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Original Articles
Seroepidemiology of Hepatitis A among Healthcare Workers and Their Response to Vaccination Recommendation at a Korean Hospital
Min Soo Kim, M.D.1, Eu Suk Kim, M.D.1,3, Yun Jung Chang, I.C.P.3, Hee Jin Huh, M.D.2, Seok Lae Chae, M.D.2 and Jin Ho Lee, M.D.1
Department of Internal Medicine1, and Laboratory Medicine2, Dongguk University College of Medicine, Infection Control Office3, Dongguk University Ilsan Hospital, Goyang, Korea
Vol.41 Num.5 (p272~278)
Background : Recently, the incidence of hepatitis A has increased in Korea and an outbreak among healthcare workers (HCWs) has also been reported. This study was performed to evaluate the seroepidemiology of hepatitis A among HCWs and their response to vaccination recommendation at a Korean hospital.
Materials and Methods :HCWs aged 20–39 years were tested for IgG antibodies against hepatitis A virus (HAV) using ARCHITECT HAVAb-IgG (Abbott Diagnostics Division, Wiesbaden, Germany) during July, 2008. Vaccination was recommended for the seronegative HCWs. Data on age, sex, place of birth, number of siblings, number of children, travel history to endemic areas, occupations, and vaccination history were collected. Statistical analyses were conducted to identify variables related to HAV seropositivity.
Results : Among a total of 391 HCWs enrolled, 75 (19%) were males and 316 (81%) were females. The percentages of HCWs aged 20 to 24 years, 25 to 29 years, 30 to 34 years, and 35 to 39 years were 23%, 48%, 17%, and 12%, respectively. The study population comprised of physicians (11%), nurses (62%), nurse aides (5%), paramedical technicians (13%), and administrative staff (9%). Seropositivity for HAV significantly increased with age (P<0.05):1.1% for 20–24, 8.6% for 25–29, 35.8% for 30–34, and 60.9% for 35–39 years-of-age. Multivariate analysis revealed that HAV seroprevalence correlated significantly with age, HCWs born in the non-metropolitan areas, and having ? 3 children (P<0.05). The types of work the HCWs do at the hospital were not significantly associated with HAV seropositivity in multivariate analyses. Of a total of 322 seronegative HCWs, 121 (38%) were not vaccinated in spite of recommendation. The reasons for non-compliance were lack of understanding on the necessity of vaccination (39%), lack of time (26%), expensive costs (16%), fear of injection (15%), and some other reasons including pregnancy (4%).
Conclusions : Since the seropositivity for HAV is low, vaccination against Hepatitis A should be considered for all HCWs aged 20-39 years in Korea. Education on the necessity of vaccination is warranted to increase compliance.
Keywords : Hepatitis A, Healthcare worker, Seroepidemiology, Vaccination