Uptake Of Hepatitis Research Articles

Uptake of Hepatitis B Treatment Eligibility Tests Among Hepatitis B Patients; The Case of Yumbe Regional Referral Hospital, Uganda.

Uptake of Hepatitis B Treatment Eligibility Tests Among Hepatitis B Patients; The Case of Yumbe Regional Referral Hospital, Uganda.

Prevalence and factors associated with hepatitis b vaccination uptake and completion among communities targeted for mass vaccination in gulu: a cross-sectional study

BackgroundHepatitis B virus (HBV) is associated with several acute and long-term complications and vaccination is the cornerstone of prevention. A recent outbreak in Gulu, Uganda, one of the districts covered by a mass vaccination campaign, suggests low uptake of HBV vaccination. This study aims to determine the uptake and completion of HBV vaccination and associated factors among residents of Gulu, Uganda.MethodsA mixed methods cross-sectional study was conducted in Gulu, Northern Uganda, among 434 adult residents. A pretested questionnaire was used to collect data on socio-demographics, perceptions, and knowledge of HBV vaccination. Modified Poisson regression analysis was used in STATA 14 software to obtain prevalence ratios for the association between the independent and dependent variables. For qualitative data, 9 key informant interviews were conducted and thematic analysis was done using Quirkos software.ResultsOut of the 434 respondents, 41.9% had received at least one dose of the hepatitis B vaccine, 32.5% had received at least 2 doses, and only 20% had completed all 3 doses, with an overall completion rate of 47.8% for participants who had been initiated on the vaccine. Gender, residence, risk perception of Hepatitis B infection, perceived safety of the vaccine, and awareness of mass vaccination were associated with uptake of Hepatitis B vaccination. Residence, knowledge, and perception of being at risk of acquiring Hepatitis B were associated with completion. Qualitative results revealed that the levels of uptake and completion could have been affected by access to vaccination sites; inadequate knowledge about the disease; myths about the vaccine and inadequate community engagement.ConclusionLow Hepatitis B vaccine uptake and completion rates were observed in Gulu. To enhance vaccination coverage, future initiatives should prioritize awareness, education, and dispelling of vaccination myths. Additionally, increased government investment in training health workers can serve as a valuable strategy to improve information dissemination and awareness among the population.

Impact of Behaviour Change Communication on Uptake of Hepatitis B Vaccination among Health Workers in Fako Division, Cameroon

Impact of Behaviour Change Communication on Uptake of Hepatitis B Vaccination among Health Workers in Fako Division, Cameroon

Uptake of hepatitis B vaccination and associated factors among health sciences students, Mogadishu, Somalia.

Hepatitis B is a potentially fatal liver infection caused by the hepatitis B virus (HBV). It is a serious issue for global health. It considerably raises the risk of cirrhosis and liver cancer-related death and can result in chronic infection. The risk of infection is high among health sciences students due to the risk of occupational contact with fluids of infected patients and the risk of needle stick injury. The most effective way of preventing HBV infection is the vaccination of students prior to their posting to healthcare settings. There is no data available about HBV vaccination uptake among Health Sciences students in Somalia. Therefore, this study aimed to determine HBV vaccination uptake and associated factors toward HBV among health science students in Somalia. A cross-sectional study was undertaken among health sciences students from August to October 2022. Data were gathered using Kobo Toolbox using a standardized questionnaire with questions on characteristics, knowledge attitude, and HBV prevention practices. A total of 569 students were involved in the study. Stata version 15 was utilized for the analysis. Bivariate and multivariate logistic regression analysis, as well as descriptive statistics, were performed. In order to assess the existence and significance of the relationship between the outcome and risk factors, an adjusted odds ratio with a 95% confidence interval (CI) was used. Statistical significance was considered as a p-value ≤0.05. Of the 569 study participants, 33.4% (95%CI: 29.6-37.4) received a full dose of the HBV vaccine in this study. Participants had good HBV prevention knowledge, attitudes, and practices at 69.6, 37.96, and 50.6%, respectively. The lack of access and the high cost of the vaccine were the reasons for not taking the vaccine. Second-year [AOR: 0.22 (0.12-0.43)]. Positive attitude [AOR: 0.54 (0.31-0.93)], and good practice [AOR: 6.99 (3.62-13.5)]. The study indicated that 33.4% of health sciences students had received the required HBV vaccination doses, academic year, attitude, and practice were significantly associated with full-dose vaccination status. The unavailability of the vaccine and the high cost of vaccination were the most common reasons for not taking the vaccine. It is recommended that students receive vaccinations before beginning clinical rotations, and give instruction on infection prevention strategies and general precautions, particularly regarding HBV infection.

