Low compliance rate to hepatitis B vaccination and post-vaccination guidelines amidst high incidence of needlestick injuries among healthcare workers in Ashanti region, Ghana: a cross-sectional study

Hepatitis B virus (HBV) infection poses a major public health threat globally. Due to the likelihood of needlestick injuries (NSIs) and the nature of their work, healthcare workers (HCWs) stand a high risk of contracting HBV infection. It is therefore necessary for HCWs to complete HBV vaccination and confirm immunity by means of post-vaccination antibody testing to reduce their risk of acquiring HBV infection. This study sought to assess compliance with the hepatitis B post-vaccination testing (PVT) guidelines, awareness of PVT, the hepatitis B vaccination rate, and the prevalence of needlestick injuries (NSIs) among HCWs. A cross-sectional study involving 625 HCWs was carried out in four hospitals in Kumasi from November to December 2023. Demographic and other information related to hepatitis B vaccination, post-vaccination testing, and incidence of needlestick injuries were obtained through an investigator-administered questionnaire. Purposive sampling technique was employed. Data obtained were analyzed using IBM SPSS version 26.0 and GraphPad Prism 8.0. Descriptive statistics, chi-square tests for association, and logistic regression analysis were done to determine factors influencing compliance with hepatitis B vaccination and post-vaccination guidelines. Among the 625 participants, only 61.6% were fully vaccinated (≥ 3 shots). Among the fully vaccinated, only 15.2% had undergone hepatitis B post-vaccination testing. Vaccination status was significantly higher among participants aged 31–40 years (aOR = 3.37, 95% CI: 1.16–9.83), married participants (aOR = 2.31, 95% CI:1.12–4.76), laboratory scientists (aOR = 4.00, 95% CI: 1.69–9.46), nurses/midwives (aOR = 2.99, 95% CI: 1.63–5.49), and permanent staff (aOR = 2.03, 95% CI: 1.31–3.15). Needlestick injuries were reported by 34.9% of the participants, with clinicians (aOR = 8.97, 95% CI: 3.52–22.85) and permanent staff (aOR = 2.10, 95% CI: 1.37–3.24) being significantly more likely to experience NSIs. Only 25.4% of the participants reported knowing about the existence of PVT, with clinicians (aOR = 7.06, 95% CI: 2.33–21.41) and permanent staff (aOR = 2.71, 95% CI: 1.47–5.00) being significantly more knowledgeable of PVT. Permanent staff were also more likely to undergo PVT in comparison to non-permanent staff (aOR = 4.37, 95% CI: 1.31–14.54). The compliance rate with hepatitis B post-vaccination testing as well as complete vaccination coverage is low, coupled with a high incidence of needlestick injury. These findings highlight the vulnerability and susceptibility of HCWs to HBV infections. There is therefore an urgent need for regular training on HBV infection prevention among HCWs. Vaccination should also be provided at no cost to HCWs, and facility managers must ensure the completion of all doses. Post-vaccination testing should also be arranged after completion of the vaccine series.