RESUMEN
Background: Chronic infection with hepatitis B virus (HBV) is a major public health concern in South Africa. Hepatitis B virus is a highly infectious blood-borne virus causing liver disease. Healthcare workers (HCWs) are at high risk of occupational exposure. Objectives: This study aimed to investigate HBV vaccination amongst HCWs at a tertiary academic hospital in Gauteng province, South Africa. Method: Self-administered questionnaires were used to collect data from 500 consecutively sampled HCWs. Data were analysed using Stata version 12. Results: A total of 460 HCWs participated in the study. Most were women (68.7%), < 40 years of age (66.9%) and worked for < 10 years (66.0%). Almost 50.0% were either doctors or medical students and 40.3% were nurses or student nurses. Most HCWs in the age group of < 30 years (79.4%) had received at least 1 dose of HB vaccine. Prevaccination immunity screening was conducted on 17.5% of the HCWs, and only 11.0% reported to be protected against HBV. About 49.0% of HCWs were fully vaccinated. Post-vaccination immunity testing was conducted on 15.1%, and 24.0% of HCWs paid for vaccinations. Nursing staff and those with > 10 years of work experience were 2.5 and 2.6 times more likely to be vaccinated, respectively. Cleaning staff were less likely to be vaccinated. Conclusion: Although not all HCWs were fully vaccinated, our study found a higher proportion of fully vaccinated HCWs than previously reported in Gauteng Province. It is recommended that HB vaccination be promoted and a local vaccination policy, aligned with the national policy, be developed and implemented for all HCWs at the tertiary academic hospital.
RESUMEN
BACKGROUND: Hepatitis B (HB) is a vaccine-preventable liver disease caused by infection with the blood-borne hepatitis B virus (HBV). South African healthcare workers (HCWs) may be at high risk of occupational exposure to HBV infection, since previous studies have found suboptimal levels of protection against HBV in HCWs. METHODS: A descriptive prevalence study based on self-administered questionnaires with data on demographics and HB vaccination status, and stored serum samples collected from 2009 to 2012, from 333 HCWs working or studying in Gauteng and Mpumalanga province hospitals or nursing colleges, was conducted. Samples were tested for HB surface antigen (HBsAg), antibodies to HBsAg (anti-HBs), antibodies to HB core antigen (anti-HBc), and HBV deoxyribonucleic acid (DNA). RESULTS: The majority of HCWs from whom the serum samples were drawn were black (91.4% [298/326]), female (82.6% [275/333]) and had received at least one dose of HB vaccine (70.9% [236/333]). The average age was 38.8years (range: 19-62). Of the HCWs, 23.2% (73/314) were susceptible (negative for all markers); 9.6% (30/314) were infected (HBsAg and/or DNA positive); 29.0% (91/314) were exposed (positive for either HBsAg, anti-HBc, or DNA); 18.8% (59/314) were immune due to natural infection (anti-HBs and anti-HBc positive only); while 47.8% (150/314) were immune due to vaccination (anti-HBs positive only). Furthermore, HBV DNA was detected in 8.6% (27/314) and occult HBV infection (OBI) (HBV DNA positive but HBsAg negative) was found in 6.7% (21/314) of samples. DISCUSSION AND CONCLUSION: This study, which is the first to report OBI in South African HCWs, found high rates of active HBV infection and sub-optimal protection against HBV in HCWs. There is a need to strengthen vaccination programmes through a policy that ensures protection for all HCWs and their patients.