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      Assessment of knowledge, attitude, and practices toward prevention of hepatitis B infection among medical students in a high-risk setting of a newly established medical institution

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          Abstract

          BACKGROUND:

          India is in the intermediate hepatitis B virus endemicity zone with hepatitis B surface antigen prevalence among the general population ranges from 2% to 8%. Among health-care workers, seroprevalence is two to four times higher than that of the general population.

          AIM:

          The aim of the study was done to assess the knowledge, attitude, and practices (KAPs) of medical students regarding hepatitis B.

          MATERIALS AND METHODS:

          This is a cross-sectional study that was conducted from March to April 2018. Students were invited to the department on specified dates for awareness and immunization against hepatitis B. Their KAP was assessed with the help of a self-administered questionnaire.

          RESULTS:

          With a response rate of 81.3%, a total of 161 students participated in the study out of 198. Out of the 161 study participants, only 13 (8%) students had received a completed course of hepatitis B vaccination in the past, 30 (18.7%) students had a history of inability to complete the three doses of hepatitis B vaccination, and the rest 118 (73.3%) students were never immunized against hepatitis B. The knowledge about the risk of acquiring the disease at the hospital or high-risk setting was present in less than half of the students. The average knowledge score was 10.63 out of 16 and average healthy practice score was 2.94 out of 4. On applying Pearson correlation test, it was found that there was a positive correlation of knowledge and practices of the students ( P = 0.012), implying that better knowledge of the disease has a positive effect on the practices exercised by an individual.

          CONCLUSION:

          Newly enrolled students and other individuals attached to a high-risk setting such as a medical institution should be screened for immunization status during initial medical examination as the number of unimmunized persons, especially against hepatitis B is high.

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          Most cited references34

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          Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers.

          The global burden of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection due to percutaneous injuries among health care workers (HCWs) is estimated. The incidence of infections attributable to percutaneous injuries in 14 geographical regions on the basis of the probability of injury, the prevalence of infection, the susceptibility of the worker, and the percutaneous transmission potential are modeled. The model also provides the attributable fractions of infection in HCWs. Overall, 16,000 HCV, 66,000 HBV, and 1,000 HIV infections may have occurred in the year 2000 worldwide among HCWs due to their occupational exposure to percutaneous injuries. The fraction of infections with HCV, HBV, and HIV in HCWs attributable to occupational exposure to percutaneous injuries fraction reaches 39%, 37%, and 4.4% respectively. Occupational exposures to percutaneous injuries are substantial source of infections with bloodborne pathogens among health-care workers (HCWs). These infections are highly preventable and should be eliminated. 2005 Wiley-Liss, Inc.
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            Guidelines for infection control in dental health-care settings--2003.

            This report consolidates previous recommendations and adds new ones for infection control in dental settings. Recommendations are provided regarding 1) educating and protecting dental health-care personnel; 2) preventing transmission of bloodborne pathogens; 3) hand hygiene; 4) personal protective equipment; 5) contact dermatitis and latex hypersensitivity; 6) sterilization and disinfection of patient-care items; 7) environmental infection control; 8) dental unit waterlines, biofilm, and water quality; and 9) special considerations (e.g., dental handpieces and other devices, radiology, parenteral medications, oral surgical procedures, and dental laboratories). These recommendations were developed in collaboration with and after review by authorities on infection control from CDC and other public agencies, academia, and private and professional organizations.
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              Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis.

              (2001)
              This report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). Recommendations for HBV postexposure management include initiation of the hepatitis B vaccine series to any susceptible, unvaccinated person who sustains an occupational blood or body fluid exposure. Postexposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine series should be considered for occupational exposures after evaluation of the hepatitis B surface antigen status of the source and the vaccination and vaccine-response status of the exposed person. Guidance is provided to clinicians and exposed HCP for selecting the appropriate HBV PEP. Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) are not recommended for PEP of hepatitis C. For HCV postexposure management, the HCV status of the source and the exposed person should be determined, and for HCP exposed to an HCV positive source, follow-up HCV testing should be performed to determine if infection develops. Recommendations for HIV PEP include a basic 4-week regimen of two drugs (zidovudine [ZDV] and lamivudine [3TC]; 3TC and stavudine [d4T]; or didanosine [ddI] and d4T) for most HIV exposures and an expanded regimen that includes the addition of a third drug for HIV exposures that pose an increased risk for transmission. When the source person's virus is known or suspected to be resistant to one or more of the drugs considered for the PEP regimen, the selection of drugs to which the source person's virus is unlikely to be resistant is recommended. In addition, this report outlines several special circumstances (e.g., delayed exposure report, unknown source person, pregnancy in the exposed person, resistance of the source virus to antiretroviral agents, or toxicity of the PEP regimen) when consultation with local experts and/or the National Clinicians' Post-Exposure Prophylaxis Hotline ([PEPline] 1-888-448-4911) is advised. Occupational exposures should be considered urgent medical concerns to ensure timely postexposure management and administration of HBIG, hepatitis B vaccine, and/or HIV PEP.
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                Author and article information

                Journal
                J Lab Physicians
                J Lab Physicians
                JLP
                Journal of Laboratory Physicians
                Medknow Publications & Media Pvt Ltd (India )
                0974-2727
                0974-7826
                Oct-Dec 2018
                : 10
                : 4
                : 374-379
                Affiliations
                [1] Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India
                Author notes
                Address for correspondence: Dr. Vikas Kumar, Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi - 110 085, India. E-mail: drvikaspsm@ 123456gmail.com
                Article
                JLP-10-374
                10.4103/JLP.JLP_93_18
                6210846
                30498306
                c8d0a50e-c5db-4937-bc07-6356dd44bdf8
                Copyright: © 2018 Journal of Laboratory Physicians

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 12 July 2018
                : 24 September 2018
                Categories
                Original Article

                Clinical chemistry
                hepatitis screening,hepatitis b,high risk,knowledge,attitude,and practices,medical students

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