Cross-sectional study on knowledge of medical workers towards hepatitis virus screening and monitoring of tuberculosis patients in Yunnan province

Abstract

Objective To investigate the knowledge of medical workers towards the screening and management of hepatitis B/C virus (HBV/HCV) among patients with tuberculosis. Methods A questionnaire survey was conducted in tertiary and secondary comprehensive hospitals of 16 autonomous prefectures and cities in Yunnan Province in 2018. The participants should be involved in the diagnosis and treatment of tuberculosis, and their decisions on screening and monitoring serum biomarkers of HBV and HCV before anti-tuberculosis and glucocorticoid treatment were collected. Results A total of 1 000 questionnaires were sent out, and 942 questionnaires were collected. After 52 invalid questionnaires were excluded, 890 questionnaires were finally valid, which came from 21 tertiary hospitals and 64 secondary hospitals. The proportion of medical workers deciding to screen anti-HCV (48.8%, 434/890) was significantly lower than that of deciding to screen HBsAg (hepatitis B surface antigen) (70.7%, 629/890;χ2 = 88.805,P < 0.001) before anti-tuberculosis treatment. The proportion of medical workers who decided to screen anti-HCV (72.1%, 642/890) was also lower than that for HBsAg screening (75.6%, 673/890) before glucocorticoid treatment, although the overall difference was not significant (χ2= 2.794, P = 0.094). Binary logistic regression multivariate analysis showed that the department category and professional title were independent predictors for medical workers screening anti-HCV before glucocorticoid treatment. The knowledge of decision on screening anti-HCV were relatively higher among the medical workers in the department of infectious diseases (OR= 1.834, 95%CI: 1.342-2.505,P= 0.001), the senior title (OR= 1.745, 95%CI: 1.115-2.731,P =0.015). Hospital level, department category and professional title were independent predictors for medical workers screening HBsAg before glucocorticoid treatment. The knowledge of decision on screening HBsAg were relatively higher among the medical workers in tertiary hospital (OR= 1.735, 95%CI: 1.223-2.441,P= 0.002), in the department of infectious diseases (OR= 1.567, 95%CI: 1.133-2.167,P = 0.007) and the senior title (OR = 1.786, 95%CI: 1.104-2.888,P = 0.018). During glucocorticoid treatment, both hospital level and department category were independent predictors for medical workers to monitor HCV RNA. The knowledge of decision on monitoring HCV RNA were relatively higher among the medical workers in tertiary hospital (OR= 1.898, 95%CI: 1.285-2.802,P= 0.001), in the department of infectious diseases (OR= 2.039, 95%CI: 1.391-2.988,P < 0.001) than those of staff in secondary hospital and not department of infectious diseases and hospital level, department category and professional title were independent predictors for medical workers to monitor HBV DNA. The knowledge of decision on monitoring HBV DNA were relatively higher among the medical workers in tertiary hospital (OR= 2.019, 95%CI: 1.385-2.943,P < 0.001), in the department of infectious diseases (OR = 2.269, 95%CI: 1.573-3.275,P< 0.001) and the senior title (OR= 2.435, 95%CI: 1.373-4.320,P= 0.002). Conclusions Medical workers might have great gaps in their knowledge towards the screening and management of hepatitis virus in tuberculosis patients. Increased training on viral hepatitis to medical worker will benefit prevention of liver injury in tuberculosis patients. Key words: Medical workers; Tuberculosis; Hepatitis C virus; Hepatitis B virus; Survey of knowledge