B (HBV) is according to the World Health Organization (WHO) the most common liver infection in the world . HBV is a virus that only can infect humans and today 240 million people are infected by chronic HBV in the world. According to the World Health Organization, the mortality rate in the world due to complications of HBV per year is more than 780 000 people . The infectious agent in HBV is transmitted with body fluids such as blood, vaginal fluids, semen, saliva, and mucous membranes. HBV can be transmitted from mother to child at birth (perinatal transmission), by sexual contact with an infected person, by using unclean needles, by unsafe blood transfusions and between children in early childhood . The HBV has a membrane called HBsAg, under the membrane there were other marks such as HBeAg and HBcAg. These ones or their corresponding antibodies will appear in the blood samples of a person who has the infection . HBV can be an acute or chronic disease. Laboratory blood tests are used to test for HBV antibodies in the blood, the tests can distinguish if it is an acute or chronic infection. In most cases among adults, the infection heals. However, about 5 %, the infection becomes chronic and causes liver inflammation . According to the World Health Organization, symptoms for HBV vary, and some get the infection but have no symptoms, while others can get symptoms such as loss of appetite, abdominal pain, nausea, dark urine, acute illness, vomiting, and fatigue that can last from weeks to months. Yellowing skin and eye-whites (jaundice) can appear .
Hepatitis B virus (HBV) infection is a worldwide healthcare problem, especially in developing areas. Globally, over 2 billion people have been infected with HBV, and there are over 350 million carriers . Acute infection of HBV can cause nonspecific symptoms or fulminant hepatitis that may cause death or require urgent liver transplantation. Chronic infection can be the cause of death associated with liver failure, cirrhosis, or hepatocellular carcinoma. Due to the severity and low survival rate of advanced-stage liver diseases even with a conventional approach, some patients resort to the use of herbal medications which most times complicate the ailment culminating in poor health outcomes. This however does not negate the importance of traditional medicine in the maintenance of health. Traditional medicine involves the use of herbs and plant products in the maintenance of good health and it is a widely acknowledged practice . Notably, scientific backup of liver-protective and curative properties of some plants is well-documented [15-18]. The secondary metabolites and other chemical constituents inherent in these plants and herbs impact them with such therapeutic capacities [19, 20].
By adhering to universal precautions which include using protective barriers such as gloves, vaccination, appropriate sterilization of medical equipment, and a suitable hospital waste management system, the spread of HBV infection can be prevented . Hepatitis B remains a major global concern despite the fact that reducing its incidence is in proper progress; more has to be done in eradicating this brutal life claimer, especially in developing countries like Uganda. Thus, this study was designed to determine the rate of full hepatitis B vaccination and its associated factors among medical workers at Jinja Regional Referral Hospital, Jinja District, Eastern Uganda.
The rate of full Hepatitis B vaccination was established to be low (only 9.0% adhered to full vaccination against Hepatitis B ) while a substantial number of respondents (91% did not adhere to full Hepatitis B vaccination as per the guidelines) among medical workers at Jinja Regional Referral Hospital. This reflects a potential danger to medical workers who could accidentally acquire HBV infection. However, data collected showed that partner support and family support increased the chances of completing the hepatitis B vaccination dose. In this study, none of the socio-demographic factors significantly influenced the completion of hepatitis B vaccination doses by medical workers at Jinja regional referral Hospital.
- The vaccination policy on HBV should be strengthened and implemented and follow-up strategies be put in place for those vaccinated to ensure full dose completion as per the guidelines.
- There is need to increase the availability of personal protective gears and usage by health workers for protection during contact with patients.
- There needs to be a strong proper implementation of exposure and post-exposure management of HBV according to standard guidelines once health workers are exposed.
- Partners and family should be encouraged and educated on the importance of their support of full Hepatitis B vaccination.
- The government should reinforce and increase awareness strategies about Hepatitis B vaccination through the most affordable means of communication like posters, radios and more regular staff training on infection control be put in place.
- More studies/research should be done to clarify the association between individual attributes with affect adherence to hepatitis B vaccination.
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CITE AS: Tumwebaze Legdan (2023). Rate of Full Hepatitis B Vaccination and its Associated Factors among Medical Workers in Jinja Regional Referral Hospital Jinja District, Eastern Uganda. IDOSR JOURNAL OF SCIENTIFIC RESEARCH 8(3) 113-124. https://doi.org/10.59298/IDOSR JSR /2023/00.9.6000