Timeliness in the uptake of hepatitis B birth dose among Indian children under age five: A population-based study

ObjectiveTo assess the timeliness and risk factors for the delay in the uptake of the hepatitis B birth dose among Indian children aged 0–59 months. Information regarding whether the children received the birth dose and the time of receiving it was recorded based on the vaccination card available at the time of the National Family Health Survey (NFHS). MethodsUsing data from the fourth and fifth round of India’s National Family Health Survey (NFHS), the percentage of uptake and timely receipt of the hepatitis B birth dose were obtained by background characteristics and at the sub-national level (state). Multinomial logistic regression analysis was used to examine the risk factors. This study further performed a negative binomial regression estimation to predict the probability of receiving the birth dose at each day within a multivariable framework. ResultsIt was found that approximately 34 % of the children who received the birth dose and the timing of receiving the birth dose was made available through the vaccination card were administered the dose within 24-hours during 2015–16. However, the percentage increased to 51.91 % during 2019–21. During 2019–21, Ladakh had the highest proportion (85.03 %) of children receiving the dose within 24-hours, followed by Jammu & Kashmir with 78 %, and Arunachal Pradesh with 68 %. Mother’s education, economic status of the child’s family and region (children belong from) were found to be significant predictors in delay of receiving the birth dose within 24 hours. ConclusionResults indicated a need for targeted interventions to improve the coverage and timeliness in the uptake of this critical vaccine dose in the country. These interventions could include strategies such as strengthening the healthcare system, improving awareness among parents and healthcare providers, addressing logistical challenges in vaccine delivery, and promoting community engagement and education on importance of timely vaccination.

Uptake of hepatitis C direct-acting antiviral treatment in China: a retrospective study from 2017 to 2021

BackgroundDirect-acting antivirals (DAAs) for hepatitis C treatment in China became available since 2017. This study expects to generate evidence to inform decision-making in a nationwide scale-up of DAA treatment in China.MethodsWe described the number of standard DAA treatment at both national and provincial levels in China from 2017 to 2021 based on the China Hospital Pharmacy Audit (CHPA) data. We performed interrupted time series analysis to estimate the level and trend changes of the monthly number of standard DAA treatment at national level. We also adopted the latent class trajectory model (LCTM) to form clusters of the provincial-level administrative divisions (PLADs) with similar levels and trends of number of treatment, and to explore the potential enablers of the scale-up of DAA treatment at provincial level.ResultsThe number of 3-month standard DAA treatment at national level increased from 104 in the last two quarters of 2017 to 49,592 in the year of 2021. The estimated DAA treatment rates in China were 1.9% and 0.7% in 2020 and 2021, which is far below the global target of 80%. The national price negotiation at the end of 2019 resulted in DAA inclusion by the national health insurance in January 2020. In that month, the number of treatment increased 3668 person-times (P < 0.05). LCTM fits the best when the number of trajectory class is four. PLADs as Tianjin, Shanghai and Zhejiang that had piloted DAA price negotiations before the national negotiation and that had explored integration of hepatitis service delivery with prevention and control programme of hepatitis C within the existing services demonstrated earlier and faster scale-up of treatment.ConclusionsCentral negotiations to reduce prices of DAAs resulted in inclusion of DAA treatment under the universal health insurance, which are critical elements that support scaling up access to hepatitis C treatment in China. However, the current treatment rates are still far below the global target. Targeting the PLADs lagged behind through raising public awareness, strengthening capacity of the healthcare providers by roving training, and integrate prevention, screening, diagnosis, treatment and follow-up management of hepatitis C into the existing services are needed.

