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Hepatitis B vaccination coverage and associated factors among nurses working at health centers in Addis Ababa, Ethiopia: a cross-sectional study

BMC Nursing volume 23, Article number: 600 (2024) Cite this article

Abstract

Background

Hepatitis B virus (HBV) poses one of the most serious workplace health risks facing healthcare workers, especially nurses, due to occupational exposure. The HBV vaccination coverage among healthcare workers in Ethiopia ranged from 5.4 to 21.9%. However, little is known about HBV vaccination coverage and associated factors among nurses in Ethiopia. Therefore, the aim of this study was to assess HBV vaccination coverage and associated factors among nurses working in health centers in Addis Ababa, Ethiopia, in 2023.

Methods

An institutional-based cross-sectional study was conducted from March 2 to March 31, 2023, among 428 nurses working in 32 health centers in Addis Ababa, Ethiopia. Data were entered into Epi-Info version 7.2.5.0 and then exported to SPSS version 27 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize the data on the study variables. Bivariate and multivariate logistic regression analyses were conducted to determine the strength of the association, and the statistical significance of associations between the variables was determined using adjusted odds ratio with a 95% CI and p values < 0.05.

Results

HBV-full vaccination coverage among 428 nurses in health centers in Addis Ababa, Ethiopia, was 36.9%. Male nurses [AOR = 1.78, 95% CI: 1.08, 2.95], taking training on infection prevention [AOR = 1.73, 95% CI: 1.08, 2.78], having good knowledge about HBV vaccine [AOR = 1.98, 95% CI: 1.28, 3.04], and testing for HBV [AOR = 1.98, 95% CI: 1.08, 3.64] were more likely to have HBV full vaccination coverage, whereas monthly salary ≤ 7,071 Ethiopian Birr was 54% less likely to have HBV full vaccination coverage [AOR = 0.46, 95% CI: 0.25, 0.85] at p-value < 0.05.

Conclusion

This study revealed that the full HBV vaccination coverage of nurses working in health centers in Addis Ababa, Ethiopia, was low (36.9%), and consequently, the majority of nurses are at a high risk of being infected with HBV. Therefore, the Ministry of Health and health centers should promote awareness, implement prevention programs, provide diagnostic, treatment, and care services, enhance information generation and utilization, and strengthen the health system to increase vaccination coverage among nurses.

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Background

Hepatitis B virus (HBV) is a viral infection that causes HBV disease, which infects the liver and can lead to chronic liver diseases like cirrhosis and hepatocellular carcinoma [1]. HBV is a major public health problem worldwide [2]. The World Health Organization’s (WHO) global hepatitis report for 2024 shows that viral hepatitis caused 1.3 million deaths in 2022, and hepatitis B caused 83% of these deaths. This report also stated that globally, an estimated 254 million people were living with HBV, and the WHO African Region accounts for 63% of new HBV infections, and the Western Pacific Region accounts for 47% of hepatitis B deaths [3]. In Ethiopia, the prevalence of HBV among the general population was 7.4% [4]. In eastern Ethiopia, the prevalence of HBV among healthcare workers (HCWs) is 9.6% [5].

Globally, HBV is one of the three most serious workplace health risks facing HCWs [6]. The incidence of HBV illness among HCWs is estimated to be two to four times higher than levels in the general population [7]. HCWs are exposed to blood-borne pathogens and other bodily fluids like saliva, menses, vaginal, and seminal fluids during their usual medical procedures [3, 6]. Exposure may be the result of a needle stick injury, contamination with the blood of an infected patient, splashing of blood or other bodily fluids into the eyes, nose, or mouth, or blood contact with broken skin [8]. HBV is more infectious than other bloodborne infections following percutaneous contact; a single needle stick injury poses a 30% risk of HBV infection, which is much higher compared to the hepatitis C virus (3%) and the human immunodeficiency virus (HIV) (0.3%) [9].

The risk of HBV infection is most closely related to the frequency of exposure or the amount of direct contact with individual blood and body fluids [10]. Nurses had higher exposure rates than other HCWs, for the reason that nurses participate in a larger variety of activities (caregiving) than other health care workers, and nurses routinely come into contact with patients’ blood and possibly contagious bodily fluids while doing their tasks (caregiving) [11].

Despite the fact that there are numerous HBV prevention methods, the HBV vaccine is the cornerstone of HBV prevention [12, 13]. The hepatitis B vaccine is a plasma-derived hepatitis B vaccine that has been commercially available since 1982 [1]. It is a three-dose vaccine series (0, 1, and 6 months) administered intramuscularly into deltoid muscle that produces a protective antibody response [14]. According to the CDC, the three-dose vaccine series has an approximate protection rate of 30–55% after the first dose, 75% after the second dose, and > 90% after the third dose in individuals aged < 40 years [15, 16].

