Factors Affecting HBV Vaccination in a Medical Training College in Kenya: A Mixed Methods Study

Abstract

Background : Hepatitis B Virus (HBV) is highly endemic in Sub-Saharan Africa with 70 to 90% of the population becoming infected before the age of 40 years. Healthcare workers (HCWs) including healthcare students (HCSs) are at an increased risk of contracting HBV due to occupational exposure. HCSs are especially at a high risk because of their inexperience with infection control procedures and insufficient knowledge about the level of risk when dealing with patients. Despite the availability of an effective vaccine, and its recommendation by Kenya’s Ministry of Health, few HCW and students are vaccinated. The aim of this study was to evaluate the influence of awareness, attitude, practices, and access factors on hepatitis B vaccination uptake by HCSs at Kenya Medical Training College (KMTC). Methods : This was a concurrent mixed methods study. For the quantitative arm, a structured questionnaire was used to assess the awareness, knowledge, attitudes and practices towards HBV disease and vaccination. Accessibility of the HBV vaccine in the participating campuses was also assessed. Two FGDs were carried out: one comprised of student representatives of the participating campuses while the second comprised of members of staff. Quantitative data was analysed using STATA (version 15) while NVIVO (version 11) was used for qualitative data. Results: Out of 634 students invited to participate in the study, 487 participated (response rate 76.8%). Majority of the respondents were from Nairobi Campus (44.2%) and from the Department of Nursing (31.2%). HBV vaccine uptake rate was 85.8% while the non-vaccination rate was 14.3%. Full vaccination was reported by only 20.2% of respondents. The major reason for not receiving the recommended doses was the unavailability of the vaccine when students went for it. The qualitative study revealed challenges in the implementation of the vaccination program at KMTC. Conclusions Full vaccination rates remained low despite good knowledge of HBV infection and positive attitude towards vaccination. There is therefore need to streamline vaccination programs in medical colleges to ensure availability and accessibility of the vaccine to healthcare students. Key words: HBV vaccination, Vaccine Uptake, Health Care Students, Kenya

Pregnant women’s hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study

“…1 However, in a previous Kenyan study, the major reason for not receiving the recommended doses was the non-availability of the vaccine. 13 In our findings, the reasons were different as the majority revealed that lack of awareness of the HBV vaccine was the greatest reason for their non-uptake of the vaccine. This finding is understandable because our present study was performed on a general antenatal (pregnant) women population while the previous Nigerian study 1 and Kenyan study 13 were on health workers.…”

“…We defined HBV vaccination status as: (i) no vaccination when no dose was received; (ii) partial vaccination when one or two doses were received; and (iii) full vaccination when three or four doses were received. 13…”