DETERMINANTS OF HEPATITIS B VACCINE UPTAKE AMONG MEDICAL STUDENTS OF KAMPALA INTERNATIONAL UNIVERSITY, WESTERN CAMPUS ISHAKA.

Table of Contents

DECLARATION ............................................................................................................................ ii

APPROVAL ..................................................................................................................................iii

ACKNOWLEDGEMENT............................................................................................................. iv

OPERATIONAL DEFINITIONS................................................................................................... v

LIST OF ABBREVIATIONS AND ACRONYMS ...................................................................... vi

LIST OF FIGURES ...................................................................................................................... vii

LIST OF TABLES.......................................................................................................................viii

CHAPTER ONE: INTRODUCTION............................................................................................. 1

1.0. BACKGROUND ................................................................................................................. 1

1.1. PROBLEM STATEMENT...................................................................................................... 2

1.0. STUDY OBJECTIVES........................................................................................................ 3

1.0.1. BROAD OBJECTIVE...................................................................................................... 3

1.3.2. SPECIFIC OBJECTIVES..................................................................................................... 3

1.4. RESEARCH QUESTIONS ..................................................................................................... 3

1.5. SIGNIFICANCE OF THE STUDY..................................................................................... 4

1.6. STUDY SCOPE................................................................................................................... 4

1.6.1. GEOGRAPHICAL SCOPE.................................................................................................. 4

1.6.2. CONTENT SCOPE .............................................................................................................. 5

1.6.3. TIME SCOPE ....................................................................................................................... 5

1.7. CONCEPTUAL FRAMEWORK ........................................................................................ 5

CHAPTER TWO: LITERATURE REVIEW................................................................................. 7

2.0. INTRODUCTION ................................................................................................................... 7

2.1. KNOWLEDGE OF MEDICAL STUDENTS ABOUT HEPATITIS B VIRUS..................... 7

2.2. DEGREE OF UPTAKE OF HEPATITIS B VACCINE AMONG MEDICAL STUDENTS 8

2.3. ATTITUDES AND DETERMINANTS OF HEPATITIS B VACCINE UPTAKE AMONG MEDICAL STUDENTS............................................................. 9

CHAPTER THREE: METHODOLOGY ..................................................................................... 11

3.0. INTRODUCTION ............................................................................................................. 11

3.1. STUDY DESIGN................................................................................................................... 11

3.2. STUDY POPULATION........................................................................................................ 11

3.2.1. INCLUSION CRITERIA.................................................................................................... 11

3.2.2. EXCLUSION CRITERIA .................................................................................................. 11

3.3. SAMPLE SIZE DETERMINATION .................................................................................... 11

3.4. SAMPLING TECHNIQUE ................................................................................................... 11

3.5. DATA COLLECTION METHOD ........................................................................................ 12

3.6. DATA COLLECTION TOOLS AND PROCEDURE.......................................................... 12

3.7. QUALITY CONTROL.......................................................................................................... 12

3.8. DATA ANALYSIS................................................................................................................ 12

3.9. ETHICAL CONSIDERATIONS........................................................................................... 12

CHAPTER FOUR: DATA ANALYSIS AND PRESENTATION .............................................. 13

4.0. INTRODUCTION ............................................................................................................. 13

4.1. DEMOGRAPHIC DATA ...................................................................................................... 13

4.1.1. Age...................................................................................................................................... 13

4.1.2. Sex....................................................................................................................................... 13

4.1.3. Religion............................................................................................................................... 14

4.1.4. Nationalities........................................................................................................................ 14

4.1.5. Class / Series....................................................................................................................... 15

4.2. FACTORS THAT CAN INFLUENCE VACCINE ADHERENCE / COMPLIANCE........ 15

4.2.1. Knowledge on Hepatitis B and Vaccination....................................................................... 15

4.2.2. Knowledge on Possible Modes of Transmission................................................................ 16

4.2.3. Knowledge on General Prevention of Hepatitis B transmission ........................................ 16

4.2.4. What one is supposed to do if accidentally exposed while in clinical rotations................. 17

4.2.5. Measures one can take to protect themselves against Hepatitis B exposure and infection while in the clinical setup ................................. 18

4.2.6. Knowledge on Curability of Hepatitis B ............................................................................ 18

4.2.7. Knowledge on Complications of Hepatitis B ..................................................................... 19

4.3. ATTITUDES AND DETERMINANTS OF HEPATITIS B VACCINE UPTAKE ............. 19

4.3.1. Age & awareness of vaccine existence............................................................................... 19

4.3.2. Sex & awareness of vaccine existence................................................................................ 19

4.3.3. Religion & awareness of vaccine existence........................................................................ 20

4.3.4. Class / series & awareness of vaccine existence................................................................. 20

4.3.5. Is there need for vaccination, as a medical student, against Hepatitis B? .......................... 20

4.3.6. Hepatitis B vaccine uptake.................................................................................................. 21

CHAPTER FIVE: DISCUSSIONS, CONCLUSIONS AND RECOMMENDATIONS ............. 23

5.0. INTRODUCTION ............................................................................................................. 23

5.1. DISCUSSION OF FINDINGS .............................................................................................. 23

5.1.1. KNOWLEDGE ON HEPATITIS B AND HEPATITIS B VACCINATION.................... 23

5.1.2. ATTITUDES, PRACTICE & FACTORS ASSOCIATED WITH HEPATITIS B VACCINE UPTAKE.............................................................. 25

5.2. CONCLUSIONS.................................................................................................................... 25

5.3. RECOMMENDATIONS....................................................................................................... 26

REFERENCES ............................................................................................................................. 28

APPENDICES .............................................................................................................................. 33

APPENDIX ONE: CONSENT FORM......................................................................................... 33

APPENDIX TWO: DATA COLLECTION TOOL...................................................................... 34

APPENDIX THREE: MAP OF UGANDA SHOWING LOCATION OF BUSHENYI

DISTRUICT (RED STAR)........................................................................................................... 38

APPENDIX FOUR (a): POLITICAL MAP OF BUSHENYI DISTRICT................................... 39

APPENDIX FOUR (b): TOPOGRAPHICAL MAP OF BUSHENYI (RED STAR) WITH ITS NEIGHBOURS.......................................................... 40

APPENDIX FIVE: MAP OF ISHAKA IN BUSHENYI DISTRICT .......................................... 40

APPENDIX SIX: GLOBAL HEPATITIS B DISTRIBUTION, CDC 2014................................ 41

APPENDIX SEVEN: APPROVAL LETTER FROM IREC, KIU-WC ...................................... 42

ABSTRACT 

Hepatitis B, though a preventable and vaccinable infection, has remained a global public health problem with significant morbidity and mortality. HBV is a notifiable infection transmissible through close contact with tissue and body fluids of an infected person. Among those at risk of infection, and reservoirs of spread, are health care workers (medical students included), who through their daily activities, interact with quite a large number of patients, some of whom might be infected. Given the importance of HBV as a deadly, non-curable but easily preventable disease, the government of Uganda directed that all health professionals and those involved in the care of patients, be vaccinated against the condition. KIU-WC is among the health institutions that took up this directive and started vaccinating its staff and students against the virus (at a fee of course). Vaccine take up, especially among the students, did not take of as expected with so many determinants as to why this was so. A descriptive, cross-sectional study, that involved 328 KIUWC medical students aimed to assess the uptake and determinants of Hepatitis B vaccine uptake was conducted and it was found that despite impressive knowledge and good attitudes, vaccine uptake was low (25%), with chief barriers being expensive, inaccessible vaccine that was feared to have side effects.

Key words: Hepatitis B, Vaccine, Uptake, Determinants