Perceptions and Cues to Action as Predictors of Nurses' Vaccination Intentions at Two Primary Health Care Facilities in Ghana.

Uptake of hepatitis B vaccination by health care providers remains suboptimal in Ghana, although it is considered an effective strategy against the hepatitis B virus. This study aimed to identify the predictors of nurses' hepatitis B vaccination intentions at two municipal health care facilities in Ghana. A descriptive cross-sectional survey was adopted. A section of the health belief model-based questionnaire was administered to 181 nurses conveniently sampled from the two facilities. Data analysis was done using Statistical Product and Service Solutions software version 23.0. Frequencies and percentages were used to assess the demographic characteristics of participants. Pearson r coefficients were used to assess the intercorrelations between individual perceptions, and the cues to action on vaccination intentions. Simple and multiple regression was used to estimate the prediction of individual perceptions, and the cues to action on hepatitis B vaccination intentions of nurses. The findings showed that nurse-perceived benefits and cues to action were positive and significantly related to hepatitis B vaccination intentions of nurses (r = 0.14, P < 0.05; r = 0.17, P < 0.05). Perceived susceptibility and perceived barrier were negative and significantly related to vaccine intentions (r = -0.13, P < 0.05; r = -0.24, P < 0.01). Notably, perceived barrier predicted hepatitis B vaccination intentions (β = -0.22, t = -2.48, P = 0.01). Nurses' vaccination behavioral intentions were positive. It was recommended that perceived barriers to hepatitis B vaccination such as vaccination ineffectiveness, time constraints, high costs, and side effects should be addressed to increase nurses' vaccination uptake.

Assessing the level of knowledge, uptake of hepatitis B virus vaccine, and its determinants among health workers across various levels of health facilities in Ondo, South West, Nigeria

Problem consideredResearch has shown that health care personnel is at higher risk of acquiring the disease than the general population. In spite of this challenge, there has been a low vaccination record among the Health WorkersThe aim of this study was to investigate the relationship between knowledge, attitude, perception, and practice of hepatitis B vaccination among health workers in Akure South Local Government Area of Ondo State, NigeriaMethodsAn institution-based cross-sectional study was conducted with 260 health professionals working at primary health centers (40), private hospitals (60), and tertiary health institutions (160). Data was collected by using self-administered questionnaires distributed at the participant’s work unit and analyzed using SPSS version 20.ResultsThe result showed that there was a statistically significant relationship between the knowledge of Health workers about the HBV vaccine and vaccine uptake.While all the non-vaccinated health workers showed interest in taking the vaccine, the majority of them (80.4 %) suggested that the vaccine should be given free to health workers.ConclusionThe study revealed that the health workers had a good knowledge of hepatitis infection but not the vaccination which affected vaccine uptake as a significant relationship exists between the two. Also, the greatest hindrance to the uptake of the vaccine is the cost of the vaccine. HBV vaccination should be made compulsory as part of occupational protection measures and made readily available gratis for all health workers.

