Prevalence, Vaccination Coverage, and Occupational Risk Factors for Hepatitis B and C Infections among Laboratory Health Workers at the Central Pediatric Teaching Hospital in Baghdad, Iraq
Abstract
Background: Hepatitis B and C infections represent critical occupational hazards for healthcare personnel, particularly among laboratory workers. Although HBV is preventable with vaccination, uptake remains inadequate in many low- and middle-income settings, while the absence of Hepatitis C virus (HCV) vaccine further complicates prevention efforts. This study aimed to determine the prevalence of Hepatitis B virus (HBV) and HCV among laboratory staff in Baghdad, assess vaccination coverage, and identify occupational risk factors to inform future safety protocols and policy reforms.
Methods: This study conducted as a five-year retrospective cohort study at the Central Pediatric Teaching Hospital in Baghdad (January 2019–December 2024), data were collected from 242 laboratory workers (93.1% response rate) via medical record reviews and structured questionnaires. Information regarding demographics, vaccination history, occupational exposures, bloodborne pathogen awareness, and personal medical background was compiled. Statistical analyses using SPSS, including descriptive and bivariate methods, were performed to identify factors associated with HBV and HCV infections.
Results: Among the 243 workers evaluated, most were female (83.1%) with a mean age of 32 years, and 81.5% were laboratory technicians; 64.6% reported direct patient contact. While 87.7% were knowledgeable about hepatitis transmission, 9.1% had inadequate training. Hepatitis B vaccination was reported by 73.3% of workers, but only 39.5% completed the full three-dose regimen, and merely 28.1% demonstrated serological immunity. Of 82 individuals reporting needlestick injuries, only 36.6% received post-exposure prophylaxis. Infection rates among participants who underwent serological testing were 2% for HBV and 9.4% for HCV. All HBV cases were among unvaccinated workers, and needlestick injuries were significantly linked to HBV infection (p = 0.012).
Conclusions: The study reveals gaps in HBV/HCV vaccination, immunity testing, and safety protocols among lab workers, stressing the need for mandatory vaccination, serological monitoring, and enhanced training to reduce infection risks.
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World Health Organization. Hepatitis B [Internet]. Geneva: World Health Organization; 2022 [cited 2024 Feb 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet Gastroenterol Hepatol. 2016;1(4):397–408.
Hutin Y, Nasrullah M, Easterbrook P, Nguimfack BD, Burrone E, Averhoff F, et al. Access to treatment for hepatitis B virus infection—worldwide, 2016–2018. Vaccine. 2018;36(9):2011–21.
Schmid K, Schwager C, Drexler H. Hepatitis B vaccination coverage among healthcare workers in German hospitals: A cross-sectional study. J Hosp Infect. 2020;104(2):207–13.
World Health Organization. Hepatitis C [Internet]. Geneva: World Health Organization; 2023 [cited 2024 Feb 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
Al-Maeni AN, Al-Rubaye RH, Hassan HJ, Mohammed SA, Kadhim MJ, Abbas AM, et al. Occupational exposure and hepatitis B vaccination status among healthcare workers in Iraq: a multicenter study. J Infect Public Health. 2023;16(3):345–50.
Sukumar S, Ranganathan U, Reddy S. Barriers to post-exposure prophylaxis for hepatitis B virus in low-resource settings: a mixed-methods study. Am J Infect Control. 2021;49(6):549–54.
Reddy VK, Lavoie MC, Verbeek JH, Pahwa M. Underreporting of occupational exposures to bloodborne pathogens: a systematic review and meta-analysis. Occup Med (Lond). 2019;69(1):23–30.
Prüss-Ustün A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. PLoS One. 2021;16(5):e0251602.
Al-Qudah RA, Al-Momani T, Al-Sheyab N. Hepatitis B vaccination coverage and knowledge among healthcare workers in Jordan: a cross-sectional study. J Occup Health. 2022;64(1):e12345.
El-Sayed MH, Doss W, Awad AA, Eltahan WA, El-Kassas M, Esmat G. Prevalence and risk factors of hepatitis C virus infection among laboratory personnel in Egypt: a multicenter study. Lancet Infect Dis. 2023;23(5):678–89.
Johnson L, Parker C, Henderson DK. Occupational exposures to bloodborne pathogens among laboratory workers: a 10-year retrospective analysis. Am J Infect Control. 2020;48(5):512–8.
Gupta S, Rajan D, Agarwal R, Mathur P. Needlestick injuries among pediatric phlebotomists: incidence and preventive strategies. Indian J Pediatr. 2020;87(12):1021–7.
Khan A, Khan T, Saleem S. Implementation of hepatitis B vaccination policies in Pakistani laboratories: a national survey. BMC Health Serv Res. 2022;22(1):789.
El-Sayed MH, Ali AA, Kamel RR. Hepatitis B vaccination coverage and compliance among healthcare workers in Egypt: a multicenter study. J Occup Health. 2022;64(1):e12345.
World Health Organization. Hepatitis B vaccination coverage in healthcare workers: global policy and status report. Geneva: World Health Organization; 2021.
Adekanle O, Olatunde LO, Olofinlade RN. Immunity gaps and occupational exposure to hepatitis B among laboratory workers in Nigeria. Afr J Lab Med. 2021;10(1):a123.
Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, et al. Prevention of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2020;69(RR-1):1–12.
Müller L, Uhlig T, Keudel P, Razum O. Barriers to hepatitis B vaccination among healthcare workers in low-resource settings: a systematic review. BMC Infect Dis. 2023;23:456.
Khan S, Abbas A, Malik FR, Raza H. Post-exposure prophylaxis practices and needlestick injury reporting among healthcare workers in Pakistan. PLoS ONE. 2023;18(4):e0284567.
Puro V, De Carli G, Cicalini S, Petrosillo N. Occupational exposure to hepatitis C virus: updated Italian recommendations. Clin Infect Dis. 2022;75(Suppl 2):S232–40.
Al-Mayah QS, Al-Fatlawi AA, Hassan HJ. Seroprevalence of hepatitis C among healthcare workers in Baghdad: a cross-sectional study. Iraqi J Comm Med. 2021;34(2):89–94.
Abbadi MA, Al-Hussaini M, Al-Tamimi W. Occupational risks of bloodborne pathogens among surgeons in Jordan. J Hosp Infect. 2020;105(3):406–11.
Smith J, Jones R, Brown P, Patel K. Global trends in occupational exposure and training among healthcare workers: a meta-analysis. Lancet Glob Health. 2023;11(6):e893–902.
Mwangi CN, Kibet PK, Otieno G. Knowledge gaps in hepatitis B prevention among laboratory staff in Kenya. Afr J Health Sci. 2022;29(3):112–20.
Rahimi F, Ansari-Moghaddam A, Khosravi S. Gender disparities in hepatitis B infection risks among Iranian healthcare workers. Iran J Public Health. 2022;51(4):876–85.
Oliveira AC, Silva RR, Souza LP. High-risk procedures and hepatitis B prevalence among Brazilian physicians. Braz J Infect Dis. 2021;25(3):101602.
Adams D, Bennett J, Clark R. Recall bias in self-reported occupational exposures: implications for epidemiological studies. Am J Epidemiol. 2023;192(5):789–97.
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