SEROPREVALENCE AND PREVENTION OF HEPATITIS B, MEASLES AND RUBELLA AMONG HEALTHCARE WORKERS IN DILI, TIMOR-LESTE

Abstract

Intro: The World Health Organisation recommends that healthcare workers (HCWs) are immune to measles and rubella, and those at risk of blood exposure are offered hepatitis B vaccine. There have been no studies of vaccine- preventable disease (VPD) seroprevalence among HCWs in Timor-Leste and there is no formal program for occupational assessment or provision of vaccinations. Methods: A cross sectional study was undertaken to determine seroprevalence of hepatitis B, measles and rubella among HCWs in Dili, Timor-Leste. All patient- facing employees at three healthcare institutions during April-June 2021 were invited to participate. Epidemiological data was collected by interview- questionnaire and a serum sample was collected by phlebotomy and analysed at the National Health Laboratory. Participants were contacted to discuss results. Vaccines were provided to seronegative individuals and those with active hepatitis B infection were referred for further assessment and management in hepatology clinic. Findings: Three-hundred-and-twenty-four HCWs were included (representing 51.3% of all eligible HCWs registered as working at the three participating institutions). Sixteen (4.9%) had active hepatitis B infection, 121 (37.3%) had evidence of previous (cleared) hepatitis B infection, 134 (41.4%) were hepatitis B naïve, and 53 (16.4%) had been vaccinated. Two-hundred-and-sixty-seven (82.4%) and 306 (94.4%) individuals exhibited antibodies to measles and rubella, respectively. At the time of writing 97/134 (72.4%) of elligible participants had recieved one or more dose of hepatitis B vaccine and 36/57 (56.8%) of elligible participants had recieved one or more dose of measles- rubella vaccine. Conclusion: This study identified significant immunity gaps and a high burden of hepatitis B infection among HCWs in Dili Municipality, Timor-Leste. HCWs and patients may be at risk. Routine occupational assessment and targeted vaccination of this group would be beneficial. This study forms a template for a national guideline.