Hepatitis B Vaccination coverage and the determinants of vaccination in Health Care Workers in seleted Health facilities

Abstract

Background: Hepatitis B is a viral infection of the liver and causes both acute and chronic disease. It is transmitted through contact with an infected person’s bodily fluids. It is an occupational hazard for health care workers (HCWs) and can be prevented by the administration of a vaccine. The vaccine is administered in three doses over a six-month period. The Centre for Disease Control recommends that HCWs must be vaccinated against vaccine preventable diseases including hepatitis B. In Zambia, the Ministry of Health acknowledges that this policy exists but is not implemented to its full potential. The objective of the study was to determine the prevalence and determinants of hepatitis B vaccination among HCWs in selected health facilities in Lusaka. Methods: This was a cross sectional study that consisted of 331 HCWs from seven different health facilities across Lusaka district. The study group consisted of nurses, doctors, laboratory personnel and general workers. Data was collected through a self-administered structured questionnaire. The dependent variable was vaccination status and the independent variables were; age, sex, sharp injuries per year, work experience, knowledge in hepatitis B, profession, training in infection control, skector and facility level. Investigator led stepwise approach was used to select the best predictor variables in a multiple logistic regression model and this was performed using STATA version 12. Results: Only 19.3% of the HCWs were vaccinated against hepatitis B, with 54.7% being fully vaccinated and 45.3% being partially vaccinated. The analysis showed that; age of the HCW, sharp injuries per year and training in infection control were the variables that were statistically significant in predicting whether a HCW is vaccinated or not vaccinated against hepatitis B. Older HCWs were more likely to be vaccinated against hepatitis B compared to their younger counterparts. HCWs who experienced more sharp injuries in a year were also more likely to be vaccinated against hepatitis B. HCWs who had undergone training in infection control were more likely to be vaccinated against hepatitis B compared to those that had not under gone any training. Conclusion: There is a low prevalence of hepatitis B vaccination among Zambia’s HCWs. To increase the number of HCWs vaccinated against hepatitis B, health institutions should bear the cost for vaccinating their staff and efforts should also be made to impart appropriate health education regarding hepatitis B infection and its prevention. Establishment of policies on compulsory hepatitis B vaccination of all HCWs in Zambia is recommended.