Abstract

Objective:to compare the direct cost, from the perspective of the Unified Health System, of assessing the post-vaccination serological status with post-exposure management for hepatitis B among health care workers exposed to biological material.Method:cross-sectional study and cost-related, based on accident data recorded in the System of Information on Disease Notification between 2006 and 2016, where three post-exposure and one pre-exposure management scenarios were evaluated: A) accidents among vaccinated workers with positive and negative serological status tests for hepatitis B, exposed to known and unknown source-person; B) handling unvaccinated workers exposed to a known and unknown source-person; C) managing vaccinated workers and unknown serological status for hepatitis B and D) cost of the pre-exposure post-vaccination test. Accidents were assessed and the direct cost was calculated using the decision tree model.Results:scenarios where workers did not have protective titles after vaccination or were unaware of the serological status and were exposed to a positive or unknown source-person for hepatitis B.Conclusion:the direct cost of hepatitis B prophylaxis, including confirmation of serological status after vaccination would be more economical for the health system.

Highlights

  • In the world, approximately 257 million individuals live with chronic hepatitis B virus (HBV) infection(1)

  • Objective: to compare the direct cost, from the perspective of the Unified Health System, of assessing the post-vaccination serological status with post-exposure management for hepatitis B among health care workers exposed to biological material

  • The aim of this study was to compare the direct cost, from the perspective of the Unified Health System, of assessing the post-vaccination serological status with post-exposure management for hepatitis B among health care workers exposed to biological material

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Summary

Introduction

Approximately 257 million individuals live with chronic hepatitis B virus (HBV) infection(1). In Brazil, 233,027 confirmed hepatitis B cases were reported in the period from 1999 to 2018, with detection rates of 6.7/100,000 inhabitants in 2018, in which 0.3% of the transmission occurred through the occupational route(4). Infection by occupational exposure can occur during accidents with biological material among Health Care Workers (HCW), according to studies that show rates of 17.3% to 58.4% in Brazil(5-6) and 36,7 % to 78,0% in other countries(7-9). In view of the risk of exposure to HBV, the main preventive measure is the vaccination(10). In Brazil, the Unified Health System (SUS - abbreviation in Portuguese) bears the costs of the HBV vaccine within the National Immunization Program, making it available free of charge since 1998(11)

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