Hepatitis B Awareness and Vaccination Patterns among Healthcare Workers in Africa

Abstract

Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the depth of this understanding is understudied. We distributed surveys to HCWs in 12 countries in Africa. Surveys had nine multiple-choice questions that assessed HCWs' awareness and understanding of HBV. Participants included consultants, medical trainees, nurses, students, laboratory personnel, and other hospital workers. Surveys were completed anonymously. Fisher's exact test was used for analysis, with a P-value of < 0.05 considered significant; 1,044 surveys were collected from Kenya, Egypt, Sudan, Tanzania, Ethiopia, Uganda, Malawi, Madagascar, Nigeria, Cameroon, Ghana, and Sierra Leone. Hepatitis B virus serostatus awareness, vaccination rate, and vaccination of HCWs' children were 65%, 61%, and 48%, respectively. Medical trainees had higher serostatus awareness, vaccination rate, and vaccination of their children than HCWs in other occupations (79% versus 62%, P < 0.001; 74% versus 58%, P < 0.001; and 62% versus 45%, P = 0.006, respectively). Cost was cited as the most frequent reason for non-vaccination. West African countries were more aware of their serostatus but less often vaccinated than East African countries (79% versus 59%, P < 0.0001 and 52% versus 60%, P = 0.03, respectively). West African countries cited cost as the reason for non-vaccination more than East African countries (59% versus 40%, P = 0.0003). Our study shows low HBV serostatus awareness and vaccination rate among HCWs in Africa, and reveals gaps in the perception and understanding of HBV prevention that should be addressed to protect HCWs and improve their capacity to control HBV infection.

Figure 1.

Survey distribution by country. Countries included in the study and the number of surveys obtained per country.

Figure 2.

Awareness of serostatus, vaccination, and children’s vaccination by occupation. Responses to survey questions of serostatus, vaccination, and children’s vaccination by occupation.

Figure 3.

Participant responses by country. Responses to survey questions on serostatus, vaccine uptake, and vaccination of children by country.

Figure 4.

Comparison of responses between East African (Kenya, Sudan, Tanzania, Ethiopia, Uganda, Malawi, and Madagascar) and West African (Nigeria, Cameroon, Ghana, and Sierra Leone) countries.

Figure 5.

Reasons for not vaccinating based on occupation. Survey participants’ stated reasons for not vaccinating for hepatitis B virus.

Figure 6.

Awareness of transmission routes and risk of hepatitis B virus (HBV) by occupation. Responses by occupation to survey questions on routes of transmission of HBV and increased risk of HBV.