Factors Associated with Timeliness of Hepatitis B Birth Dose: A Cross-sectional Study in North-Western Nigeria

Highlights: Uptake of hepatitis B birth dose vaccine within 24 hours of birth is low in Katsina, north-western Nigeria. The most common reason for delay presentation for hepatitis B birth dose vaccine is maternal illness. Abstract: No studies focused on the hepatitis B birth dose (HepB-BD) vaccine since Nigeria adopted the strategy to reduce hepatitis B viral infection. Hence, we determined the uptake of HepB-BD, factors associated with timeliness, and those that contributed to delay. This study was a cross-sectional descriptive study carried out at an immunization post in north-western Nigeria. We recruited 400 mother-infant pairs that presented for the first immunization and obtained relevant information, including socio-demographics and reasons for the delays. Of the 400 infants, 44 (11.0%) received HepB-BD within 24 hours (timeliness), 105 (26.3%) and 274 (68.5%) by day 7 and 14, respectively. Multivariate analysis showed that mothers' education (primary adjusted odds (AOR) 17, 95% CI 1.404, 204.611), secondary AOR 5.9, 95% CI 1.148, 29.895), and tertiary AOR 7.7, 95% CI 1.228, 48.545), and third born AOR 8.2, 1.625, 41.018) were associated with HepB-BD timeliness. Maternal-related factors were the commonest (129; 46.6%) for delayed HepB-BD, with maternal illness the most commonly cited reason (37; 28.7%). This study showed a deficient level of uptake of HepB-BD vaccines among infants. Factors that were associated with timeliness included maternal education and higher birth order. The commonest reason for delayed HepB-BD was maternal illness.

Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.

To examine trends in the direct acting antiviral (DAA) uptake in a multi-state Medicaid population with hepatitis C virus (HCV) prior to and after ledipasvir/sofosbuvir (LDV/SOF) approval and changes in prior authorization (PA) requirements. Analyses utilized enrollment, medical, and pharmacy claims in four states, December 2013-December 2017. An interrupted time series examined trends in uptake (1+ claim for a DAA) before and after two events: LDV/SOV approval (October 2014) and lifting of PA requirements for 40% of members (July 2016). Analyses were also performed in subgroups defined by the number and dates of change in PA requirements in members' Medicaid plans. Members aged 18-64 years with an ICD code for HCV were included in the sample from diagnosis date until treatment initiation or Medicaid disenrollment. The annual sample size ranged from 38,302 to 45,005 with approximately 30% ages 18-34 years and 40% female. In December 2013, 0.08% was treated, rising to 0.74% in December 2017 (p < 0.001). Uptake increased from 0.34%/month in October 2014 to 0.70%/month after LDV/SOF approval, (p < 0.001), and increased relative to the pre-LDV/SOV trend through June 2016 (p=0.04). Uptake increased to 1.18%/month after PA change, (p < 0.001) and remained flat through 2017 (p=0.64). Cumulatively, 20.1% were treated by December 2017. In plans with few/no requirements through 2017, uptake increased to 1.19%/month after LDV/SOF approval (p < 0.001) and remained flat through 2017 (p=0.11), with 22.2% cumulatively treated. Among plans that lifted PA requirements from three to zero in mid-2016, uptake did not increase after LDV/SOF approval (p=0.36) but did increase to 1.41%/month (p < 0.001) after PA change, with 18.1% cumulatively treated. HCV Treatment increased through 2017. LDV/SOF approval and lifting PA requirements led to an increase in uptake followed by flat monthly utilization. Cumulative uptake was higher in plans with few/no PA requirements relative to those with three requirements through mid-2016.

Predictors of Uptake and Completion of Hepatitis B Vaccine amongst Health Care Personnel in a Rural Teaching Hospital in South-South Nigeria

