Protecting health workers from nosocomial Hepatitis B infections: A review of strategies and challenges for implementation of Hepatitis B vaccination among health workers in Sub-Saharan Africa

Abstract

The Sub-Saharan region has the highest Hepatitis B virus (HBV) rates, and health workers are at an increased risk of contracting nosocomial HBV infection. Vaccination of health workers plays a critical role in protecting them from sequelae of HBV; however, health-worker vaccination remains a challenge for many countries. This study was conducted to review practices/measures and challenges in the Sub-Saharan region relating to vaccination of health workers against HBV. We performed a literature review of articles addressing any aspect of HBV vaccination of health workers in the Sub-Saharan region sourced from PubMed, Embase, and Web of Science, including a case study of Malawi policies and strategies in training institutions and facilities. Our findings indicated that HBV awareness and vaccination were relatively high, but vaccination rates were lower, with 4.6-64.4% of those "ever vaccinated" completing the vaccination regimen. There was also great variation in the proportion of health workers exhibiting natural immunity from previous exposure (positive for anti-Hepatitis B core antibodies; 41-92%). Commonly cited reasons for non-uptake of vaccine included cost, lack of awareness of vaccine availability, and inadequate information concerning the vaccine. Countries in this region will require locally relevant data to develop cost-effective strategies that maximize the benefit to their health workers due to the great diversity of HBV epidemiology in the region.

Healthcare professionals' level of medication knowledge in Africa: a systematic review

“…Another area that was well studied was vaccines, where we observed knowledge gaps for different types of vaccines for hepatitis B (HBV), influenza and human papilloma viruses (HPV). Awareness of available HBV vaccines in our study (56–97%) was in line with a previous report . Cervical cancer caused by human papillomavirus (HPV) is the leading cause of cancer mortality among women in Africa .…”

Hepatitis B vaccination coverage among health-care workers in Africa: A systematic review and meta-analysis

“…Therefore, the priority in these countries should be the screening of HCWs for hepatitis B surface antigen and hepatitis B core antibody. [11] Such screening would help identify HCWs requiring vaccination and those with chronic infection who may benefit from antiviral treatment.…”

“…However, policies regarding adult vaccination including those involving HCWs are yet to be implemented in many African countries. [11,12] Several studies have investigated the level of hepatitis B vaccination coverage among HCWs in Africa and have reported full coverage as low as in 0.8% in Rwanda [13] and as high as 72.0% in Libya [14] . However, no study to date has pooled the available data on the current hepatitis B vaccination coverage among HCWs in the continent.…”

Malezya'da bir devlet üniversitesindeki sağlık öğrencilerinin Hepatit B enfeksiyonuna yönelik bilgi ve tutumları

“…In term of applying protection, most respondents agreed for the usage of protections such as gloves or gowns while handling blood and blood products. Many studies demonstrated that personal protective equipment (PPE) are important and remain as the main preventive measure for HBV infection 14,21,22 .…”