The CDC recommends that all health care professionals get a three-dose vaccine series to effectively protect themselves against HBV infection [15, 16]. However, studies conducted in different areas of the world show that the HBV vaccination coverage rates of HCWs range from 10.5 to 96% [17,18,19,20,21,22]. In Ethiopia, the proportion of HBV vaccination coverage among HCWs ranges from 5.4 to 21.9% [23,24,25]. In Addis Ababa, Ethiopia, 24.6% of nurses working in public hospitals had HBV vaccination coverage [26].

A multitude of factors may affect hepatitis B vaccination coverage among nurses. These include socio-demographic factors such as age, sex, marital status, educational status, monthly salary, year of service, and work unit/ward [17, 18, 26,27,28,29,30,31,32]; personal or behavioral factors such as fear of vaccine side effects, negligence, history of HBsAg test/screening, and cost/inability to afford [9, 23, 28, 31, 33,34,35]; knowledge about HBV infection and vaccine [9]; and health service factors such as training on infection prevention, history of occupational exposure, workload (lack of time) and unavailability of vaccine [19, 26, 36,37,38].

Ethiopia’s strategic plan aims to achieve global viral hepatitis elimination targets by 2030 through five main strategies: advocacy, communication, social mobilization, viral hepatitis prevention programs, access to diagnostic, treatment, and care services, strengthening strategic information generation and utilization, and strengthening the health system for effective viral hepatitis programs [39]. The implications of having these strategic plans and policies on the HBV vaccine are to significantly increase vaccination coverage, improve access, use data-driven strategies, and strengthen the health system. However, there have been a few studies conducted in Ethiopia showing that healthcare workers, especially nurses, are at greater risk for HBV infection [23, 26, 31].

Despite the fact that nurses had a higher exposure rate than other HCWs, very little research has been conducted to evaluate the HBV vaccination coverage, with the exception of two studies: one on HBV vaccination coverage among nurses working in public hospitals six years before [26] and another among HCWs working in health centers located in only one locality of Addis Ababa, Ethiopia [31]. Additionally, nurses who work in health centers are at high risk for HBV infection, and increasing HBV vaccination coverage among nurses could provide both direct and indirect community protection [40]. Therefore, the aim of this study was to assess hepatitis B vaccination coverage and associated factors among nurses working in health centers in Addis Ababa, Ethiopia, in 2023.

Methods and materials

Study design, area and period

This institutional-based cross-sectional study was conducted from March 2 to March 31, 2023, in 32 selected health centers from 107 government health centers located in Addis Ababa, Ethiopia, using a simple random sampling technique.

Inclusion and exclusion criteria

All nurses working in health centers in Addis Ababa who were willing to participate in the study were included in the study. Nurses working in health centers in Addis Ababa who were on maternity leave, annual leave, and sick leave at the time of data collection were excluded from the study.

Sample size and sampling procedure

The sample size of this study was determined using a single population proportion formula based on the assumptions of 24.6% population proportion taken from the study done in Addis Ababa, Ethiopia [26], a 95% confidence level, and a 5% margin of error. The final sample size (N) was 471 by adding 10% of the non-response rate and considering the design effect of 1.5. In Addis Ababa, there are 107 government health centers distributed throughout 11 sub-cities, and 32 health centers were selected using the simple random sampling (SRS) technique. The sample size (N) was proportionally allocated to each health center depending on the population size in each health center (N). Each nurse was finally selected using a lottery method after obtaining the list of nurses working in the selected health centers from the administrative records of each health center. Out of 471, 428 nurses, with a 90.87% response rate, were consented to and recruited for the study.

Study variables

Dependent variable

The dependent variable was hepatitis B vaccination coverage.

Independent variables

The independent variables included socio-demographic factors (age, sex, marital status, educational status, monthly salary, year of service, work unit/ward), personal or behavioral factors (fear of vaccine side effect, negligence, history of HBsAg test/screening, cost/inability to afford), knowledge about HBV infection and vaccine, and health service factors (training on infection prevention, history of occupational exposure, workload (lack of time), unavailability of vaccine).

