Sero-prevanence of Hepatitis-B and C Infection and the knowledge,Attitude and Practice among Healthcare Workers and Traditional Healers at Selected Sites of Kolfe Keranio Sub-city, Addis Ababa,Ethiopia.
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Date
2019-06
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Addis Ababa University
Abstract
Background: Hepatitis B and C viruses are the leading causes for global morbidity and mortality of viral hepatitis. According to the world health organization report, globally an estimated 257 million and 150 million people are living with chronic HBV and HCV respectively. The risk of these infectious blood borne pathogens are highest on the health care settings and the health care workers or people who work in the field of medicine are at highest risk for these infections. In Ethiopia, although reports showed that more than 60% of chronic liver disease and up to 80% of hepato-cellular cancers have occurred due to hepatitis B and C viral infections, still there is limited surveillance data regarding the impacts of these infectious pathogens among the health care workers and the impact of hepatitis was totally neglected among the traditional healers. So far in Ethiopia, very limited studies were conducted to show the prevalence and risk factors of hepatitis among allopathic health care workers. Yet, no studies have been conducted to show the burdens of hepatitis and risk factors among traditional healers. Therefore, further studies should be conducted to show the impact of hepatitis among the healers alongside the aliphatic health care workers.
Objective: the aim of this study was to assess the sero-prevalence and associated risk factors of hepatitis B and C among the health care workers and the traditional healers at selected study sites of Kolfe-Keraniyo sub city Addis
Ababa Ethiopia.
Method: An institution based cross-sectional study was conducted from the study period of November, 2017toJanuary; 2019.Study participants were selected using a multi-stage sampling technique. A multi-item standardized questioner was used to collect data on the demographic information and potential risk factors for hepatitis B and C. Five to ten milliliters of blood was collected from each study participants for sero-prevalence study. The serum from each study participants was screened for hepatitis B surface antigen and anti-hepatitis C antibody by using rapid screening test kits. All positive samples for hepatitis B surface antigen had confirmed for the presence of hepatitis B envelop antigen (HBeAg) and hepatitis B nucleic acid (DNA)by laboratory test method of enzyme linked immunosorbant assay (ELISA).In addition, all hepatitis C positive samples had confirmed for the presence of hepatitis C nucleic acid (HCV-RNA) by enzyme linked immunosorbant assay test method. Finally, collected data were entered into Epi-Data 3.1” software and analyzed by statistical software program SPSS version 20.0 (SPSS, Chicago, IL, USA).
Results: in the study period, 248 (95.4% response rate) study participants had administered the questioner properly and gave blood for sero-prevalence study. The overall prevalence rate for of HBV was 2.8 % (CI= 0.7-5.4%) and for
HCV was 0.8 % (CI=0.3-1.9%). Most (82.8%) study participants had good knowledge of hepatitis B and C transmission and preventive strategies. However, only 64% of participants had positive risk perception (attitude) and
only 43% of the study participants had good hepatitis preventive practice. The overall prevalence rate for occupational was 56% among participants with in the past three years. Exposure for blood, body fluids, needle stick and sharp injuries were 79%, 56%, 27% and 63% respectively. Among all, only 155(62.5%) study participants had a history of anti hepatitis B vaccination and only 65 (25% of the total) was fully vaccinated. Generally, we find the risk factor analysis for hepatitis C was very difficult since its’ sero-prevalence was too small. However, lengths of working time per week (COR= 9.1 p<0.043), non-compliance to safety measures (COR=9.55 P< 0.038), needle stick injuries (COR= 7.22, P<0.02) and absence of HBV vaccination history (COR= 10.62, P< 0.03) were found to
be significantly associated with hepatitis B sero-positivity on univariate analysis. Finally, absence of history of vaccination remains the only significant (AOR= 9.2, P<0.02) predictor risk factor for hepatitis B infection after removing cofounding risk factors on multivariate logistic regression analysis.
Conclusion and recommendation: despite having good knowledge of hepatitis transmission and preventive measures, hepatitis risk perception (attitude) of the study participants and their hepatitis preventive practices were not good. Frequencies of occupational exposures were high yet the immunization coverage and the infection prevention training coverage were poor. Our study revealed like the allopathic health workers the risk of hepatitis is high. These all shortcoming indicate the need for regular infection prevention trainings, enhanced immunization coverage and inclusive health policy targeting the traditional healers.
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Keywords
Attitude, Healthcare Workers, Hepatitis B, Hepatitis C, Knowledge, Sero-prevalence