Protective hepatitis B surface antibody (Anti-HBs) levels among health care workers in Duhok city of Iraq
Abstract
Objective: This cross sectional study aimed to find the prevalence of protective hepatitis B surface antibodies (anti-HBs) and HBV infection among health care workers in Duhok city. Method: In this cross sectional study, 504 health care workers from Duhok city were studied. The data requested included some demographics and risk factors of exposure. Blood samples were tested for HBsAg, anti-HBc and anti-HBs by enzyme-linked immunosorbent assay (ELISA). Results: The prevalence of protective anti-HBs was higher among vaccinated participants (p<0.001) and was positively associated with the number of vaccine doses (p<0.001). Around 60.0% of participants had received at least one dose of vaccine and 38% were fully vaccinated. Prevalence of postvaccination anti-HBs testing among fully vaccinated participants was 26.7%. The rate of protective anti-HBs levels among fully vaccinated participants was 84.8 %. The rates of HBsAg and overall HBV infection were 1.8%, and 9.5% respectively. HBV infection was significantly associated with occupational exposure to blood (OR=2.38; 95% CI=1.26-4.50) and dental interventions (OR=2.36; 95% CI=1.25-4.46). Conclusion: The rate of protective anti- HBs level among fully vaccinated HCWs is acceptable. Vaccination coverage and post-vaccination testing are still low and there is no post-exposure prophylaxis policy in Duhok health care facilities.
Keywords
Hepatitis B virus,Hepatitis B antibodies,Hepatitis B vaccines,health personnel
References
- 1. WHO. Global Hepatitis Report 2017. Available at: http://apps.who.int/iris/bitstream/106 65/255016/1/9789241565455eng.pdf?ua=1. Accessed July 10, 2018.
- 2. CDC. Health care settings and viral hepatitis, Division of Viral Hepatitis and National Center for HIV/AIDS,Viral Hepatitis, STD, and TB Prevention 2008. Available at: http://www.cdc.gov/hepatitis/Settings/ Health careSettings.htm. Accessed March 3, 2017.
- 3. Merza MA, Hassan WM, Muhammad AS. Frequency of HBV and HCV among patients undergoing elective surgery in a tertiary care referral hospital in Duhok, Iraqi Kurdistan. JMSCR 2014;2(7):18101815.
- 4. Saleh MA, Ali R, Omer AR, Atallah M, AlSalmani AM, Karrem SA. Hepatitis B seroprevalence in ten Iraqi governorates. Al- Mustansiriya J Sci 2011;1(22):220222.
- 5. Szmuness W, Stevens CE, Zang EA, Harley EJ, Kellner A. A controlled clinical trial of the efficacy of the hepatitis B vaccine (Heptavax B): a final report. Hepatology 1981;1(5):377-385.
- 6. Dannetun E, Tegnell A, Torner A, Giesecke J. Coverage of hepatitis B vaccination in Swedish healthcare workers. J Hosp Infect 2006;63(2):201204.
- 7. Mengal HU, Howteerakul N, Suwannapong N, Rajatanun T. Factors relating to acceptance of hepatitis B virus vaccination by nursing students in a tertiary hospital. Pakistan J Health Popul Nutr 2008;26(1):46-53.
- 8. Hatipoglu CA, Yetkin MA, Ergin F, Ipekkan K, Erdinc FS, Bulut C, et al. Vaccination of healthcare workers against hepatitis B virus in a teaching hospital. J Hosp Infect 2007;67(2):200202.
- 9. Burnett RJ, Francois G, Mphahlele MJ, Mureithi JG, N Africa P, Satekgea MM, et al. Hepatitis B vaccination coverage in healthcare workers in Gauteng Province, South Africa. Vaccine 2011;29(25):42934297.
- 10. Floreani A, Baldo V, Cristofoletti M, Renzulli G, Valeri A, Zanetti C, et al. Longterm persistence of anti-HBs after vaccination against HBV: an 18 year experience in health care workers. Vaccine 2004;22(5-6):607-610.