Uptake Of Hepatitis B Vaccination And Its Determinants Among High Risk Health Care Workers In Selected Hospitals In Kenya

ABSTRACT

Hepatitis B Virus (HBV) infection poses a grave public health problem worldwide. Over two billion people are infected and an estimated 387 million of these suffering from chronic HBV infection, with a rate of ten million new carriers each year. Another one million die annually. About 90% of these cases live in developing countries with half of Kenya’s population being estimated to be infected by HBV by the age of 30-40. Health care workers are among the most vulnerable groups to acquire HBV; with an estimated risk of four times higher than that of the general population. It is also a well-established fact that an unvaccinated individual stands the risk of 6% to 30% to acquire the infection on exposure to HBV contaminated blood or body fluids. Vaccination of high-risk groups is a key strategy for prevention. Despite the safe, effective and highly acceptable HBV vaccine that has been around since 1982, its use among health care workers in the developing world is low. Immunization among health care workers has two purposes; to protect them from several infectious diseases they may be exposed to through professional activities and to minimize the odds of infecting the patients they are taking care of. The study aimed at establishing the uptake of Hepatitis B vaccination and its determinants among high-risk health care workers in selected hospitals in Kenya. This was a descriptive cross-sectional study. Multistage sampling, including cluster and random sampling were used. Key informants from the Ministries of Public Health and Sanitation and Kenya Medical Research Institute were also interviewed. A pre-designed key informant interview guide and semi-structured questionnaires were used to collect the necessary data from 384 willing respondents. Chi-Square and Fishers Exact Test were performed to establish relations between variables. A high proportion of the respondents (78.6%) had good knowledge of Hepatitis B. Slightly more than half (50.3%) of the institutions did not have advocacy mechanisms in place, 36.5% had inadequate and only 13.3% had adequate advocacy mechanisms. Majority of the respondents (90.6%) had a positive attitude towards hepatitis B infection and vaccination. However, the uptake of hepatitis B vaccination among the high-risk health care workers was average, as only 59.6% had been vaccinated. Of these, only 32.0% had completed the recommended three dose vaccination. There was no statistically significant association between knowledge and uptake of vaccination (χ2 = 0.629; df = 1; P = 0.233 at 0.05 confidence level). There was also no statistically significant association between advocacy mechanisms and uptake of vaccination (χ2 = 0.425, df = 2 P = 1.710 at 0.05 level of significance). But there was a statistically significant association between attitude of health care workers and uptake of hepatitis B vaccination (Fishers Exact Test = 0.007, df = 3 and P value of 11.612 at 0.05 confidence level). There was a statistically significant association between the knowledge of HCW on HB and attitude of HCW towards hepatitis B vaccination (χ2 = 0.023, P = 5.151, 1= df at 0.05 level of significance and). In conclusion, the study found that attitude affects uptake while knowledge affects attitude. Therefore, the study recommends that institutions should put in place measures of increasing the knowledge of hepatitis B which will in turn improve the attitude of the health care workers towards hepatitis B. This will in ultimately increase the uptake of hepatitis B vaccination among the health care workers.