Date of Award

1-2020

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Amna Rehana Siddiqui

Second Advisor

Mrs. Zahra Rahim

Third Advisor

Mr. Sadiq Sikandar

Department

Community Health Sciences

Abstract

Background
 Health Care Workers (HCWs) are at a high risk of transmission of blood-borne infections like Hepatitis B virus (HBV) transmission. Hepatitis B vaccination is effective in protecting against HBV disease. Several factors influence HCWs' vaccination status, including a lack of knowledge or awareness about vaccination, cost, vaccination availability, and vaccine hesitancy. The research aimed to determine the vaccination status of Hepatitis B and factors influencing vaccination status in HCWs of two secondary care Hospitals in Sindh, Pakistan.
Methods A cross-sectional study was conducted from June-July 2020 in two Aga Khan secondary care Hospitals in Sindh, Pakistan. We enrolled a total of 252 HCWs by using a systematic sampling technique. HCWs' list was obtained from the management of two secondary care hospitals to systematically select Doctors, Nurses, Allied HCWs, Laboratory, and Housekeeping staff. A self[1]administered web-based Hepatitis B vaccination status tool was used to collect the data for Hepatitis B vaccination status. Hepatitis B vaccination status was determined as complete, partial, and no vaccination. A one-way ANOVA test was used to check the difference in mean knowledge scores. We used Multivariable ordinal logistic regression to measure the effect of participant's sociodemographic characteristics, knowledge, and work-related characteristics on Hepatitis B vaccination status.
Results vi Overall, 69.4% (175/252) of the Health Care Workers were completely vaccinated (for three doses). The mean (S.D.) age of the HCWs was 36.2 (9.4) years, 79.8% were females, and 85.7% were full-time employees. The complete Hepatitis B vaccination status was 64.9% in Doctors, 75.2% in Nurses, 58.3% in Allied HCWs, 40.0% in Laboratory staff, and 70.8% in Housekeeping staff. 59.9% of full-time HCWs and 66.6% of part-time employees were completely vaccinated. There was no difference in mean knowledge scores regarding Hepatitis B and Hepatitis B vaccination among these different categories of HCWs (P-value 0.78). Female HCWs' had greater odds of having complete vaccination status (AOR 1.2, 95% CI 0.5-3.4) than male HCWs. Health Care Workers who received first-ever Hepatitis B vaccination dose more than ten years ago had significantly higher odds (AOR 8.6, 95% CI 2.8-26.9) of complete vaccination than those who received the first dose less than ten years ago. However, the primary factor associated with complete vaccination status was the belief in the protection of self, family, and patients (AOR 4.9, 95% CI 1.6-14.4). Those who had taken any one of the other recommended vaccines like MMR, Tdap, Varicella, or Meningococcal vaccine had lower odds of complete vaccination status (AOR 0.4, 95% CI 0.2-0.8) compared with those who received all of these recommended vaccines. An interaction was observed between secondary care hospitals and getting the first dose of vaccine. The odds of having complete vaccination status to partially or not vaccinated among HCWs working in Secondary Hospital Karachi and have received vaccination before working in that hospital were 4.3 times greater (AOR 4.3, 95% CI 1.8-10.4) compared to HCWs working in working Secondary Hospital Hyderabad and have received first-ever vaccination dose after working in a hospital.
Conclusion vii More than two-third of the HCWs were completely vaccinated in Aga Khan Secondary Care Hospitalsin Sindh, Pakistan. Factors influencing Hepatitis B vaccination status such as vaccination cost, knowledge about vaccination, and vaccine hesitancy should be addressed to increase Hepatitis B vaccination compliance. Hepatitis B vaccination should be made compulsory as a job entry requirement to achieve more complete vaccination status numbers. Vaccination policies require to implement for all part-time and full-time Health Care Workers.

First Page

1

Last Page

115

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