한 병원 의료종사자의 A형 간염 혈청역학과 예방접종
Seroepidemiology of Hepatitis A among Healthcare Workers and Their Response to Vaccination Recommendation at a Korean Hospital
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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.
Abstract
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.
참고문헌 (34)
- Cuthbert JA, "Hepatitis A: old and new", Clin Microbiol Rev, 14, pp.38~58 (2001)
- Brundage SC, , American Family Physician, 73, pp.2162~2168 (2006)
- Headler SC, "Hepatitis A in day-care centers. A community-wide assessment", N Eng J Med, 302, pp.1222~1227 (1980)
- Lednar WM, "Frequency of illness associated with epidemic hepatitis A virus infections in adults", Am J Epidemiol, 122, pp.226~233 (1985)
- Jeong SH, "Current status of acute viral hepatitis in Korea; epidemiology, clinical, virological characteristics, and effects of antiviral treatment in severe acute hepatitis B and C- intrim report", Korean J Hepatol, 13(4), pp.101~107 (2007)
- Van Damme P, "Viral hepatitis among health care workers - epidemiology and prevention", pp.1993, Ecomed, Landsberg
- Hofmann F, "Hepatitis A as an occupational hazard", Vaccine 10 Suppl, 1, pp.S82~84 (1992)
- Chodick G, "The risk of hepatitis A infection among health care workers: a review of reported outbreaks and sero-epidemiologic studies", J Hosp Infect, 62, pp.414~420 (2006)
- Lerman Y, "Occupations at increased risk of hepatitis A: a 2-year nationwide historical prospective study", Am J Epidemiol, 150, pp.312~320 (1999)
- Park JY, "Molecular characterization of an acute hepatitis A outbreak among healthcare workers at Korean hospital", J Hosp Infect, 67, pp.175~181 (2007)
- 송영봉, "한국인 건강검진자에서 연령 특이적 A형간염바이러스 항체 혈청 양성률대한간학회지 제 13 권 제 1 호 2007 ; 27-33", The Korean Journal of Hepatology, 13(1), pp.27~33 (2007), 대한간학회
- Feinstone SM, "Hepatitis A: epidemiology and prevention", Eur J Gastroenterol Hepatol, 8, pp.300~305 (1996)
- Shapiro CN, "Worldwide epidemiology of hepatitis A virus infection", J Hepatol 18 Suppl, 2, pp.S11~14 (1993)
- Steffen R, "Risk of hepatitis A in travellers", Vaccine 10 Suppl, 1, pp.S69~72 (1992)
- Corey L, "Sexual transmission of hepatitis A in homosexual men: incidence and mechanism", N Engl J Med, 302, pp.435~843 (1980)
- Holter E, "Hepatitis A in young Norwegian drug addicts and prison inmates", Infection, 16, pp.91~94 (1988)
- Bell BP, "The diverse patterns of hepatitis A epidemiology in the United States-implications for vaccination strategies", J Infect Dis, 178, pp.1579~1584 (1998)
- Kim CY, "Seroepidemiology of type A and type B hepatitis in Seoul area", Korean J Intern Med, 25, pp.19~27 (1982)
- Lee JI, "Epidemiologic study of antibody to hepatitis A antigen in Choong Chung area", Korean J Gastroenterol, 14, pp.87~91 (1982)
- Kim TW, "Antibody of hepatitis A antigen in children and adolescents in Korea", J Korean Pediatr Soc, 25, pp.36~40 (1982)
- Lee KY, "Seroepidemiology of hepatitis A in Taejon, Korea 1996", J Korean Pediatr Soc, 41, pp.53~61 (1998)
- Gelber SE, "Hospital-acquired viral pathogens in the neonatal intensive care unit", Semin Perinatol, 26, pp.346~356 (2002)
- Doebbeling BN, "An outbreak of hepatitis A among health care workers: risk factors for transmission", Am J Public Health, 83, pp.1679~1684 (1993)
- Gastmeier P, "How outbreaks can contribute to prevention of nosocomial infection: analysis of 1,022 outbreaks", Infect Control Hosp Epidemiol, 26, pp.357~361 (2005)
- Skidmore SJ, "An outbreak of hepatitis A on a hospital ward", J Med Virol, 17, pp.175~177 (1985)
- Chodick G, "Hepatitis A virus seropositivity among hospital and community healthcare workers in Israel-the role of occupation, demography and socioeconomic background", J Hosp Infect, 54, pp.135~140 (2003)
- Clemens R, "Clinical experience with an inactivated hepatitis A vaccine", J Infect Dis 171 Suppl, 1, pp.S44~S49 (1995)
- Ashur Y, "Comparison of immunogenicity of two hepatitis A vaccines-- VAQTA and HAVRIX--in young adults", Vaccine, 17, pp.2290~2296 (1999)
- McMahon BJ, "Immunogenicity of an inactivated hepatitis A vaccine in Alaska Native children and Native and non-Native adults", J Infect Dis, 171, pp.676~679 (1995)
- Van Damme P, "International Consensus Group on Hepatitis A Virus Immunity", Hepatitis A booster vaccination: is there a need? Lancet, 362, pp.1065~1071 (2003)
- Van Herck K, "Inactivated hepatitis A vaccine-induced antibodies: follow-up and estimates of long-term persistence", J Med Virol, 63, pp.1~7 (2001)
- Korean Society of Pediatrics, "Hepatitis A, Guidelines for vaccination", pp.P223~ (2002), Kwangmoon Co
- The Korean Society of Infectious Dise, "Vaccination for adult", pp.P46~ (2007), Koonja Publishing Co
- 김정수, "병원에서 사용된 백신양으로 평가한 예방접종 실태", Infection and Chemotherapy, 40(3), pp.154~161 (2008), 대한감염학회