Limits...
Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania.

Mueller A, Stoetter L, Kalluvya S, Stich A, Majinge C, Weissbrich B, Kasang C - BMC Infect. Dis. (2015)

Bottom Line: There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***).HCV prevalence was low (HCV antibodies 1.2% and HCV-RNA 0.3%).Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.

View Article: PubMed Central - PubMed

Affiliation: Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany. andreas.mueller@missioklinik.de.

ABSTRACT

Background: Sub-Saharan Africa has a high prevalence of hepatitis B virus (HBV) infections. Health care workers (HCWs) are at high risk of contracting HBV infection through their occupation. Vaccination of HCWs against HBV is standard practice in many countries, but is often not implemented in resource-poor settings. We aimed with this cross-sectional study to determine HBV prevalence, HCW vaccination status, and the risk factors for HCWs contracting HBV infection in Tanzania.

Methods: We enrolled 600 HCWs from a tertiary Tanzanian hospital. Their demographics, medical histories, HBV vaccination details and risk factors for contracting blood-borne infections were collected using a standardized questionnaire. Serum samples were tested for HBV and hepatitis C virus (HCV) markers by ELISA techniques, PCR and an anti-HBs rapid test. HCWs were divided in two subgroups: those at risk of contracting HBV (rHCW 79.2%) via exposure to potentially infectious materials, and those considered not at risk of contracting HBV (nrHCW, 20.8%).

Results: The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0% (42/598). Chronic HBV infection was found in 7.4% of rHCW versus 5.6% of nrHCW (p-value = 0.484). HCWs susceptible to HBV (HBsAg-, anti-HBc-, anti-HBs-) comprised 31.3%. HBV immunity achieved either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) comprised 36.5% and 20.2%, respectively. 4.8% of participants had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-). Only 77.1% of HCWs who received a full vaccination course had an anti-HBs titer >10 ml/U. An anti-HBs point-of-care test was 80.7% sensitive and 96.9% specific. There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***). HCV prevalence was low (HCV antibodies 1.2% and HCV-RNA 0.3%).

Conclusions: Chronic HBV infection is common among Tanzanian HCWs. One third of HCWs were susceptible to HBV infection, highlighting the need for vaccination. Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.

No MeSH data available.


Related in: MedlinePlus

HBV- status in HCWs in Tanzania. Prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-), HBV immunity achieved by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+), indeterminate result (HBsAg-, anti-HBc+, anti-HBs-) and HBV susceptibility (HBsAg-, anti-HBc-, anti-HBs-) in Tanzanian HCWs in a tertiary hospital as determined by HBV serology. HBV: hepatitis B virus; HCWs: health care workers
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4581415&req=5

Fig1: HBV- status in HCWs in Tanzania. Prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-), HBV immunity achieved by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+), indeterminate result (HBsAg-, anti-HBc+, anti-HBs-) and HBV susceptibility (HBsAg-, anti-HBc-, anti-HBs-) in Tanzanian HCWs in a tertiary hospital as determined by HBV serology. HBV: hepatitis B virus; HCWs: health care workers

Mentions: The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0 % (42/598). Chronic HBV infection was found in 7.4 % of rHCWs versus 5.6 % of nrHCWs, with no statistical significance difference between these groups (p-value = 0.484). Those still susceptible to HBV infection comprised 31.3 % of the HCWs (HBsAg-, anti-HBc-, anti-HBs-). HBV immunity achieved in HCWs either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) was found in 36.5 % and in 20.2 % respectively. A serum marker constellation considered as healing HBV infection (HBsAg+, anti-HBc+, anti-HBs+) was found in one participant (0.2 %). We found that 29 participants (4.8 %) had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-) with isolated anti-HBc positivity caused by long-standing resolved infections with low anti-HBs titers or current infections with low HBsAg titers (Table 1 and Fig. 1).Table 1


Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania.

Mueller A, Stoetter L, Kalluvya S, Stich A, Majinge C, Weissbrich B, Kasang C - BMC Infect. Dis. (2015)

HBV- status in HCWs in Tanzania. Prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-), HBV immunity achieved by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+), indeterminate result (HBsAg-, anti-HBc+, anti-HBs-) and HBV susceptibility (HBsAg-, anti-HBc-, anti-HBs-) in Tanzanian HCWs in a tertiary hospital as determined by HBV serology. HBV: hepatitis B virus; HCWs: health care workers
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4581415&req=5

Fig1: HBV- status in HCWs in Tanzania. Prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-), HBV immunity achieved by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+), indeterminate result (HBsAg-, anti-HBc+, anti-HBs-) and HBV susceptibility (HBsAg-, anti-HBc-, anti-HBs-) in Tanzanian HCWs in a tertiary hospital as determined by HBV serology. HBV: hepatitis B virus; HCWs: health care workers
Mentions: The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0 % (42/598). Chronic HBV infection was found in 7.4 % of rHCWs versus 5.6 % of nrHCWs, with no statistical significance difference between these groups (p-value = 0.484). Those still susceptible to HBV infection comprised 31.3 % of the HCWs (HBsAg-, anti-HBc-, anti-HBs-). HBV immunity achieved in HCWs either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) was found in 36.5 % and in 20.2 % respectively. A serum marker constellation considered as healing HBV infection (HBsAg+, anti-HBc+, anti-HBs+) was found in one participant (0.2 %). We found that 29 participants (4.8 %) had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-) with isolated anti-HBc positivity caused by long-standing resolved infections with low anti-HBs titers or current infections with low HBsAg titers (Table 1 and Fig. 1).Table 1

Bottom Line: There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***).HCV prevalence was low (HCV antibodies 1.2% and HCV-RNA 0.3%).Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.

View Article: PubMed Central - PubMed

Affiliation: Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany. andreas.mueller@missioklinik.de.

ABSTRACT

Background: Sub-Saharan Africa has a high prevalence of hepatitis B virus (HBV) infections. Health care workers (HCWs) are at high risk of contracting HBV infection through their occupation. Vaccination of HCWs against HBV is standard practice in many countries, but is often not implemented in resource-poor settings. We aimed with this cross-sectional study to determine HBV prevalence, HCW vaccination status, and the risk factors for HCWs contracting HBV infection in Tanzania.

Methods: We enrolled 600 HCWs from a tertiary Tanzanian hospital. Their demographics, medical histories, HBV vaccination details and risk factors for contracting blood-borne infections were collected using a standardized questionnaire. Serum samples were tested for HBV and hepatitis C virus (HCV) markers by ELISA techniques, PCR and an anti-HBs rapid test. HCWs were divided in two subgroups: those at risk of contracting HBV (rHCW 79.2%) via exposure to potentially infectious materials, and those considered not at risk of contracting HBV (nrHCW, 20.8%).

Results: The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0% (42/598). Chronic HBV infection was found in 7.4% of rHCW versus 5.6% of nrHCW (p-value = 0.484). HCWs susceptible to HBV (HBsAg-, anti-HBc-, anti-HBs-) comprised 31.3%. HBV immunity achieved either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) comprised 36.5% and 20.2%, respectively. 4.8% of participants had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-). Only 77.1% of HCWs who received a full vaccination course had an anti-HBs titer >10 ml/U. An anti-HBs point-of-care test was 80.7% sensitive and 96.9% specific. There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***). HCV prevalence was low (HCV antibodies 1.2% and HCV-RNA 0.3%).

Conclusions: Chronic HBV infection is common among Tanzanian HCWs. One third of HCWs were susceptible to HBV infection, highlighting the need for vaccination. Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.

No MeSH data available.


Related in: MedlinePlus