Data collection instruments and procedures

Data were collected using a structured self-administered English version questionnaire. A pre-test was done on 5% of the study population (24 nurses) before the actual data collection at Kolfe Keranio woreda 06 health centers in Addis Ababa, Ethiopia. Based on the findings of the pre-test, modifications to the questionnaire were made. The questionnaire consisted of five parts. Part 1: socio-demographic characteristics (7 items); part 2: occupational exposure (5 items); part 3: knowledge about HBV (20 items) [25]; part 4: knowledge of HBV vaccine (13 items) [26]; and part 5: HBV screening and vaccination coverage (13 items) [26]. Training was provided to the study team, data collectors, and supervisors by the principal investigator to make them familiar with the data collection tool. The completeness of the questionnaires was checked daily by supervisors, and they were handed over to the principal investigator on the day of data collection. The completeness of the questionnaires was checked daily by supervisors, and they were handed over to the principal investigator on the day of data collection.

Data collection procedure and data quality management

A knowledge-about-hepatitis B infection questionnaire was used to measure the knowledge of nurses about hepatitis B infection. This tool consists of three parts: the first part is general knowledge about hepatitis B infection (3 questions), the second part is knowledge about the route of transmission of hepatitis B infection (11 questions), and the third part is knowledge about ways of preventing hepatitis B infection (6 questions). A total of 20 questions were used to assess a nurse’s knowledge about hepatitis B infection with a choice of ‘yes’, ‘no’, and ‘I don’t know.’ For each correct answer, 1 point is given, and 0 is given for incorrect answers and “I don’t know” responses. The score range is 0–20 [25]. The tool’s Cronbach’s alpha value (α) in this study was 0.79, which indicates a good level of reliability.

A knowledge of hepatitis B vaccine questionnaire was used to measure the knowledge of nurses about the HBV vaccine. A tool consists of 13 questions used to assess a nurse’s knowledge about the HBV vaccine, with 12 questions that have a choice of ‘yes’, ‘no’, and ‘I don’t know’ and 1 question about the number of hepatitis vaccination doses available with four options (1 dose, 2 dose, 3 dose, 4 dose). For each correct answer, 1 point is given, and 0 is given for incorrect answers, and I don’t know the responses. The score range was 0–13 [26].

Data analysis and processing

The collected data were coded, cleaned, and entered into Epi-Info version 7.2.5.0 and then exported to SPSS version 27 for analysis. Descriptive statistics were used to calculate the frequencies, percentage, mean, and standard deviation of independent and dependent variables. Hepatitis B vaccination coverage was assessed depending on the hepatitis B vaccine doses they received, and it was categorized into fully vaccinated and not fully vaccinated. Fully vaccinated were those nurses who received three or more doses of the hepatitis B vaccine. Not fully vaccinated were those nurses who were partially vaccinated by having received 1 or 2 dose and never received any dose of the hepatitis B vaccine [9, 25]. In preparation for logistic regression analysis, the knowledge-about-hepatitis B infection is dichotomized by the mean value, with scores above the mean indicating having good knowledge of the hepatitis B infection. The knowledge of the hepatitis B vaccine is dichotomized by the mean value, with scores above the mean indicating having good knowledge of the hepatitis B vaccine. A binary logistic regression analysis model was used to identify factors associated with HBV vaccination coverage. Those variables with a p-value ≤ 0.200 in the bivariate logistic regression were entered into a multivariable logistic regression analysis. A multivariable logistic regression model was used to identify the association between independent variables and HBV vaccination coverage. In multivariable logistic regression analysis, the statistical significance of associations between independent variables and HBV vaccination coverage was determined using odds ratios with a 95% confidence interval. The model fitness of logistic regression analysis was checked by the Hosmer-Lemeshow Test (X2 = 10.14, p-value = 0.255).

Results

Socio-demographic characteristics of nurses

Out of 471 nurses, 428 participated in the study, with a response rate of 90.87%. The majority of the nurses, 335 (78.3%) were female, and 254 (59.3%) were ≤ 30 years of age, with a median age of 30 (IQR = 7) years. More than half of nurses, 252 (58.9%), were married, and the majority of nurses, 308 (72.0%), had an educational status of bachelor’s degree. More than half of nurses, 245 (57.2%) had work experience of ≤ 7.86 years, and 269 (62.9%) had a monthly salary of ≤ 7,071 Ethiopian Birr (ETB). The majority of nurses, 314 (73.4%), were working in the outpatient department (Table 1).

Table 1 Socio-demographic characteristics of nurses in health centers in Addis Ababa, Ethiopia, 2023 (N = 428)
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History of occupational exposure to conditions that predispose nurses to HBV infection and training on infection prevention (N = 428)

Almost half of the nurses (n = 216, or 50.5%) had a history of exposure to blood or body fluids on intact skin. The vast majority of them (n = 346, 80.8%) did not have the history of splashing blood or body fluids into the eye or mouth in the past 12 months; and had not experienced splashing blood on cuts or unprotected skin (n = 375; 87.6%). The majority of the nurses (n = 292, 68.2%) had taken training on infection prevention; among whom, more than half (n = 159, 54.5%) had taken training on infection prevention once (Table 2).

