A cross-sectional serosurvey on hepatitis B vaccination uptake among adult patients from GP practices in a region of South-West Poland

Abstract

BackgroundHepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination is widely recommended for those not covered by the national immunisation program. Objective: To assess the coverage and influencing determinants of HBV vaccination among adult patients attending GP clinics as well as to establish serological status in terms of HBV infection.MethodsPatients who were seen consecutively in March 2013 at four randomly selected GP practices located in Zgorzelec county, in south-western part of Poland, were invited to participate and complete questionnaires on socio-demographic data and other factors related to vaccination. A pilot study was done in one urban GP practice in the city of Gryfino (Gryfino county), the results have been included in the study. Patients’ immunisation status was assessed basing on vaccination cards and anti-HBs titer with the use of third-generation testing methods. In addition, serum samples were assayed for anti-HBc total.ResultsResponse rate: 99.3 %. Of 410 participants (66.1 % females, median age 56 years), 55.4 % (95%CI:50.5-60.1 %) were previously vaccinated; in those 11.5 % took 2 doses, 66.1 % - 3 doses,18.1 % – 4 doses. Elective surgery was the main reason (57.7 %) for HBV immunization, 4.8 % - were vaccinated due to recommendations by GPs. The multivariable logistic regression model revealed that living in a city (OR 2.11), and having a surgery in the past (OR 2.73) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6 % (95%CI:9.3 %-19,5 %), and 7.2 % (95%CI:4.4-11.8 %) among those vaccinated.ConclusionsLow HBV immunization coverage among adult patients from GP clinics and the presence of serological markers of HBV infection among both - those unvaccinated and vaccinated call for comprehensive preventative measures against infection, including greater involvement of family doctors. Although interventions should cover the whole population, inhabitants living in the rural areas should be a group of special interest. Preoperative immunization for HBV seems to be an efficient public health tool to increase the vaccination uptake.

Seroprevalence of Markers of Hepatitis B Virus Infection, Associated Factors, and Vaccination Status in Young Adults in Arkhangelsk, Northwest Russia: A Population-Based Cross-Sectional Study

“…Our results also fit with the incidence rate of acute HBV infection in the Arkhangelsk Region, which has decreased more during last 20 years than in other regions [ 11 , 24 ]. The prevalence of anti-HBc among our participants was close to that reported in Poland, where 10.3% of adults were positive for this marker [ 25 ]. Data from Tajikistan showed that 30% of 15–24-year-olds are positive for anti-HBc, compared to 47% of adults aged 20–59 years in China, and 57.4% of adults aged 20–39 years in Nigeria [ 16 , 26 , 27 ].…”

“…Data from Tajikistan showed that 30% of 15–24-year-olds are positive for anti-HBc, compared to 47% of adults aged 20–59 years in China, and 57.4% of adults aged 20–39 years in Nigeria [ 16 , 26 , 27 ]. Data from other parts of the world demonstrate that the higher the proportion of the vaccinated population, the lower the proportion of HBV-infected individuals: in Poland 55% of the adult population is vaccinated, and in China and Nigeria these values are 23.7% and 7.9%, respectively [ 16 , 25 , 27 ].…”

Are men who have sex with men in Europe protected from hepatitis B?

“…We identified three sources for targeted vaccination programmes: the European Centre for Disease Prevention and Control (ECDC) [12], the Vaccine European New Integrated Collaboration Effort (VENICE) [13] and the European Liver Patients Association (ELPA) [14]. For 18 countries, we found additional sources on their vaccination programmes for indication groups MSM or people with frequently changing sexual partners [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Furthermore, contact persons from 34 European countries answered our short survey.…”

A cross-sectional sero-survey on preoperative HBV vaccination policy in Poland

“…Another study, conducted by us in 2013 among patients attending a primary care clinic, revealed that planned elective surgery was the main reason for their HBV immunization; similar rates were observed among adult patients from the Polish city of Katowice [10, 11]. …”