Uptake of Hepatitis B Vaccine Among Health Care Workers in Mutare City Clinics , Manicaland Province, Zimbabwe, January to December 2020

Abstract

HBV infection has long been recognised as an occupational risk for health care personnel and the risk of infection after exposure to highly infectious fluids such as blood from a patient who is actively transmitting the disease is up to 30%. WHO in 2017, recommended Hepatitis B vaccination for all healthcare workers. The vaccine provides more than 90% effective protection after all doses. WHO estimate showed that HBV vaccination coverage among HCWs is only 18–39% in low- and middle-income countries compared to 67–79% in developed countries. Zimbabwean Ministry of Health and Child Care currently has no documented policy regarding HBV vaccination for HCW and there is no data in Zimbabwe on HBV vaccine coverage in healthcare workers. This study determined the proportion of HBV uptake and the associated factors in Healthcare workers at Mutare city clinics, Manicaland province, Zimbabwe. This analytical cross sectional study reviewed data of 111 purposively selected healthcare workers from the 9 Mutare city health centers. Two key informant healthcare workers, Director City Health and Senior Nursing Officer, were also interviewed. Univariate and multivariate logistic regression analyses in Epi Info 7 were performed to determine the factors associated with HBV uptake. The study results revealed that the prevalence of HBV vaccination uptake stand at 21% among health professionals in Mutare district. The association between HBV uptake and demographic variables was assessed using the Chi-square test. Only age (p=0,001); education level (p=0.045); profession (p=0.05); household expenditure (p= 0.032) and religion (p= 0.048) were significantly associated with HBV uptake by health professionals in Mutare. Only 11 (10%) of the participants had correct knowledge of the definition of HBV and only 40% of the participants had the correct knowledge on the number of times one should be inoculated. Only 30% of the participants had the correct knowledge as to the intervals of HBV boosters. With regards to availability of the vaccine, only 24 (22%) of the participants confirmed regular availability of HBV, 83 (75%) claimed that there are no awareness campaigns that are being conducted to raise aware on the vaccine among health professionals and stating its essence in protecting them in the clinical area and 62 (56%) said that the HBV vaccine is free and affordable. The study conducted a step-wise multivariate binary regression analysis to determine the predictors of uptake of HBV by health service providers in Mutare. Only age [AOR = 2.1, 95% CI (1 – 3.3)], household expenditure per month [AOR = 18.8, 95% CI (3.1 – 11.2)], knowledge on HBV [AOR =2.6, 95% CI 0.5 – 15.3], scheduling for HBV [AOR = 3.9, 95% CI (1 – 14.9)], and health service related factors [AOR = 10, 95% CI (2.3 – 43.3)] were statistically significant predictors of HBV uptake. These findings indicate that the health management team for Mutare City council need to invest more in social behaviour change communication, raising awareness on the essence and importance of the HBV vaccine; and most importantly to make the vaccine available, to increase uptake by health care workers.