Table 2 History of occupational exposure to conditions that predispose nurses to HBV infection and training on infection prevention in health centers in Addis Ababa, Ethiopia, 2023 (N = 428)
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Knowledge of nurses about HBV infection and vaccine (N = 428)

As indicated in Fig. 1, slightly more than half of the nurses (n = 244, 57.0%) had good knowledge of hepatitis B infection with a mean score of 14.76 (SD = 2.19) and good knowledge about the hepatitis B vaccine (n = 238, 55.6%), with a mean score of 7.64 (SD = 1.66).

Fig. 1
figure 1

Knowledge of nurses about HBV infection and vaccine in health centers in Addis Ababa, Ethiopia, 2023 (N = 428)

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Hepatitis B screening of nurses (N = 428)

The majority of nurses (n = 343; 80.1%) had tested for hepatitis B virus; out of whom 168 (49.0%) had tested for HBV 3 years earlier, and almost all of them (n = 338; 98.5%) reported that the result of their test for HBV was negative. Out of those nurses who had not tested for the HBV (n = 85, 19.9%), the most commonly reported reason was negligence (n = 50, 50.5%) and the unavailability of a diagnosis (n = 21, 21.2%) (Table 3).

Table 3 Screening of nurses in health centers in Addis Ababa, Ethiopia, 2023 (n = 428)
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Hepatitis B vaccination coverage of nurses

The majority of the nurses (n = 311, 72.7%) had vaccinated against HBV; and out of these, about half (n = 158, 50.8%) had received three or more doses of the vaccine. Among the nurses who had been vaccinated against HBV, about half of them (n = 154, 49.5%) did not complete the vaccination within the appropriate schedule, and the majority it to the unavailability of the vaccine (n = 127, 83.0%), the cost of the vaccine (n = 66, 43.1%), and being unaware of the correct schedule of the vaccine (n = 40, 26.1%).

Concerning the nurses who had received three or more doses (n = 158, 50.8%) of HBV vaccine, 69 (43.7%) of them had checked after vaccination for the establishment of hepatitis B antibodies, and almost all of them (n = 67, 97.1%) reported negative test results. With regard to the nurses who had received three or more doses (n = 158, 50.8%) of the HBV vaccine, the majority of them (n = 134, 84.8%) had been vaccinated for free. On the other hand, among those who had not received the vaccine for free, the majority (n = 19, 79.2%) claimed it was expensive. As for the nurses who had not been vaccinated against HBV (n = 117, 27.3%), the majority stated that unavailability of the vaccine through government channels (n = 107, 91.5%) and the high cost of the vaccine (n = 82, 70.1%) were the main reasons. The nurses who had received full vaccination against were 158 (36.9%) of all the respondents (Table 4).

Table 4 Hepatitis B vaccine coverage of nurses in health centers in Addis Ababa, Ethiopia, 2023 (N = 428)
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Factors associated with the hepatitis B vaccination coverage of nurses

In bivariate logistic regression analysis, covariates including sex, age, work experience, monthly salary, history of splashing blood on cut or unprotected skin, training on infection prevention, knowledge about HBV infection, knowledge about HBV vaccine, and HBV screening were associated with nurses HBV vaccination coverage. In multivariable logistic regression analysis, sex, monthly salary, training on infection prevention, knowledge about the HBV vaccine, and HBV screening were significantly associated with the nurses HBV vaccination coverage at a 95% confidence level.

Male nurses were 1.78 times more likely to be fully vaccinated as compared to female nurses [AOR = 1.78, 95% CI: 1.08, 2.95]. The nurses who had a monthly salary ≤ 7,071 ETB were 54% less likely to be fully vaccinated compared to those who had a monthly salary > 7,071 ETB [AOR = 0.46, 95% CI: 0.25, 0.85]. Those who had taken training on infection prevention were 1.73 times as likely to be fully vaccinated as their counterparts [AOR = 1.73, 95% CI: 1.08, 2.78]. The nurses who had good knowledge about the hepatitis B vaccine were 1.98 times more likely to be fully vaccinated than those who had poor knowledge about the vaccine [AOR = 1.98, 95% CI: 1.28, 3.04]. The ones who had tested for HBV were 1.98 times more likely to be fully vaccinated compared to those who had not tested for HBV [AOR = 1.98, 95% CI: 1.08, 3.64] (Table 5).