Hepatitis B and C viral infections are amongst the most critical occupation-related infections in the hospital workplace. This study assesses the determinants of uptake and completion of hepatitis B vaccine amongst health care personnel (HCP) in a tertiary health facility in South-South, Nigeria. This study employs a descriptive cross-sectional study design, and data were collected using a quantitative method. Pre-tested, semi-structured interviewer-administered questionnaires were administered to 280 HCP. The IBM SPSS version 21.0 was used for data analysis. About half of HCP had received the first dose of the hepatitis B vaccine, with less than half of that number completing the third dose. It is significantly higher amongst the core healthcare professionals than the non-healthcare professionals. There is a high drop-out rate in the hepatitis B vaccination process which was more amongst the non-clinical group than the clinical. The short duration of work (1-5 years) is a significant predictor of initiation of the vaccination process, while good knowledge of hepatitis B and C viruses was a strong predictor for complete uptake. This study reveals a fair uptake of the first dose of hepatitis B vaccine amongst HCP with a high drop-out rate and a concomitant low completion of the vaccine course amongst respondents. Priority should be given to ensure planned programmes that will help enhance optimal uptake of hepatitis B vaccine amongst HCP.

Uptake of Hepatitis B vaccine and its predictors among healthcare workers in south-south Nigeria: a cross-sectional survey

Uptake of Hepatitis B vaccine and its predictors among healthcare workers in south-south Nigeria: a cross-sectional survey

Projected Long-Term Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hepatitis C Outcomes in the United States: A Modeling Study.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic disrupted access to and uptake of hepatitis C virus (HCV) care services in the United States. It is unknown how substantially the pandemic will impact long-term HCV-related outcomes.MethodsWe used a microsimulation to estimate the 10-year impact of COVID-19 disruptions in healthcare delivery on HCV outcomes including identified infections, linkage to care, treatment initiation and completion, cirrhosis, and liver-related death. We modeled hypothetical scenarios consisting of an 18-month pandemic-related disruption in HCV care starting in March 2020 followed by varying returns to pre-pandemic rates of screening, linkage, and treatment through March 2030 and compared them to a counterfactual scenario in which there was no COVID-19 pandemic or disruptions in care. We also performed alternate scenario analyses in which the pandemic disruption lasted for 12 and 24 months.ResultsCompared to the “no pandemic” scenario, in the scenario in which there is no return to pre-pandemic levels of HCV care delivery, we estimate 1060 fewer identified cases, 21 additional cases of cirrhosis, and 16 additional liver-related deaths per 100 000 people. Only 3% of identified cases initiate treatment and <1% achieve sustained virologic response (SVR). Compared to “no pandemic,” the best-case scenario in which an 18-month care disruption is followed by a return to pre-pandemic levels, we estimated a smaller proportion of infections identified and achieving SVR.ConclusionsA recommitment to the HCV epidemic in the United States that involves additional resources coupled with aggressive efforts to screen, link, and treat people with HCV is needed to overcome the COVID-19-related disruptions.

Risk of Exposure, Perception and Vaccination Status of Chronic Viral Hepatitis among Health Care Workers in Benue State, North Central Nigeria

Health care workers are high-risk group for contracting hepatitis B and C virus infections. Hepatitis B and C can be contracted in the hospital setting by needle prick injury, contact with blood (and body fluids) and during invasive medical procedures. This study aims to assess the risk of exposure, the concern or perception of healthcare workers about getting infected (with HBV and/or HCV) from the workplace and the level of HBV vaccination uptake among them. The study was carried out during a capacity building workshop organized for health care workers from all the Local Government Areas in Benue State. A self-administered questionnaire was distributed to 168 participants in attendance, after obtaining verbal consent. One hundred and thirty-eight (138) questionnaires were properly filled and returned, 115 (83.3%) have had needle prick injury, 127 (92%) have had blood spilling on them and 118 (85.5%) have been involved in the management of hepatitis patients. One hundred and nineteen (86.2%) were afraid of contracting hepatitis infection from their place of work, 133 (96.4%) were aware of hepatitis B vaccine for adult, 87 (63%) had received at least one dose of hepatitis B vaccine but only 56 (40.6%) received the complete three doses. Health care workers in Benue State are aware of the risk of contracting viral hepatitis at their workplace and are concerned about this risk. However, the uptake of hepatitis B vaccination among them remains poor.

