A Cross-sectional Study on Hepatitis B Immune Status among Vaccinated Healthcare Workers in Khartoum, Sudan


Background: Hepatitis B virus (HBV) infection can lead to chronic hepatitis, liver cirrhosis, and Hepatocellular Carcinoma (HCC). Vaccination against the virus plays an important role in its prevention. Health personnel at risk of infection are recommended to receive the vaccine and to check their immune status thereafter
Objective:   To determine Hepatitis B Immune status among vaccinated health personnel in Khartoum state, Sudan.
A total of 106 health personnel from different hospitals and doctors’
mess in Khartoum and from different jobs were surveyed and their HBV surface antibodies levels were determined by HBsAb (Quantitative) ELISA Kits.
Methods: Of the 106 participants in this study, the majority were females 72.6%. The mean age of those involved was 27.69 years, and nurses made for more than 50% of those surveyed. About 56.6% (60) of the health personnel involved took three or more doses of HBV vaccine while the rest received one or two doses. The results of the participants who received three or more doses of the vaccine represented immunity by 70%. In general, about 47.2% (50) of the participants in this study did show excellent immune response (> 100 mIU/mL) and 18.9% (20) had weak protective levels (between 10 and 100 mIU/mL)
So, we concluded that HBV post-vaccination immunity status of health personnel in Khartoum state is lower than post-vaccination HBV immunity in other parts of the world. There is an urgent need for a national protocol of HBV vaccination to improve the immunization status of health personnel with a regular checkup of HBV immunity and easy access to a good-quality vaccine.

Keywords: hepatitis B vaccines; healthcare workers; immune response

[1] Liang, T. J. (2009). Hepatitis B: the virus and disease. Hepatology, vol. 49, no. 5, pp. S13–S21.

[2] Ganem, D. and Prince, A. M. (2004). Hepatitis B virus infection--natural history and clinical consequences. N Engl J Med, vol. 350, no. 11, pp. 1118–1129.

[3] WHO. (2016). Hepatitis B. Fact Sheet.

[4] Mudawi, H. M. (2008). Epidemiology of viral hepatitis in Sudan. Clin Exp Gastroenterol, vol. 1, pp. 9–13.

[5] Hamadalnil, Y. and Bakheit, S. (2017). Hepatitis B virus _ surface gene mutations and their clinical implications. Sudan J Med Sci, vol. 12, no. 2, pp. 101–13.

[6] Nelson, N. P., Easterbrook, P. J., and McMahon, B. J. (2016). Epidemiology of hepatitis B virus infection and impact of vaccination on disease. Clin Liver Dis, vol. 20, no. 4, pp. 607–628.

[7] Bagheri-Jamebozorgi, M., Keshavarz, J., Nemati, M., Mohammadi-Hossainabad, S., Rezayati, M. T., Nejad-Ghaderi, M., et al. (2014). The persistence of anti-HBs antibody and anamnestic response 20 years after primary vaccination with recombinant hepatitis B vaccine at infancy. Hum Vaccin Immunother, vol. 10, no. 12, pp. 3731–3736.

[8] Yang, S., Tian, G., Cui, Y., et al. (2016). Factors influencing immunologic response to hepatitis B vaccine in adults. Sci Rep, vol. 6, p. 27251.

[9] Coppola, N., Onorato, L., Minichini, C., et al. (2015). Clinical significance of hepatitis B surface antigen mutants. World J Hepatol, vol. 7, no. 27, pp. 2729–2739.

[10] Pruss-Ustun, A., Rapiti, E., and Hutin, Y. (2005). Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. The Am J Ind Med, vol. 48, no. 6, pp. 482–490.

[11] Ayalew, M. B. and Horsa, B. A. (2017). Hepatitis B vaccination status among health care workers in a tertiary hospital in Ethiopia. Hepat Res Treat, vol. 2017, article ID 6470658.

[12] Akibu, M., Nurgi, S., Tadese, M., et al. (2018). Attitude and vaccination status of healthcare workers against hepatitis B infection in a teaching hospital, Ethiopia. Scientifica, vol. 2018, article ID 6705305.

[13] Kisangau, E. N., Awour, A., Juma, B., et al. (2018). Prevalence of hepatitis B virus infection and uptake of hepatitis B vaccine among healthcare workers, Makueni County, Kenya 2017. J Public Health (Oxf), vol. 41, no. 4, pp. 765–771.

[14] Ziglam, H., El-Hattab, M., Shingheer, N., et al. (2013). Hepatitis B vaccination status among healthcare workers in a tertiary care hospital in Tripoli, Libya. J Infect Public Health, vol. 6, no. 4, pp. 246–251.

[15] Ganczak, M. (2012). A cross-sectional study on anti-hepatitis B immune status in vaccinated healthcare workers in the West Pomeranian Region of Poland. Hepat Mon, vol. 12, no. 3, pp. 185–189.

[16] Lasemi, E., Haddadpour, N., Navi, F., et al. (2011). Rate of acquired immunity in dental students after hepatitis B vaccination. Dent Res J, vol. 8, no. 3, pp. 128–131.

[17] Abdel, A., Khamis, G., Jacoub, A. O., et al. (2014). Knowledge, attitudes and practices of surgical staff at Khartoum State hospitals towards Hepatitis B infection. Khartoum Med J, vol. 7, no. 1, pp. 932–940.