Hepatitis B immunity status of healthcare workers in Lagos, Nigeria

Abstract

Healthcare workers (HCWs) are at risk of acquiring and transmitting parenteral infections including Hepatitis B Virus (HBV). The aim of this study was to determine the Hepatitis B immunity level among categories of health workers in Lagos metropolis. We evaluated 104 healthcare workers consisting of 66 males and 38 females aged 18-45 years, mean age 31.33±5.28 years. Of the 104 subjects evaluated, 39 (37.5%) had detectable anti HB-s (mean ± SEM titre, 237.78 ± 15.20 iμ/L) while 64 (%) had a titre of <10 iμ/L. Among the 41 subjects who had prior 3 doses of hepatitis B immunization prior to testing, 39(95.1%) had HB-S antibody titre >10 iμ/L while 2 (4.9%) were potential non-responders with titre <10 iμ/L. There was no statistically significant difference in antibody response based on gender (p> 0.05). All the subjects who were referred for testing as a pre-employment requirement and those who had accidental percutaneous and mucosal exposures to high risk patient’s blood and body fluid had HB-S titre <10 iμ/L (mean ± SEM titre 3.50 ± 2.09 iμ/L). Hepatitis B immunity was significantly higher (χ 2 =1.92) among subjects previously vaccinated against hepatitis B virus. (p = 0.01). This study indicates the grave risk particularly to HBV to which healthcare workers in Nigeria are exposed in the course of the work caring for patients. There is need to urgently address the issue of formulation of occupational health policy in Nigeria as well as provision of training on universal precaution, phlebotomy, modifying procedures that have high risk, developing institutional policy for handling of sharps and postexposure management of healthcare workers, universal provision of protective HBV vaccine as well as provision of post exposure prophylaxis for those accidentally exposed.
 
Keywords: Occupational exposure, healthcare worker, needle sticks injury, hepatitis B vaccination.