Hepatitis B vaccination status and associated factors among undergraduate students of Makerere University College of Health Sciences
April
Hepatitis B vaccination status and associated factors among undergraduate students of Makerere University College of Health Sciences
Yvette WibabaraID 0 1
Cecily Banura 1
Joan Kalyango 0 1
Charles Karamagi 0 1
Alex Kityamuwesi 0 1
Winfred Christine Amia 0 1
Ponsiano Ocama 1
0 Clinical Epidemiology Unit, Makerere University , Kampala , Uganda , 2 Department of Paediatrics, Makerere University , Kampala , Uganda , 3 Department of Medicine, Makerere University , Kampala , Uganda
1 Editor: Isabelle Chemin, Centre de Recherche en Cancerologie de Lyon , FRANCE
Hepatitis B is a global health problem. Trainees in the health-related fields are exposed to occupational risk of Hepatitis B Virus. In Uganda, there is scarcity of information on vaccination among students in health-care. The objective of this study was to assess hepatitis B vaccination status of the students and factors associated.
Background
Methods and findings
This was a cross sectional study, conducted at Makerere University College of Health
Sciences among undergraduate students who were eligible. A self-report on Hepatitis B
vaccination status and various characteristics were collected on each participant, using a
standardized structured self-administered questionnaire. Descriptive statistics were
computed, bivariate and multivariate analysis were done using Stata 14.
Results
Out of 760 participants, 44.3% (95% CI 35.2?52.8) reported full vaccination. Vaccination
was associated with gender, course, year of study and student?s sponsorship. Males were
less likely to be vaccinated, Prevalence Ratio (PR) 0.79; P-value <0.001, while
self-sponsored students were also most likely to be vaccinated, PR 2.08; P-value <0.001. About 37%
reported an accidental needle injury during their training.
Conclusion
Full vaccination was low and given the high prevalence of needle injuries, it raises a safety
concern. Vaccination should be mandatory for all students prior to clinical exposure. There
is need for targeted interventions to increase uptake.
Funding: The authors received no specific funding
for this work.
Competing interests: The authors have declared
that no competing interests exist.
Abbreviations: Anti-HBs, Antibody to hepatitis B
surface antigen; BDS, Bachelor of Dental Surgery;
BEH, Bachelor of Environmental Health Science;
BMR, Bachelor of Science in Medical Radiography;
BPH, Bachelor of Pharmacy; BSB, Bachelor of
Science in Biomedical Sciences; HBsAG, Hepatitis
B surface antigen; HBV, Hepatitis B Virus;
MakCHS, Makerere University College of Health
Sciences; MBChB, Bachelor of Medicine and
Bachelor of Surgery; NUR, Bachelor of Science in
Nursing; PEP, Post Exposure Prophylaxis; PPE,
Personal Protective Equipment; PR, Prevalence
ratio; SOMREC, School of Medicine Research
Ethics Committee; WHO, World Health
Organization.
Introduction
Hepatitis B is a viral infection that attacks the liver. It is a major global health problem, and the
most serious type of viral hepatitis. It is estimated that about 780,000 people die each year due
to consequences of hepatitis B [1]. In Uganda, Hepatitis B infection is highly endemic with a
national prevalence of 10%, with geographical variation across the country ranging from 4% in
the southwest 5% in Kampala and surrounding districts and 25% in Northeast [
2
].
Like other health workers, trainees in the health care professions are also exposed to an
equal magnitude of occupational risk of Hepatitis B Virus (HBV), as they work in the same
health care delivery system. In fact, the risk for accidental exposure among the trainees could
be higher due to their lack of experience and insufficient training on how to use Personal
Protective Equipment PPE [
3
]. A study done among medical students in School of Medicine
Makerere University Uganda found that overall 11% of medical students had hepatitis B
infection defined as Hepatitis B surface antigen (HBsAg) positive[
4
].
Uganda?s endemicity for Hepatitis B infection poses a great risk of occupational exposure
to HBV for persons in health-related fields. World Health Organization (WHO) guidelines for
the prevention, care and treatment of hepatitis B infection recommend special consideration
of health-care workers and students for HBV screening and vaccination. However, these
guidelines are not widely implemented in Low and Middle-Income Countries [5]. The Uganda
Ministry of Health?s statutory instrument on hepatitis B requires all health workers and
students to be vaccinated against HBV within six months from the commencement of clinical
exposure.
There is paucity of information about what the current Hepatitis B vaccination coverage
among students in the health-related fields. Therefore, this study sought to assess the
vaccination status of students in the College of Health Sciences and the factors associated. The study
findings will generate information necessary for formation of policies on vaccination against
Hepatitis B among students in health re (...truncated)