Hepatitis B Surface Antigen-Prevalence, Knowledge, Attitude and Vaccination Status among Healthcare Workers in a Tertiary Health Facility

Healthcare workers (HCWs) are at increased risk of acquiring hepatitis virus B infection through occupational exposure. Having adequate knowledge and proper attitudes toward hepatitis B virus infection are crucial for its prevention. This study assessed the knowledge, attitude, and hepatitis B virus vaccination status of health care workers. A descriptive cross-sectional study among 120 healthcare workers that attended the World Hepatitis B-Day Celebration in June 2018 was undertaken. Data were obtained with a self-administered questionnaire on socio-demographic characteristics, knowledge, attitude towards HBV infection, and practice of hepatitis B vaccination. Commercial enzyme-linked immunosorbent assay kits were used to determine the prevalence of hepatitis B surface antigen. Data were analyzed using computer software SPSS version 22. The prevalence of HBsAg among the subjects was 4.5%. Only 53(47.7%) of the respondents had good knowledge of hepatitis B virus infection. The majority of respondents 91(82.0%) demonstrated a positive attitude towards hepatitis B virus infection and vaccination. Over 30% of respondents were aware of their hepatitis B virus infection status, and 29(26.1%) of them had received the hepatitis B virus vaccine. The major reason for the poor uptake of hepatitis B virus vaccination was not knowing where to get the vaccine in 40(57.1%) of them. Good knowledge of HBV infection had a statistically significant association with the age of respondents and their years of experience (p&lt;0.05). It is recommended that a healthcare worker should be provided with more education and information on hepatitis B virus infection and vaccination. Also, hepatitis B screening and vaccination should be made mandatory as part of the pre-employment exercise of all healthcare workers with follow up screening before any upgrade or promotional examination exercise.

Uptake of hepatitis C virus screening and treatment in persons under opioid substitution therapy between 2008 and 2013 in Belgium

Hepatitis C is a viral infection caused by the hepatitis C virus (HCV) with people who inject drugs as the main group at risk worldwide. This study investigated the differences in uptake for HCV screening and treatment between persons in opioid substitution therapy (OST) and the other members of the Christian Health Insurance Fund in Belgium. Invoice data were retrospectively collected from the Christian Health Insurance Fund, representing 42% of the healthcare users. Information on demographics, screening, diagnostic tests, treatment and disease progression was obtained from 2008 till 2013. All people in this study were aged 20-65 year. Persons in the OST group were identified as having at least one prescription reimbursed for methadone. This group was compared to the other members of the Insurance Fund not on OST (NOST). The Insurance Fund registered 8,409 unique OST and 3,525,190 members in the general group. HCV RNA screening rate was higher in the OST group after correction for age and gender (4.3% vs. 0.2%). Ribavirin reimbursement, did not differ between the OST and NOST group screened for HCV RNA (16.9% vs. 14.4%), though the probability of having ribavirin reimbursed was smaller for females than for males. Procedures concerning disease progression were reimbursed less frequently in the HCV RNA screened OST group compared to the NOST group (0.3% vs. 1.2%). People on OST were screened more often for HCV RNA. However, the general uptake for HCV screening and treatment in both populations remained suboptimal.

Pregnant women's hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study.

