Seroepidemiology of HBV infection among health-care workers in South Sulawesi, Indonesia
Seroepidemiology of HBV infection among health-care workers in South Sulawesi, Indonesia
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DOI：
10.1186/s12879-018-3190-x
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发表时间：
2018-06-18
影响因子：
3.7
通讯作者：
Muljono, David H.
中科院分区：
文献类型：
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作者：
Wijayadi, Teguh;Sjahril, Rizalinda;Muljono, David H.
背景：B型肝炎病毒（HBV）感染是一个世界性的健康问题，估计有2.57亿慢性感染者。印度尼西亚的B型肝炎表面抗原（HBsAg）流行率为7.1%，被列为中度流行国家。医护人员（HCW）是HBV感染的高职业风险，并可能成为进一步感染的传播者。在印度尼西亚，尚无HCW感染B型肝炎的程度和具体的控制策略。本研究评估了HBV感染的血清阳性率和相关的危险因素HCWs从四个地区在南苏拉威西省，Indonesia.Methods：共467 HCWs（中位年龄28岁，男/女89/378）被招募。所有保健工作者被分为三个年龄组（≥ 40岁），三个工作类型（行政，非干预，干预），和三个服务期（< 5，5-9，>= 10年）。通过问卷调查获得有关社会人口学特征和危险因素的数据，并检测血清样本中的HBV标志物（HBsAg、其抗体[抗-HBs]和核心抗原抗体[抗-HBc]）。卡方或Fisher精确检验用于确定分类变量的差异，而危险因素报告为比值比（OR）。结果：目前HBV感染（HBsAg+），暴露于HBV（抗-HBc+），和免疫力HBV（抗-HBs+）的患病率分别为6.2%，19.2%和26.1%。三分之二（66.17%）的HCW不表达任何HBV标志物。不同年龄组、不同干预工种、不同服务年限的医务人员HBV暴露水平呈上升趋势（分别为p < 0.001、p < 0.001和p < 0.010）和自然感染HBV的免疫力（HBsAg-、抗-HBc+、抗-HBs+）（分别为p = 0.004、p < 0.001和p < 0.010）。针刺伤是医务人员感染的最高危险因素（OR = 1.71，95%CI：1.05-2.77，p = 0.029），主要发生在干预组（p = 0.046）。针刺伤是HBV感染的最高危险因素，干预工作类型中发生率最高。三分之二的HCW仍然容易感染HBV。需要在国家一级采取干预策略，以预防、控制和管理HCW中的HBV感染。
Background: Hepatitis B virus (HBV) infection is a world health problem with an estimated 257 million chronically infected people. Indonesia, with 7.1% prevalence of hepatitis B surface antigen (HBsAg), is classified as a moderately endemic country. Healthcare workers (HCWs) are at high occupational risk for HBV infection and potentially becoming transmitters for further infections. In Indonesia, the extent of hepatitis B among HCWs and specific control strategy are not available. This study evaluated the seroprevalence of HBV infection and associated risk factors in HCWs from four areas in South Sulawesi, Indonesia.Methods: A total of 467 HCWs (median age 28 years, male/female 89/378) were recruited. All HCWs were classified into three age groups (= 40 years old), three work types (administration, non-intervention, and intervention), and three service periods (< 5, 5-9, and >= 10 years). Data on socio-demographic characteristics and risk factors were obtained by questionnaire and serum samples were tested for HBV markers (HBsAg, its antibody [anti-HBs], and antibody to core antigen [anti-HBc]. Chi-square or Fisher's exact test was used to determine differences in categorical variables, while risk factors were reported as odds ratios (OR).Results: The prevalence of current HBV infection (HBsAg+), exposure to HBV (anti-HBc+), and immunity to HBV (anti-HBs+) was 6.2, 19.2, and 26.1%, respectively. Two thirds (66.17%) of all HCWs did not express any of HBV markers. In relation to the age groups, intervention work-type, and service period of HCWs, increasing trends were observed in the exposure to HBV (p < 0.001, p < 0.001, and p < 0.010, respectively) and the immunity to HBV by natural infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004, p < 0.001, and p < 0.010, respectively). Needlestick injury contributed the highest risk factor (OR = 1.71; 95% CI: 1.05-2.77; p = 0.029) for infection acquisition, which mostly occurred in the intervention group (p = 0.046).Conclusion: Exposure to HBV showed significant association with HCWs' age, work type, and service period. Needlestick injury was the highest risk factor for the acquisition of HBV, with highest events in the intervention work-type. Two thirds of HCWs were still susceptible to HBV infection. Intervention strategies at the national level are required to mount prevention, control, and management of HBV infection in HCWs.