Hepatitis B and liver cancer knowledge and practices among healthcare and public health professionals in China: a cross-sectional study

Abstract

BackgroundChronic hepatitis B virus (HBV) infection is the leading cause of liver disease and liver cancer and a major source of health-related discrimination in China. To better target HBV detection and prevention programs, it is necessary to assess existing HBV knowledge, educational resources, reporting, and preventive practices, particularly among those health professionals who would be responsible for implementing such programs.MethodsAt the China National Conference on the Prevention and Control of Viral Hepatitis on April 26-29, 2004, the Asian Liver Center at Stanford University partnered with the China Foundation for Hepatitis Prevention and Control to distribute a voluntary written questionnaire to Chinese healthcare and public health professionals from regional and provincial Chinese Centers for Disease Control and Prevention, health departments, and medical centers. Correct responses to survey questions were summed into a total knowledge score, and multivariate linear regression was used to compare differences in the score by participant characteristics.ResultsAlthough the median score was 81% correct, knowledge about HBV was inadequate, even among such highly trained health professionals. Of the 250 participants who completed the survey, 34% did not know that chronic HBV infection is often asymptomatic and 29% did not know that chronic HBV infection confers a high risk of cirrhosis, liver cancer, and premature death. Furthermore, 34% failed to recognize all the modes of HBV transmission and 30% did not know the importance of the hepatitis B vaccine in preventing liver disease. Respondents who reported poorer preventive practices, such as not having personally been tested for HBV and not routinely disposing of used medical needles, scored significantly lower in HBV knowledge than those who reported sound preventive practices. Of note, 38% of respondents reported positive HBsAg results to patients' employers and 25% reported positive results to patients' schools, thereby subjecting those with positive results to potential discriminatory practices.ConclusionsThese results indicate that there is a need for development of effective educational programs to improve HBV knowledge among health professionals and the general public to avoid missed vaccination opportunities, reduce misconceptions, and eliminate discrimination based on chronic hepatitis B in China.

The level of knowledge of, attitude toward and emphasis given to HBV and HCV infections among healthcare professionals: Data from a tertiary hospital in Turkey

“…Similar positive attitudes towards a patient or a colleague with HBV/HCV infections among our HCWs, regardless of the hospital unit, seems to be in line with the results of a past report indicating that 86% of the examined nurses stated that they treated each patient as if they were carrying a BBV (compared with 41% of the doctors) [32]. Since the available treatment for a hepatitis B virus infection does not provide a complete cure, prevention remains crucial [19]. While the differences in the HBV infection rates may reflect the disparities in the risk of exposure to this infection [19], the exposure risk of accidental punctures with contaminated needles was evident in 47.1% of the participants, with no significant difference with respect to the hospital unit.…”

“…Since the available treatment for a hepatitis B virus infection does not provide a complete cure, prevention remains crucial [19]. While the differences in the HBV infection rates may reflect the disparities in the risk of exposure to this infection [19], the exposure risk of accidental punctures with contaminated needles was evident in 47.1% of the participants, with no significant difference with respect to the hospital unit. Healthcare workers are known to have 2-4 fold risk of hepatitis infections compared to the general population [15].…”

“…Findings concerning the knowledge about HBV/HCV infections among healthcare professionals working in a tertiary hospital in Turkey revealed a moderate degree of knowledge in most of the HCWs, regardless of the risk exposure, with the highest knowledge scores and vaccination rates among the in-patient clinic staff and similar high departments, have been considered to be at a considerably high risk [19]. Similar positive attitudes towards a patient or a colleague with HBV/HCV infections among our HCWs, regardless of the hospital unit, seems to be in line with the results of a past report indicating that 86% of the examined nurses stated that they treated each patient as if they were carrying a BBV (compared with 41% of the doctors) [32].…”

“…Based on reported HbsAg positivity in 8.0% (3.5-16.4%) and Anti-HBs positivity in 40.0% (17.9-52.9%) of HCWs in our country [16], the screening of HBsAg and anti-HBc, as well as vaccination of the under-risk populations have been recommended [17,18]. The limited access to vaccination in the group of HCW is associated with the lack of initiative on the part of the governments to formulate the policy and guidelines to ensure that all HCWs get vaccinated [19]. The vaccination rates among HCWs were reported to be low in the developing world, despite the fact that a safe, effective and highly acceptable HBV vaccine has been around since 1982 [19].…”

“…In this context, based on the reported HbsAg positivity in 8.0% (3.5-16.4%) and Anti-HBs positivity in 40.0% (17.9-52.9%) of HCWs in our country [16], screening HBsAg and anti-HBc as well as vaccination of the under-risk populations have been recommended [17,18]. Poor compliance and adherence to universal precaution (UP) standards by hospital management and HCWs as well as the lack of advanced knowledge of HCWs as health providers were considered among the factors that may constitute a major obstacle barring the implementation of preventive programs [19,20].…”