Objective:To determine the hepatitis B vaccination coverage, full-dose (⩾3) coverage and the associated factors affecting uptake among pregnant women.Methods:This was a cross-sectional study among pregnant women attending antenatal care in six tertiary hospitals across all the geopolitical zones of Nigeria. Pregnant women who consented to the study completed screening questions about their hepatitis B vaccination status and coverage. The main outcome measures were hepatitis B vaccination coverage rate, dose, and factors affecting uptake. Bivariate analysis was performed by the chi-square test and conditional logistic regression analysis was used to determine variables associated with uptake of the vaccination. Odds ratios (ORs) and adjusted odds ratios (aORs) were calculated and statistical significance was accepted when p-value was < 0.05.Results:Of 159 pregnant women who completed the interview questions, 21 [13.2%, 95% confidence interval (CI) 7.9–18.5%] were vaccinated for hepatitis B for one to three doses. The numbers of doses received were: three doses (8/159, 5.0%), two doses (5/159, 3.1%), and one dose (8/159, 5.0%). The reasons for non-uptake of vaccination included: lack of awareness of the vaccine 83/138 (60.1%), inadequate access to vaccine 11/138 (8.0%), and positivity to hepatitis B virus 10/138 (7.2%). The uptake of hepatitis B vaccination was significantly affected by the level of education (OR 0.284, 95% CI 0.08–1.01, p = 0.041), but in multivariable logistic regression, adjusted for confounders, the association between hepatitis B vaccination and participants’ level of education (aOR 3.09; 95% CI 0.95–10.16; p = 0.061) did not remain significant.Conclusions:In Nigeria, the national hepatitis B vaccination coverage among pregnant women appears poor, with the full-dose coverage even poorer. The level of education was not positively associated with uptake of hepatitis B vaccination, while lack of awareness of the vaccine was the commonest reason for non-uptake.Funding:TETFund National Research Fund 2019 (grant number TETFund/DR&D/CE/NRF/STI/33).

Assessing Level of Knowledge and Uptake of Hepatitis B Vaccination among Health Care Workers at Juba Teaching Hospital, Juba City, South Sudan

Background Chronic hepatitis B (CHB) virus (HBV) infection remains a severe problem worldwide. An estimated 240–400 million persons are reported to have chronic HBV infection, and the annual mortality from HBV-related complications including cirrhosis and hepatocellular carcinoma was 600,000 persons. In Sub-Saharan Africa, the prevalence of HBV chronic infection is particularly high while in South Sudan, hepatitis B remains a serious problem of public health importance with health care workers being more at greater risk. Vaccination coverage against HBV is low among all age groups, yet vaccination status among health care workers is not even known in South Sudan. This study aimed at assessing viral hepatitis B vaccination uptake among health care workers at Juba Teaching Hospital, Juba City, South Sudan. Objective To assess the uptake of viral hepatitis B vaccination among health care workers in Juba Teaching Hospital, Juba City, South Sudan. Methods An analytical cross-sectional study design was conducted targeting 154 health workers. A convenient sampling procedure was used to recruit study participants. Questionnaires were used to collect data. SPSS version 20.0 was used for data analysis. Chi-square tests were used to determine the association between the uptake of hepatitis B vaccination and individual and health facility factors. Multivariable analysis was conducted. Adjusted OR was used to interpret the findings. Results Uptake of hepatitis B vaccination was found to be low at 44.20%, only 48.8% had received one dose, 29.1% received two doses, and 22.1% had received all three doses. Being married (p ≤ 0.008), knowing that hepatitis B can be prevented by vaccination (p ≤ 0.001), knowing that HBV can be got through unprotected sexual intercourse (p ≤ 0.001), awareness of where to get hepatitis B vaccination from (p ≤ 0.001), availability of vaccines in the health facility (p ≤ 0.027), and availability of guidelines followed by all health workers in this facility (p ≤ 0.006) were the factors independently associated with the uptake of hepatitis B vaccination. Conclusion The uptake of hepatitis B vaccination among health workers at Juba Teaching Hospital was low (22.1%), putting health workers at great risk of HBV infection. Having knowledge about hepatitis B vaccination and unprotected sexual intercourse were individual factors associated with hepatitis B vaccination. Availability of the vaccine and vaccination guidelines were the health-related factors associated with hepatitis B vaccination. The government of South Sudan through the Ministry of Health should first track approval of the viral hepatitis B vaccination policy and ensure that it is adopted and implemented by all hospitals. Health care workers must be prioritized and mandatorily vaccinated against viral hepatitis B.

