Out of the 370 participants, 73.5% were female and the mean age for all participants was 36.4 years (SD = 8.4). On average females were older than males (36.9 years compared to 34.6 years) respectively. Female HCW on average had spent about 14 years in service compared to about 8 years for the males. About 56.5% of HCW were working in a surgical department, 38.4% in a medical/pediatric department and only about 5.1% were working in laboratories.
Potential for exposure at work place
Exposure to potentially infectious body fluids at the work place was assessed using a set of variables as shown in Table . Needle stick injuries in the last one year were reported in 67.8% of the respondents mainly affecting doctors, nurses, and laboratory technicians. The doctors were mainly affected during surgical procedures, while nurses were affected while preparing or giving medication and laboratory clinicians while recapping needles. Over 67.0% of all participants who reported a needle stick injury had been injured two or more times in the past one year (results not shown). Exposure of mucous membranes (mouth and eyes) to patient's body fluids occurred in about 41.0% of respondents in the previous year affecting mainly doctors and midwives. Over 65.0% of respondents thought that the work place and surfaces are not adequately disinfected mainly due to limited availability of disinfectants (results not shown). Doctors suffered most cuts with 31.7% of them having had a cut at least once in the last one year. Consistent use of gloves (that is, use of gloves each time they carried out a procedure involving body fluids) as a means of preventing risk of infection was reported in 55.4% of respondents. The laboratory technician category was the least likely to consistently use gloves (18.2%), while 87.0% of the nursing assistants reported consistent use of gloves. Although continuing medical education is mandatory for all HCW, training in infection control in the last five years was reported by only 34.3% of the respondents. Results in Table also show that about 58.5% of respondents reported that their risk of getting infected was high compared to 13.9% who reported that it was low. Nursing assistants (73.9%) and laboratory technicians (77.3%) categories had the highest proportions of individuals who thought their own risk of infection was high.
Potential for exposure to hepatitis B virus infection by socio-demographic characteristics
Vaccination against Hepatitis B Virus Infection
Only 6.2% of respondents were vaccinated against hepatitis B virus infection. Doctors (20.3%), males (11.2%), other Christians (15.5%) and respondents who were younger than 30 years of age (10.0%) reported higher rates of vaccination than their counterparts. Of those who had ever been vaccinated, about 34.8% completed the recommended three dose schedule. The majority (65.2%) got vaccinated either through payment from own pocket, or through a promotional activity by a pharmaceutical company. Over 95% of health care workers were willing to be vaccinated if the vaccine was provided free of charge and about 65.6% were willing to be vaccinated if the cost of vaccination was subsidized to a lower fee.
From Table , it can be seen that 48.9% of all participants did not have any of the markers and thus classified as susceptible to infection. About 23.0% were positive for anti-HBs and anti-HBc, an indication that they were immune to HBV infection following a natural infection while only 3.0% were immune following vaccination. Current HBV infection (HBsAg positive and anti-HBc positive) was present in 8.1% of respondents. Overall, 17.0% of respondents were classified as indeterminate because they had a positive anti-HBc result and were negative for HBsAg and anti-HBs. Four possible interpretations are possible: resolving infection (window phase), remote resolved infection with low anti-HBs, chronic infection with low levels of HBsAg or false positive anti-HBc.
Interpretation of serologic markers: HBV infection status and corresponding percentages
HBV infection status by socio-demographic characteristics
Table shows prevalence of current HBV infection and life time exposure to HBV infection by socio-demographic characteristics. By HCW category, nursing assistants had the highest prevalence of current infection at (26.1%), followed by laboratory technicians (18.2%) and clinical/dental officers (12.0%). Individuals who had been in service for longer had lower prevalence of current infection, as were unmarried HCW. By department, participants from laboratory units had the highest prevalence of current infection of about 15.8%. About 48.1% (95% CI: 43.0-53.2) had evidence of life time exposure to HBV infection. Participants who were older, Muslims, widowed/separated, those who had been in service for longer, and those from surgical and laboratory departments had higher prevalence of exposure to HBV infection. Laboratory technicians had the highest prevalence of exposure to HBV infection with 72.7% being positive.
Distribution of current HBV infection and lifetime exposure by socio-demographic characteristics
Risk factors for current hepatitis B virus infection and life time exposure to hepatitis B virus infection
Table shows unadjusted and adjusted odds ratios for risk factors for current hepatitis B virus infection. In the logistic regression model, a number of variables were found to be significantly associated with current hepatitis B virus infection at 5% level of significance (Table ). The category of "other Christians (mainly Pentecostal church, and Seventh Adventists) were at a lower risk of hepatitis B virus infection compared to Catholics (OR = 0.07; P value = 0.017). The duration (number of years spent) in service was inversely associated with the risk of current hepatitis B virus infection. The higher the number of years spent in service the lower the risk of current infection. For example the odds of current hepatitis B virus infection in individuals who had spent 20 or more years compared to the odds of current hepatitis B virus infection in those who had fewer than ten years in service was 0.13 (P value = 0.048), while this ratio was 0.25 in those individuals who had spent between 10 and 20 years (P value = 0.039). Laboratory technicians and nursing assistants had about 12 times (OR = 12.23; P value = 0.009) and 18 (OR = 17.78; P value = 0.007) more risk than doctors respectively. Individuals who had a history of a cut, mucocutaneous exposure, surgical operation, and those who did not routinely use other protective gear (other than gloves) had a higher risk of infection although this didn't reach significance level.
Risk factors: Results from a logistic regression model for current hepatitis B virus infection
With regard to life time exposure to hepatitis B virus infection (Table ), being a laboratory technician was associated with about 4 times risk of one having ever been exposed to hepatitis B virus infection (OR = 3.99; P value = 0.023) compared to doctors. Individuals with no history of surgical operation were at a higher risk of exposure (OR = 1.78; P value = 0.028). Having no training in infection prevention was associated with a 2 times (OR = 1.85; P value = 0.015) higher risk of having been exposed to hepatitis B virus infection. The rest of the other variables were not significantly associated with exposure to hepatitis B virus infection in the regression model.
Risk factors: Results from a logistic regression model for life time exposure to Hepatitis B Virus infection