Knowledge of Hepatitis B Transmission Risks Among Health Workers in Tanzania

Abstract

Abstract. Healthcare workers are at increased risk of contracting hepatitis B virus (HBV), particularly in settings of high HBV seroprevalence, such as sub-Saharan Africa. We evaluated HBV knowledge among health-care workers in rural Tanzania by distributing an HBV paper survey in two northern Tanzanian hospitals. There were 114 participants (mean age 33 years, 67% female). Of the participants, 91% were unaware of their HBV status and 89% indicated they had never received an HBV vaccine, with lack of vaccine awareness being the most common reason (34%), whereas 70% were aware of HBV complications and 60% understood routes of transmission. There was a significant difference in knowledge of HBV serostatus and vaccination between participants with a medical background and others, P = 0.01 and 0.001, respectively. However, only 33% of consultants (senior medical staff) knew their HBV serostatus. There was no significant difference between knowledge of HBV transmission routes and occupation. Our study reveals low knowledge of HBV serostatus and vaccination status among hospital workers in Tanzania.Infection with the hepatitis B virus (HBV) represents a major cause of morbidity and mortality worldwide, with an estimated 350 million people infected, of which the great majority reside in Asia and sub-Saharan Africa.1,2 Chronic infection with HBV can lead to cirrhosis and/or liver cancer. The therapeutic resources to battle either cirrhosis or liver cancer in the developing world are scarce, and in sub-Saharan Africa, both conditions carry an extremely high risk of mortality within a year of diagnosis.2,3 It is well known that health-care workers are at increased risk for HBV transmission, largely due to transmission via blood contacting mucosa. 4,5 Although the likelihood of chronic disease during contact with HBV in adulthood is low, the probability of being infected through this route is higher than with the human immunodeficiency virus (HIV). 6The risk of HBV transmission in health-care workers is highest in a setting of high seroprevalence of the virus within a population, such as sub-Saharan Africa, where the overall prevalence of hepatitis B surface antigen in blood is > 8%. 2,5 In this environment, adherence to universal precautions is critical to prevent HBV transmission. A recent survey regarding occupational exposure in Tanzania observed that nearly half of health-care workers experienced at least one occupational injury within the 12 months preceding the survey. 7 In that study, workers were mainly concerned about transmission of HIV. Knowledge of HBV transmission risks in African healthcare facilities is important since it is likely to modify healthcare workers' adherence to precautions. 8In this study, we aimed to assess the knowledge of HBV serostatus as well as barriers to HBV vaccination in Tanzanian health-care workers. We provided a paper survey to staff in two hospitals in northern Tanzania (Arusha Lutheran Medical Center and Selian Lutheran Hospital, both within the Arusha region of northern Tanzania...

Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

“…None of the infected HCWs were aware of their infection status [ 29 ]. This finding is similar to the one observed in Arusha, where >90% of HCWs in two teaching hospitals were reported not to be aware of their HBV statuses [ 35 ].…”

“…Of these, 23% were unable to mount the immunity (anti-HBs titre < 10 ml/U), leaving them in a risk of acquiring HBV infection [ 29 ]. The same trend has also been observed in Arusha where 89% of HCWs reported not to have received any HBV vaccine, the main reason being unawareness of the vaccine [ 35 ].…”

A Retrospective Study on the Prevalence and Health Worker’s Perspective on Hepatitis B virus Infection in Ngora District, Eastern Uganda

“…In another study Epidemiological data for Hepatitis B in Africa contrary to our findings carried out in Tanzania to assess Knowledge of Hepatitis B Transmission Risks Among Health Workers where 114 participants (mean age 33 years, 67% female) were involved, 91% were unaware of their HBV status and 89% indicated they had never received an HBV vaccine, with lack of vaccine awareness being the most common reason (34%) [21].…”

Prevention and Care of Hepatitis B in Senegal; Awareness and Attitudes of Medical Practitioners

“…Previous studies from Tanzania and Rwanda have found poor HBV screening and vaccination uptake among health-care workers despite them knowing that working in health-care settings increases their risk to acquire HBV. 21,29 In our population, the natural history of HBV infection as well as its clinical complications were relatively well mastered, potentially explaining the good self-reported practices of personal HBV screening and vaccination. Nevertheless, more education about the drastic effects of the virus is needed in health-care settings throughout sub-Saharan Africa.…”