SEROEPIDEMIOLOGICAL PROFILE AND RISK FACTORS FOR HEPATITIS B INFECTION IN HEALTH CARE WORKERS IN DIALYSIS UNITS

Virus Reviews Research Pub Date : 2009-03-04 DOI:10.17525/VRRJOURNAL.V14I1.22

T. Vilella, M. R. Coêlho, Veridiana Sales Barbosa de Souza, J. L. Silva, R. L. Santos, S. Hinrichsen

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Abstract

The objective of this study was to determine the prevalence of serological markers of hepatitis B and risk factors in health care workers of dialysis units. An analytical descriptive transversal study was performed with 138 health professionals from six dialysis units of Recife city, Brazil. Blood samples were collected between March and July, 2007 and tested for the HBsAg markers (HBsAg, anti-HBs and total anti-HBc) using ELISA method of third generation. Two softwares were used for statistical analysis: the Epi Info (v. 6.04) for the univariate analysis and the Statistical Package for the Social Sciences- SPSS (v. 8.0) for multiple logistical regression. The prevalence of hepatitis B infections, determined by presence of the HBsAg and/or total anti-HBc markers in dialysis staff was 13%. Positivity rate for anti-HBs was 75.4%. However, 11.6% of them were susceptible to infection. In the univariate analysis the variables: length of employment in hemodialysis, quantity of individual protective equipment (IPEs), surgery and/or dentary-surgery antecedents and incomplete vaccination against HBV presented statistically significant association with HBV seropositivity. But, according the multivariate analysis, only length of employment in hemodialysis, quantity of individual protective equipment (IPEs) used and incomplete vaccination against HBV presented statistically significant association with HBV seropositivity. These results showed that dialysis units have been focused on reducing the occurrence of exposure to blood and body fluids. These strategies include reevaluating the kind of material used, demanding strict compliance for protection in risky occupational procedures, the use of gloves and other barriers and a follow-up with serological tests whenever there is a case of work-related injury with biological material, as well as mandatory vaccination after exposure. DOI: http://dx.doi.org/10.17525/vrrjournal.v14i1.22

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透析单位卫生保健工作者乙型肝炎感染的血清流行病学概况和危险因素

本研究的目的是确定透析单位卫生保健工作者中乙型肝炎血清学标志物的患病率和危险因素。对巴西累西腓市6个透析单位的138名卫生专业人员进行了一项分析性描述性横向研究。于2007年3 - 7月采集患者血样，采用第三代ELISA法检测HBsAg标志物(HBsAg、anti-HBs、total anti-HBc)。两种软件用于统计分析:用于单变量分析的Epi Info (v. 6.04)和用于多元逻辑回归的社会科学统计软件包- SPSS (v. 8.0)。通过检测HBsAg和/或总抗hbc标记物，透析人员中乙型肝炎感染的患病率为13%。抗体阳性率为75.4%。但易感染的占11.6%。在单变量分析中，血液透析工作时间长短、个人防护装备(IPEs)数量、手术和/或牙科手术经历以及不完全的HBV疫苗接种等变量与HBV血清阳性呈统计学显著相关。但是，根据多变量分析，只有血液透析工作时间、个人防护装备(IPEs)的使用数量和不完全的HBV疫苗接种与HBV血清阳性有统计学意义的关联。这些结果表明，透析单位一直致力于减少血液和体液暴露的发生。这些战略包括重新评估所使用材料的种类，要求在危险的职业程序中严格遵守保护规定，使用手套和其他屏障，在发生与生物材料有关的工伤病例时进行血清学检测，以及在接触后强制接种疫苗。DOI: http://dx.doi.org/10.17525/vrrjournal.v14i1.22

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Virus Reviews Research

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8 weeks