Hepatitis B in Moroccan health care workers.

AIM: To evaluate knowledge and perception of hepatitis B, including prevention, among Moroccan health care workers (HCWs) and to estimate seroprevalence of hepatitis B and vaccine coverage (VC). METHODS: Four hundred and twenty HCWs were randomly selected and stratified by site: 120 in Rabat, 140 in Taza and 160 in Témara-Skhirat. The study included an anonymous questionnaire about knowledge of hepatitis B and its prevention and a serological survey. Oral statements and vaccine registers were used to analyse the VC of the HCWs. Serological testing and VC were analysed according to the occupational exposure. RESULTS: Participation rates in the questionnaire and serological tests were 68% (285/420) and 66% (276/420), respectively. Fifteen (5%) HCWs had a history of hepatitis B. All HCWs considered that hepatitis B virus (HBV) infection may be acquired through blood exposure. Vaccination was acknowledged as a necessary means against HBV transmission by 276 (98%) HCWs. Forty-two per cent HCWs had no HBV serological markers. The prevalence of hepatitis B surface antigen was 1%. The mean prevalence of hepatitis B core antibody (anti-HBc) was 28% and was significantly higher (P < 0.05) among nursing auxiliaries (57%), nurses (30%), medical physicians (31%) and midwives (25%) than among laboratory technicians (13%). According to the vaccination registers (available in two sites), VC (> or =3 doses) was 55%. VC was 75% among midwives, 61% among nurses, 53% among nursing auxiliaries and 38% among medical staff. Of the fully vaccinated HCWs without anti-HBc, 51% had serological evidence of protection. CONCLUSION: HBV vaccines should be more readily available for Moroccan HCWs by reinforcing current vaccination programmes.

[Cost/effectiveness comparison of the vaccine campaign and reduction of sick leave, after vaccination against influenza among the Clermont-Ferrand University Hospital staff]. / Comparaison coût/bénéfice de la campagne vaccinale et de la réduction de l'absentéisme, après vaccination contre la grippe du personnel du CHU de Clermont-Ferrand.

OBJECTIVE: The aim of this study was to compare the cost of vaccination for the Clermont-Ferrand University hospital (CHU) personnel and the cost of sick leave among vaccinated and non-vaccinated employees in 2003, 2004, and 2005. DESIGN: The study included 7256 CHU staff (medical and non-medical personnel). The cost of sick leave was calculated on the basis of short-term disease (four to nine days) over the three months of the epidemic season in 2004, 2005, and 2006. RESULTS: In 2005, the overall cost of vaccination was 4.02 euros per vaccinated employee. Over the three years, the total sick leave reached 804 days for employees vaccinated against 5670 for non-vaccinated employees. In 2003, 2004, and 2005, the vaccinal coverage was 13, 20.5, and 30.1%, the mean duration of sick leave was 0.16, 0.17, and 0.18 day among vaccinated staff, and 0.26, 0.39, and 0.34 day among non-vaccinated staff corresponding to a benefit per vaccinated employee of 5, 26, and 20 euros, respectively for each year. The total benefit for the institution was 86,458 euros (4630+38,168+43,660). If the vaccinated rate of 75% recommended by the Haute Autorité de santé (HAS) had been reached, the additional benefit would have been 250,193 euros (33,157+152,256+65,180). CONCLUSIONS: The number of sick leave days and the related cost were approximately twice less important for vaccinated employees, economically justifying this vaccination including a period of weak epidemic, as checked over three consecutive years.

[Occupational risk for blood exposure and staff behaviour: a cross-sectional study in 3 Moroccan healthcare centers]. / Comportement et conditions de travail exposant au sang: analyse des pratiques dans trois établissements de soins du Maroc.

OBJECTIVE: As in other countries, Moroccan health-care workers are exposed to occupational blood exposure (OBE) hazards. The purpose of this study was to estimate the occupational safety and hygiene conditions determining the OBE risk for health-care workers. WORKERS AND METHODS: In March 2000, a multicentric study was carried out in Morocco on 420 health-care workers, with an anonymous questionnaire. The study included health-care workers in the Taza and Temara hospitals and health centers, as well as in a Rabat public medical analysis laboratory. RESULTS: The participation rate was 67.8% (285/420). The population was mainly female (61%) with a mean age of 41.4 years (+/-7 years). Health-care workers answered that: occupational hygiene and safety were inadequate (55.1%); wearing single-use gloves was rare (34.5%); resheathing used needles was frequent (74.5%); safe containers were often missing (67%). In 1999, the annual average incidence of OBE was 1.5 (+/-4.3) per capita. If we consider the whole career of health-care workers, the incidence reached about 14.3+/-28.1 per capita. The absence of post-exposure chemoprophylaxis was the rule. CONCLUSION: The study shows that there is a need to improve occupational hygiene and safety conditions for Moroccan health-care workers in order to reduce OBE hazards.

[Seroprevalence of markers of viral hepatitis A, B and C in hospital personnel at the Clermont-Ferrand University Hospital Center]. / Séroprévalence des marqueurs des hépatites virales A, B et C, parmi le personnel hospitalier du centre hospitalo-universitaire de Clermont-Ferrand.

OBJECTIVES: Evaluate risk of hepatitis A, B and C infection and anti HBV vaccination policy in hospital personnel. METHODS: A sample of 440 health care workers (7.5% of the personnel at the Clermont-Ferrand University Hospital) representing 74.5% people directly involved in health care and 25.5% other workers were selected at random and stratified by work classification and age. A questionnaire was used to establish personal data on viral hepatitis status and blood samples were drawn for serological tests. RESULTS: Seroprevalence for hepatitis A was 52% with no significant difference between health care and other workers. For hepatitis B, 88.3% of the population had been vaccinated and anti-HBs titre was > or = 10 mIU/ml for 91.6% and > or = 50 mIU/ml for 86.1%. Seroprevalence for anti-HBc was 7% and none of the subjects were positive for HBs antigen. Anti-hepatic C antibodies were found in 2 health care workers (0.7%). CONCLUSION: These findings emphasize the need to persue further preventive actions against hepatitis A, B and C and the requirement for continued efforts in elementary hygiene.