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Occupational Medicine Advance Access published online on June 18, 2008
Occupational Medicine, doi:10.1093/occmed/kqn071
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Hepatitis B in Moroccan health care workers

K. Djeriri1, H. Laurichesse2,3, J. L. Merle1, R. Charof4, A. Abouyoub5, L. Fontana1,3, N. Benchemsi5, E. Elharti5, R. El Aouad4, A. Chamoux1,3 and J. Beytout2,3

1 Service Santé-Travail-Environnement, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
2 Service des Maladies Infectieuses et Tropicales, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
3 Faculté de Médecine, Université Clermont 1, F-63003 Clermont-Ferrand, France
4 Institut National d'Hygiène, 27, avenue Ibn Batouta, Rabat, Maroc
5 Centre National de Transfusion Sanguine, 472, avenue Hassan II, Rabat, Maroc

Aim To evaluate knowledge and perception of hepatitis B, including prevention, among Moroccan health care workers (HCWs) and to estimate seroprevalence of hepatitis B and vaccine coverage (VC).

Methods Four hundred and twenty HCWs were randomly selected and stratified by site: 120 in Rabat, 140 in Taza and 160 in Témara–Skhirat. The study included an anonymous questionnaire about knowledge of hepatitis B and its prevention and a serological survey. Oral statements and vaccine registers were used to analyse the VC of the HCWs. Serological testing and VC were analysed according to the occupational exposure.

Results Participation rates in the questionnaire and serological tests were 68% (285/420) and 66% (276/420), respectively. Fifteen (5%) HCWs had a history of hepatitis B. All HCWs considered that hepatitis B virus (HBV) infection may be acquired through blood exposure. Vaccination was acknowledged as a necessary means against HBV transmission by 276 (98%) HCWs. Forty-two per cent HCWs had no HBV serological markers. The prevalence of hepatitis B surface antigen was 1%. The mean prevalence of hepatitis B core antibody (anti-HBc) was 28% and was significantly higher (P < 0.05) among nursing auxiliaries (57%), nurses (30%), medical physicians (31%) and midwives (25%) than among laboratory technicians (13%). According to the vaccination registers (available in two sites), VC (≥3 doses) was 55%. VC was 75% among midwives, 61% among nurses, 53% among nursing auxiliaries and 38% among medical staff. Of the fully vaccinated HCWs without anti-HBc, 51% had serological evidence of protection.

Conclusion HBV vaccines should be more readily available for Moroccan HCWs by reinforcing current vaccination programmes.

Keywords      Cross-sectional study; HBV seroprevalence; HBV vaccine coverage; health care workers; hepatitis B; intermediate endemicity; knowledge; Morocco—Rabat

Correspondence to: Khalid Djeriri, Service Santé-Travail-Environnement, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France. Tel: +33 4 7317 8260; fax: + 33 4 7327 4649; e-mail: kdjeriri{at}chu-clermontferrand.fr


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