As part of efforts to reach the elimination target by 2030, the WHO and CDC recommend that all healthcare workers (HCWs) adhere to the 3-dose hepatitis B vaccination schedule to protect themselves against the infection. This study assessed Hepatitis B vaccination coverage and associated factors among personnel working in health facilities in Kumasi, Ghana. A cross-sectional study involving 530 HCWs was conducted in four hospitals in Kumasi from September to November 2023. An investigator-administered questionnaire was employed in gathering participant demographics and other information related to vaccination coverage. IBM SPSS version 26.0 and GraphPad Prism 8.0 were used for analysing the data. Even though, the majority (70.6%) reported having taken at least one dose of the vaccine, only 43.6% were fully vaccinated (≥ 3 doses). More than a quarter (29.4%) had not taken any dose of the HBV vaccine. Close to a quarter (23.6%) had not screened or tested for HBV infection in their lifetime. The Statistically significant variables influencing vaccination status were age, marital status, profession, and status in the hospital. The majority (44.9%) of the participants who have not taken the vaccine reported they do not have a reason for not taking the vaccine and a high proportion (80.1%) were willing to take the vaccine when given for free. To combat the low hepatitis B vaccination coverage among healthcare workers in Kumasi, Ghana, amidst the significant public health threat of HBV infection, comprehensive measures are necessary. These include implementing infection prevention control programmes, enhancing occupational health and safety, and conducting health promotion campaigns in healthcare facilities. Extending and intensifying hepatitis B screening and vaccination initiatives to tertiary institutions and encouraging employers, supervisors, or team leaders to provide these services nationwide are also recommended.

Study Design and Population

A cross-sectional study was conducted in four hospitals in Kumasi from 5th September to 9th November 2023. These study sites included 4 different hospitals.

Kumasi, the second largest city in Ghana, is situated between latitudes 6.35°N and 6.40°N and longitudes 1.3°W and 1.35°W. Covering an area of approximately 150 square kilometres, it resides within the rainforest region of West Africa. The city has a population of around 2 million inhabitants [1].

In the suburbs of Kumasi [2], reported the prevalence levels of HBsAg are 6.78% in Garrison, 9.02% in Aboabo, and 10.0% in Tafo. The overall prevalence of HBsAg seropositivity within the study population was calculated to be 8.68%. These findings indicate that local prevalence rates of HBsAg can vary significantly within different areas of Kumasi.

A total of 530 participants were recruited using a purposive sampling technique from the four different health facilities. The sample size was calculated using the Raosoft sample size calculator [3]. The minimum sample size required for this study was 377 participants at a 95% confidence level, a 5% margin of error, and a response distribution of 50%. It was increased to 530 to increase the statistical power of prediction.

Ethical approval was sought from the Committee on Human Research, Publication and Ethics (CHRPE), School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST).

Inclusion and exclusion criteria

The study participants were healthcare workers (HCWs) comprising clinicians, pharmacists, laboratory scientists, nurses, midwives, administrative staff, securities, and cleaners. Healthcare workers in the four study sites during the study period who were willing to participate in the study were included. Healthcare workers on fieldwork, maternity, annual, or sick leave who were unable to remain in the study area during the data-collecting period were excluded.

We engaged in pilot interviews and discussions with a cohort of healthcare workers to enhance the clarity and applicability of our research questionnaire. Their feedback enabled us to fine-tune the questionnaire, ensuring it was more accessible to patients and effectively captured pertinent information. Before commencing data collection, all researchers involved underwent training. After each day's data gathering, a team of investigators meticulously reviewed the obtained data for inconsistencies and omissions. Subsequently, data-cleaning procedures were implemented to ensure the accuracy, consistency, and completeness of variables. Any incomplete participant responses were identified, rejected, and excluded from the dataset before analysis.

Data analysis

Data entry was done using Microsoft Excel 2019 and analysis was performed using IBM SPSS Version 26.0 and GraphPad Prism version 8.0. Categorical data were presented as frequency (proportion). Multivariate logistic regression analysis was performed to evaluate the factors that influence vaccination coverage of the study participants. All statistical results obtained were considered at a significant value of p < 0.05.

References

1.     Gss GSS, NMIMR/Ghana NMI for MR, Macro ORC. Ghana Demographic and Health Survey 2003. 2004 Sep 1 [cited 2024 Apr 21]; Available from: https://dhsprogram.com/publications/publication-FR152-DHS-Final-Reports.cfm

2.     Amidu N, Alhassan A, Obirikorang C, Feglo P, Majeed SF, Timmy E, et al. Sero-prevalence of hepatitis B surface (HBsAg) antigen in three densely populated communities in Kumasi, Ghana.

3.     Sample Size Calculator by Raosoft, Inc. [Internet]. [cited 2024 Apr 21]. Available from: http://www.raosoft.com/samplesize.html