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Background: Healthcare workers (HCWs) are at increased risk of acquiring hepatitis B virus (HBV) infection through occupational exposure. In American Samoa hepatitis B prevalence is moderately high (~5%) further increasing the risk of transmission. Though vaccination against HBV is recommended for HCWs, there is no policy requiring vaccination thus hepatitis testing and vaccine utilization among American Samoan HCWs is unknown.
Objectives: To determine the awareness and prevalence of HBV infection, immunity and susceptibility among American Samoan HCWs.
Methods: A cross-sectional sero-epidemiological study was conducted at the island’s only hospital. Demographic, risk factor and self-reported HBV vaccination data were collected. Serum was tested for markers of HBV infection/immunity. Descriptive and univariate analyses were performed. Statistical significance of p≤.05 was assessed by Fisher’s exact test.
Results: Of 344 HCWs, 122 (35.5%) participated. The median age was 36.0 years [range=21-64 years], 84.2% were female, and average years involved in patient care was 11.2 years. Thirty-three percent (23/69) reported receiving hepatitis B vaccination and 55.9% (66/118) reported prior HBV testing. Fifty-eight respondents reported HBV testing and awareness of a subsequent result; 27 (46.6%) correctly classified their status. Serologic testing revealed 3 (2. 5%) chronically infected, 47 (38.5%) susceptible, and 72 (59.0 %) immune HCWs. There were no acute HBV infection cases. Chronically infected and susceptible HCWs did not differ by age (p=.57), gender (p=.41), ethnicity (p=.18), history of needle-stick injury (p=1.0), or length of patient-care involvement (p=1.0).
Conclusions: One third of HCWs knew their HBV infection status and about two-thirds had immunity leaving a significant proportion either not aware of their status or susceptible to infection. American Samoan HCWs should be tested and if susceptible, should be offered vaccination.