Hepatitis B Vaccination and Antibody Status of Healthcare Workers in Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan

Abstract Introduction: Globally, hepatitis B virus (HBV) is the major cause of hepatitis. Bhutan introduced HBV vaccine in 1997 and maintains high childhood vaccination coverage. HBV vaccine has an efficacy of 80%–100%. Methods: A descriptive cross-sectional study was carried out among healthcare workers (HCWs) in Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) to assess HBV vaccination and antibody status. Participants ( n = 440) were selected through a systematic random sampling method from the list of about 1200 HCWs. After obtaining written informed consent, study questionnaire was administered, blood was collected, serum separated and tested for antibody against hepatitis B (HB) surface antigen. Results: Of the 440 HCWs, 92% reported being vaccinated against HB but only 70.7% completed the full course. Females were more likely to opt for vaccination (Odds ratio [OR] 2.93, 95% confidence interval [CI] 1.39, 6.12, P = 0.005) but there was no sex difference in completing the full course (OR 1.28, 95% CI 0.8, 1.99, P = 0.27). Only 52.7% (232/440) had a detectable level (≥10 IU/mL) of protective antibody against HB. Among those vaccinated ( n = 406), 53.7% (217/406) were positive for antibody but 44.1% (15/34) of those unvaccinated also had protective antibodies. Only 68% of the participants have undertaken HBV testing and HBV positivity rate was 3.3%. An alarming 44.6% of the participants were accidentally exposed to needle stick injuries at work. Conclusions: This study revealed HBV vaccination gaps and high incidence of accidental needlestick injuries among HCWs in Bhutan’s National Referral Hospital. Relevant public health programs of the Ministry of Health must address this urgently as part of the HCWs work health safety program.