Hepatitis b vaccination status and associated factors among undergraduate students of Makerere university college of health sciences.

Abstract

Introduction: Hepatitis B is a global health problem leading to approximately 780,000 deaths each year. In Uganda Hepatitis B Virus (HBV) is highly endemic with a prevalence of 10%. Trainees in the health-related fields are exposed to occupational risk of HBV. Studies done among students elsewhere show a low coverage of vaccination in this group mainly due to a gap in knowledge. In Uganda literature on HBV is old with no information regarding vaccination against HBV among trainees in health-related fields. We aimed at assessing the vaccination status among students. Objective: To determine the Hepatitis B virus vaccination status and the associated factors among undergraduate students of the Makerere University College of Health Sciences (MakCHS). Methods: This was a Cross sectional study, conducted at MakCHS among undergraduate students who met the eligibility criteria. A self-report on Hepatitis B vaccination status, social demographic characteristics and other variables were collected on each consenting participant, using a standardized structured self-administered questionnaire. Descriptive statistics were computed, the proportion and 95% confidence interval of students who reported full vaccination was calculated. Bivariate and multivariate analyses of the factors associated with vaccination status were done by fitting a modified Poisson model using Stata 14. Results: Out of 760 students that participated in the study, only 44.3% (95% CI 35.2 – 52.8) were fully vaccinated. Vaccination was found to be associated with male sex (PR=0.79, 95% CI= 0.69 – 0.91, p<0.001), being self-sponsored (PR 2.08, 95% CI 1.57-2.74, p <0.001), course of

study (MBChB PR= 1.94, p<0.001; BPH PR=1.98, p<0.001; BDS PR=2.56, p<0.001; BSB PR= 1.68, p<0.001 compared to BMR) and year of study (Year V PR=1.88, p=<0.001; Year IV PR=2.07, p<0.001; Year III PR=3.28, p<0.001; Year II PR=2.47, p<0.001 compared to Year I). There was significant interaction between year and course of study. About 37% (279/760) of the students reported having had an accidental needle prick injury during their training and 19% of these had taken Post Exposure Prophylaxis (PEP) for HIV. Conclusion: The proportion of self-reported vaccinated students in MakCHS is low (44.3%), compared to the 100% required by Ministry of Health Uganda. This coupled with a high prevalence of needle prick injuries raises a safety concern that needs attention by the policy makers in the University and Ministry of Health. Vaccination of students against Hepatitis B should be declared mandatory for all students prior to any clinical exposure and the vaccine made available free of charge. There is also need for targeted interventions for the different subgroups especially targeting male student involvement to increase vaccination against Hepatitis B.