Hepatitis B vaccination status and associated factors among health science students

Abstract

Objective: To evaluate hepatitis B virus (HBV) vaccine coverage and its associated factors among health science students in Vietnam. Methods: This cross-sectional study involving 459 health science students at Tra Vinh University was conducted between April and June 2022. Data were collected using a structured questionnaire with items on sociodemographic characteristics, knowledge and attitude about HBV, and vaccination status. A multivariable logistic regression model was used to explore the factors associated with vaccination status. Results: The majority of participants were female (65.8%) and enrolled at the medical school (56.2%). A total of 30.3% participants received the full dose of the HBV vaccine. The percentages of participants with sufficient knowledge and positive attitudes toward HBV infection were 75.2% and 43.4%, respectively. Vaccination was 11.8 times higher in sixth-year medical students than any healthcare student in their first-year [adjusted odds ratio (aOR) 11.8, 95% CI 3.1-45.1, P<0.001], and the coverage was also significant higher in those who had sufficient knowledge (aOR 2.0, 95% CI 1.1-3.9, P<0.05) and positive attitudes (aOR 3.0, 95% CI 1.9-4.8, P<0.05) than in their counterparts. Conclusions: The majority of students were not fully vaccinated against HBV, indicating they were vulnerable to the disease. Administrators and authorities should reinforce health education messages aimed at encouraging all students to get vaccinated with the HBV vaccine, enhance their awareness and knowledge of HBV, and improve attitudes toward HBV infection prevention.

Keywords

Hepatitis B / Knowledge / Attitude / Practice / Vaccination / Students

References

[1] World Health Organization. Hepatitis B. 2022. [Online]. Available from:https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. [Accessed on 7 February 2023].

[2] Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45(4):529-538.

[3] El-Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 2012; 142(6):1264-1273.e1.

[4] Cooke GS, Andrieux-Meyer I, Applegate TL, et al. Accelerating the elimination of viral hepatitis: A Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2019; 4(2):135-184.

[5] Khue PM, Thuy Linh NT, Vinh VH, Dung LV, Nguyen Van B. Hepatitis B infection and mother-to-child transmission in Haiphong, Vietnam: A cohort study with implications for interventions. Biomed Res Int 2020; 2020:4747965.

[6] Huy Do S. Epidemiology of hepatitis B and C virus infections and liver cancer in Vietnam. Euroasian J Hepatogastroenterol 2015; 5(1):49-51.

[7] Duong MC, Le PVD, Pham ONK, Pham HDT, Nguyen TB, Phan HT. Patterns of hepatitis B virus exposure and associated predictors in Vietnam: A cross-sectional study. Asian Pac J Trop Med 2020; 13(12):535-541.

[8] Centers for Disease Control and Prevention. Hepatitis B. 2023. [Online]. Available from:https://www.cdc.gov/hepatitis/hbv/index.htm. [Accessed on 7 February 2023].

[9] Yazie TD, Tebeje MG. An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia. BMC Infect Dis 2019; 19(1):917.

[10] Malewezi B, Omer SB, Mwagomba B, Araru T. Protecting health workers from nosocomial hepatitis B infections: A review of strategies and challenges for implementation of hepatitis B vaccination among health workers in Sub-Saharan Africa. J Epidemiol Glob Health 2016; 6(4):229-241.

[11] Hadler SC. Hepatitis B virus infection and health care workers. Vaccine 1990; 8(Suppl):S24-S28; discussion S41-S43. doi: 10.1016/0264-410x(90)90211-4.

[12] Belay AS, Abateneh DD, Yehualashet SS, Kebede KM. Hepatitis B virus infection and associated factors among adults in southwest Ethiopia: Community-based cross-sectional study. Int J Gen Med 2020; 13:323-332.

[13] Abdela A, Woldu B, Haile K, Mathewos B, Deressa T. Assessment of knowledge, attitudes and practices toward prevention of hepatitis B virus infection among students of medicine and health sciences in Northwest Ethiopia. BMC Res Notes 2016; 9(1):410.

[14] Scaglione SJ, Lok AS. Effectiveness of hepatitis B treatment in clinical practice. Gastroenterology 2012; 142(6):1360-1368 e1.

[15] Lee LA, Franzel L, Atwell J, Datta SD, Friberg IK, Goldie SJ, et al. The estimated mortality impact of vaccinations forecast to be administered during 2011-2020 in 73 countries supported by the GAVI Alliance. Vaccine 2013; 31(Suppl 2):B61-B72.

[16] Kane MA, Hadler SC, Lee L, Shapiro CN, Cui J, Wang X, et al. The inception, achievements, and implications of the China GAVI Alliance Project on Hepatitis B Immunization. Vaccine 2013; 31(Suppl 9):J15-J20.

[17] Nguyen T, Pham T, Tang HK, Phan L, Mize G, Lee WM, et al. Unmet needs in occupational health: Prevention and management of viral hepatitis in healthcare workers in Ho Chi Minh City, Vietnam: A mixed-methods study. BMJ Open 2021; 11(10):e052668.

