Factors influencing the uptake of hepatitis B vaccine among health care workers at Kenyatta National Hospital

Abstract

Introduction: Hepatitis B disease affects the liver resulting from an infection with the Hepatitis B virus. It is an occupational danger to health care workers. Not only is it potentially fatal but it also carries the risk of exposure to chronic infection and transmission to patients. A recombinant yeast-derived Hepatitis B vaccine has been in use since 1987, but the rate of uptake in the face of high risks and free provision among health workers at Kenyatta National Hospital (KNH) is not known. Objectives: The study sought to determine the availability and accessibility of Hepatitis B vaccine, the prevalence of hepatitis B vaccine uptake, and assess the level of Post Exposure Prophylaxis utilization after blood-borne occupational exposure among healthcare workers at KNH. Methods: The study was cross-sectional descriptive one that was carried out in KNH. Complementary mixed methods consisting of a structured questionnaire and in-depth interviews were used to collect data from health workers with direct patient contact primarily by stratified sampling and simple random sampling procedures. Data management: Data was cleaned and entered into SPSS version 2.0 for analysis. The presentation was done by tables, pie charts and bar graphs and correlation analysis by chi-square and T-tests done to test relationships between the variables. Results: The study was able to determine that 40% of the study participants were nurses; 28% were working in the medicine department. It was revealed that 87% had been immunized, with only 10% having received the complete three doses. It was also found out that 50% of the ones who were not fully immunized stated to have forgotten to return for the remaining doses; 55% stated that they had encountered challenges. The demographic characteristics of hepatitis B uptake were found to be significant (P<0.05). Doctors, nurses, xiii lab personnel and CO's were the highest numbers of healthcare workers immunized. Knowledge and HBV uptake was also significant (P<0.05) with health care workers who had heard about the vaccine being reported to have the highest levels of uptake. Conclusion: The Uptake of HBV is still low based on the 45% prevalence obtained in the study. Most healthcare workers were not fully immunized among them defaulters with the main challenges experienced being lack of education and sensitization. The PEP uptake amongst the staff was found to be good.. Recommendations: HBV administration points should be made mobile to reach all staff in their work areas; the institution should create a database of all staff receiving the vaccine to be able to track full immunization and follow up on immunity status using antibody tests; a 24/7 staff support center should be established to deal with needle prick injuries. Dissemination: This will be done through a presentation to management and publishing in a refereed journal.