Hepatitis B vaccination coverage among health-care workers in Africa: a systematic review and meta-analysis

Abstract

Objective: To estimate full hepatitis B vaccination coverage (uptake of ≥3 doses of vaccine) among health-care workers (HCWs) in Africa.
Methods: We systematically searched the PubMed®, Embase®, CINAHL and Psych-Info databases for studies published from January 2010 to October 2017 that reported full hepatitis B vaccination coverage among HCWs in Africa. A random effects meta-analysis was conducted to determine pooled estimates of full vaccination coverage.
Results: Of the 331 articles identified, 35 studies from 15 African countries met the inclusion criteria and were included in the review. The estimated full hepatitis B vaccination coverage was 24.7% (95% CI: 17.3 – 32.0). Regional coverage was highest in northern Africa (62.1%, 95% CI: 42.5 – 81.7) and lowest in central Africa (13.4%, 95% CI: 4.5 – 22.3). Doctors were more likely (OR: 2.6, 95% CI: 1.8 – 3.7) to be fully vaccinated than Nurses with estimated pooled estimates of 52.4% (95% CI: 31.1 – 73.8) and 26.3% (95% CI: 9.7 – 42.9), respectively. Also, HCWs with 10 or more years of experience were more likely to be vaccinated than those with less than 10 years of experience (OR: 2.2, 95% CI: 1.5 – 3.3). The common reasons identified for non-vaccination of HCWs were unavailability of vaccine 50.5% (95% CI: 26.5 – 74.4), busy work schedule 37.5% (95% CI: 12.6 – 62.4) and cost of vaccination 18.4% (95% CI: 7.1 – 29.7).
Conclusion: The evidence available suggests that many HCWs in Africa are at risk of Hepatitis B infection as only a quarter of them were fully vaccinated against Hepatitis B virus. This study highlights the need for all African governments to establish and implement hepatitis B vaccination policies for HCWs.