Hepatitis B vaccination coverage across India: exploring the spatial heterogeneity and contextual determinants

BackgroundAlthough hepatitis B vaccinations have been integrated in the Universal Immunization Program (UIP) in India over a decade, only half of the children are immunized against hepatitis B. The national average in hepatitis B vaccination conceals large variations across states, districts and socio-economic groups. In this context, the aim of this paper is to examine the spatial heterogeneity and contextual determinants of hepatitis B vaccination across the districts of India.MethodsUsing data of 199,899 children aged 12–59 months from the National Family Health Survey-4 (NFHS-4), 2015–16 we have examined the district level spatial distribution and clustering of hepatitis B vaccination with the help of Moran’s I and Local Indicator of Spatial Autocorrelation (LISA) measures. We investigated the low coverage of HBV vaccination using spatial autoregressive models (SAR) at the meso scale. And we applied multivariate binary logistic regression analysis to understand the micro-level predictors of hepatitis B vaccination.ResultsIn 2015–16, 45% of the children aged 12–59 months were not vaccinated against hepatitis B in India. The coverage of hepatitis B vaccine across the districts of India showed a highly significant spatial dependence (Moran’s I = 0.580). Bivariate Moran’s I confirmed the spatial clustering of hepatitis B vaccination with mother’s education, full antenatal care (ANC) utilization, post natal care (PNC) utilization, institutional births and registration of births at the district level. Districts with a very low coverage of HBV vaccine are clustered in the western, north-eastern regions and in some parts of central India. At the unit (child) level, children’s hepatitis B immunization status is mostly determined by the socio-economic and demographic characteristics like their mother’s educational status, caste, religion, household’s wealth condition, birth order, year of birth and the region they belong to.ConclusionsDistrict level variation in hepatitis B vaccination is spatially heterogeneous and clustered in India with a strong neighbourhood effect. Uptake of hepatitis B vaccine among Indian children is predominantly dependent upon their socio-economic and demographic characteristics.

Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: Year 2

BackgroundTo increase the uptake of evidence-based treatments for hepatitis C (HCV), the Department of Veterans Affairs (VA) established the Hepatitis Innovation Team (HIT) Collaborative. Teams of providers were tasked with choosing implementation strategies to improve HCV care. The aim of the current evaluation was to assess how site-level implementation strategies were associated with HCV treatment initiation and how the use of implementation strategies and their association with HCV treatment changed over time.MethodsA key HCV provider at each VA site (N = 130) was asked in two consecutive fiscal years (FYs) to complete an online survey examining the use of 73 implementation strategies organized into nine clusters as described by the Expert Recommendations for Implementing Change (ERIC) study. The number of Veterans initiating treatment for HCV, or “treatment starts,” at each site was captured using national data. Providers reported whether the use of each implementation strategy was due to the HIT Collaborative.ResultsOf 130 sites, 80 (62%) responded in Year 1 (FY15) and 105 (81%) responded in Year 2 (FY16). Respondents endorsed a median of 27 (IQR19–38) strategies in Year 2. The strategies significantly more likely to be chosen in Year 2 included tailoring strategies to deliver HCV care, promoting adaptability, sharing knowledge between sites, and using mass media. The total number of treatment starts was significantly positively correlated with total number of strategies endorsed in both years. In Years 1 and 2, respectively, 28 and 26 strategies were significantly associated with treatment starts; 12 strategies overlapped both years, 16 were unique to Year 1, and 14 were unique to Year 2. Strategies significantly associated with treatment starts shifted between Years 1 and 2. Pre-implementation strategies in the “training/educating,” “interactive assistance,” and “building stakeholder interrelationships” clusters were more likely to be significantly associated with treatment starts in Year 1, while strategies in the “evaluative and iterative” and “adapting and tailoring” clusters were more likely to be associated with treatment starts in Year 2. Approximately half of all strategies were attributed to the HIT Collaborative.ConclusionsThese results suggest that measuring implementation strategies over time is a useful way to catalog implementation of an evidence-based practice over time and across settings.