[18] Wibabara Y, Banura C, Kalyango J, Karamagi C, Kityamuwesi A, Amia WC, et al. Hepatitis B vaccination status and associated factors among undergraduate students of Makerere University College of Health Sciences. PLoS One 2019; 14(4):e0214732.

[19] Adam A, Fusheini A. Knowledge, risk of infection, and vaccination status of hepatitis B virus among rural high school students in Nanumba North and South Districts of Ghana. PLoS One 2020; 15(4):e0231930.

[20] Shrestha DB, Khadka M, Khadka M, Subedi P, Pokharel S, Thapa BB. Hepatitis B vaccination status and knowledge, attitude, and practice regarding hepatitis B among preclinical medical students of a medical college in Nepal. PLoS One 2020; 15(11):e0242658.

[21] Huynh G, Nguyen MQ, Tran TT, Nguyen VT, Nguyen TV, Do THT, et al. Knowledge, attitude, and practices regarding COVID-19 among chronic illness patients at outpatient departments in Ho Chi Minh City, Vietnam. Risk Manag Healthc Policy 2020; 13:1571-1578.

[22] Haile K, Timerga A, Mose A, Mekonnen Z. Hepatitis B vaccination status and associated factors among students of medicine and health sciences in Wolkite University, Southwest Ethiopia: A cross-sectional study. PLoS One 2021; 16(9):e0257621.

[23] Aroke D, Kadia BM, Anutebeh EN, Belanquale CA, Misori GM, Awa A, et al. Awareness and vaccine coverage of hepatitis B among Cameroonian medical students. Biomed Res Int 2018; 2018:3673289.

[24] Abebaw TA, Aderaw Z, Gebremichael B. Hepatitis B virus vaccination status and associated factors among health care workers in Shashemene Zonal Town, Shashemene, Ethiopia: A cross sectional study. BMC Res Notes 2017; 10(1):260.

[25] Acikgoz A, Yoruk S, Kissal A, Yildirimcan Kadicesme S, Catal E, Kamaci G, et al. Healthcare students' vaccination status, knowledge, and protective behaviors regarding hepatitis B: A cross-sectional study in Turkey. Hum Vaccin Immunother 2021; 17(11):4595-4602.

[26] Pathoumthong K, Khampanisong P, Quet F, Latthaphasavang V, Souvong V, Buisson Y. Vaccination status, knowledge and awareness towards hepatitis B among students of health professions in Vientiane, Lao PDR. Vaccine 2014; 32(39):4993-4999.

[27] Huynh G, Nguyen TB, Cao NN, Phan MH, Dang TBH, Nguyen TNH. Hepatitis B birth dose among children in District 2 hospital, Ho Chi Minh City, Vietnam: Prevalence and associated factors. Can J Infect Dis Med Microbiol 2020; 2020:5680154.

[28] Nguyen TD, Dang AD, Van Damme P, Nguyen CV, Duong HT, Goossens H, et al. Coverage of the expanded program on immunization in Vietnam: Results from 2 cluster surveys and routine reports. Hum Vaccin Immunother 2015; 11(6):1526-1533.

[29] Tu F, Yang R, Wang W, Li R, Du G, Liu Y, et al. Analysis of knowledge, attitude and practice of hepatitis B among freshmen in Jiangsu based on Lasso-logistic regression and structural equation model. Infect Drug Resist 2022; 15:3063-3073.

[30] Hebo HJ, Gemeda DH, Abdusemed KA. Hepatitis B and C viral infection: Prevalence, knowledge, attitude, practice, and occupational exposure among healthcare workers of Jimma University Medical Center, Southwest Ethiopia. ScientificWorldJournal 2019; 2019:9482607.

[31] Chhabra D, Mishra S, Gawande K, Sharma A, Kishore S, Bhadoria AS. Knowledge, attitude, and practice study on hepatitis B among medical and nursing undergraduate students of an apex healthcare institute at Uttarakhand foothills: A descriptive analysis. J Family Med Prim Care 2019; 8(7):2354-2360.

[32] Mesfin YM, Kibret KT. Assessment of knowledge and practice towards hepatitis B among medical and health science students in Haramaya University, Ethiopia. PLoS One 2013; 8(11):e79642.

[33] Giao H, Quang Vinh B, Huynh Tam Lang N, Le An P. Parents' attitude about hepatitis B disease and practice of hepatitis B vaccination among children in Ho Chi Minh City, Vietnam. Biomed Res Int 2019; 2019:9323814.

[34] Huynh G, Pham LA, Tran TT, Cao NN, Nguyen TNH, Bui QV. How knowledge of hepatitis B disease and vaccine influences vaccination practices among parents in Ho Chi Minh City, Vietnam. Asian Pac J Trop Med 2021; 14(3):122-127.