Hepatitis B virus: Prevalence, vaccination coverage and immune responses to immunization among healthcare workers at Muhimbili National Hospital

Abstract

Background Healthcare workers (HCWs) are at an increased risk of contracting and transmitting the hepatitis B virus (HBV). Vaccination coverage against HBV a cost- effective prevention, remains low among HCWs in some settings. Objective To determine the prevalence of HBV infection, vaccination coverage, and immune responses to HBV vaccine among HCWs at Muhimbili National Hospital (MNH) in Dar es Salaam. Methodology This cross-sectional study used a proportional probability systematic sampling to recruit HCWs from MNH in Dar es Salaam. A structured questionnaire was used to collect social demographic characteristics, infection prevention and control practices, HBV vaccination status and reasons for not vaccinating. Five mLs of a peripheral venous sample was obtained from each participant, the sample was used to test for HBV surface antigen, HBV surface antibody and HBV core antibody for assessing for infection, and vaccine immunity respectively. A Robust Poisson Regression analysis was used to assess factors associated with not vaccinating. Results The prevalence of HBV infection was 5 (1.2%) among the 415 recruited HCWs. Only 192 (46.3%) HCWs were vaccinated and 169 (96%) had protective immunity against HBV infection among 176 participants who had received at least two vaccine doses. HCWs who were laboratory scientist aPR = 2.01, 95% CI (1.35–3.00) and had < 10 years of employment aPR = 1.62, 95% CI (1.04–2.50) were unlikely to vaccinate against HBV. Vaccine unavailability 114 (51.1%), hesitancy 42 (18.8%), time constraints 41 (18.4%) and f inancial constraints 26 (11.7%) were factors associated with not vaccinating. Conclusion Vaccine coverage against HBV among HCWs at MNH is alarmingly low. Vaccine access, subsidizing cost, protecting time for vaccination could improve vaccination uptake. Qualita tive studies are needed to assess for reasons for vaccine hesitancy among HCWs.