Table 5 Factors associated with hepatitis B vaccination coverage among nurses in health centers in Addis Ababa, Ethiopia, 2023 (N = 428)
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Discussion

This study explored the hepatitis B vaccination coverage and associated factors among nurses in health centers in Addis Ababa, Ethiopia. HBV full vaccination coverage among health center nurses in Addis Ababa, Ethiopia, was 36.9%. Factors positively associated with HBV full vaccination coverage were male sex, having training on infection prevention, having good knowledge about the HBV vaccine, and having HBV screening, whereas lower monthly income was negatively associated with HBV full vaccination coverage.

This finding shows that the full HBV vaccination coverage among nurses in health centers in Addis Ababa was low (36.9%) in accord with the WHO estimation of the HBV vaccination rates of HCWs in low-income countries (18–39%) [3]. Consequently, the majority of HCW’s are at a high risk of being infected with HBV. Therefore, the government should make more available the HBV vaccine through government channels and provide the vaccine free of charge to all nurses working in the health centers of Addis Ababa to increase HBV vaccination coverage in this population.

The 36.9% of full HBV vaccination coverage among the nurses in this study was higher than that in a study conducted in Ethiopia in Bahir Dar (5.4%), Hawassa (21.9%), Shashamane (12.9%), Addis Ababa (8.8%) [23,24,25,26], and other countries such as Tanzania (33.6%) and Zambia (10.5%) [20, 41]. The variation in HBV vaccination coverage in Ethiopia may be related to the study period and differences in the population. With the exception of the study in Hawassa, all of these studies had been conducted five years before. Thus, the subsequent increase in the vaccination coverage may be attributed to the widespread global efforts in recent years to raise nurses’ awareness of the benefits of HBV testing and vaccination. Moreover, most of the studies conducted in Ethiopia on HBV vaccination coverage were conducted among health care workers, while the present study was carried out among the nurses only. In the case of Tanzania and Zambia, the differences could be due to different health systems, socioeconomic differences, and the availability and accessibility of HBV vaccines. Therefore, a study on HBV vaccination coverage among nurses in different parts of the country and at different levels of health facilities is recommended. However, the 36.9% full vaccination coverage was lower than that of a study done in other countries like the USA (63.4%), China (60%), Serbia (81.1%), India (38.8%), and Rwanda (96%) [17,18,19, 21, 27]. The discrepancy could be due to the difference in the health care systems, socioeconomic differences, the availability of the HBV vaccine, the focus given to the prevention of HBV infections by the government, and the difference in the study population; most of the studies mentioned were conducted on HCWs in contrast to this study, which was conducted only on nurses.

Furthermore, it was revealed that male nurses were more likely to be fully vaccinated as compared to female nurses. This finding is similar to a study done in Serbia [27] but different from a study conducted in Pakistan that showed that females had higher odds of complete HBV vaccination compared to males [29]. Although it is difficult to pinpoint the exact causes of the variation, the variation may be due to a difference in sample size, and the study population. The study done in Pakistan was among HCWs while this study was among the nurses. Therefore, female nurses need special emphasis when designing interventions aimed at improving HBV vaccination coverage for nurses.

This study showed that nurses who had a lower monthly salary (≤ 7,071 ETB) were less likely to be fully vaccinated compared to those who had a higher monthly salary (> 7,071 ETB). This finding is supported by a study conducted at Akaki Kaliti Health Center, Ethiopia, among HCWs [31]. The reason for this might be the cost of the HBV vaccine, as government health facilities do not offer the HBV vaccination for free. Therefore, nurses with lower monthly salaries need special emphasis when designing and implementing interventions aimed at increasing the HBV vaccination coverage of this population group. This may involve the provision of the HBV vaccination for free through government channels.

Our study shows that nurses who took training on infection prevention were more likely to be fully vaccinated compared to their counterparts. This finding is supported by a study done at Adama General Hospital and Medical College, Ethiopia [38]. This might be related to the fact that providing nurses with basic infection prevention training may help increase their knowledge and perceptions of the value of such preventative measures. Therefore, to enhance the coverage of HBV vaccinations among nurses, the Ministry of Health and health centers should implement viral hepatitis prevention programs as part of the strategic plan of the Ministry of Health Ethiopia and provide infection prevention training interventions to nurses who are not taking the training [39].

In this study, another modifiable factor associated with HBV full vaccination coverage was knowledge about the HBV vaccine. Those nurses who had good knowledge about the HBV vaccine were more likely to be fully vaccinated compared to nurses who had poor knowledge about the HBV vaccine. This finding is similar to a study done among HCWs in Wolayita Sodo hospitals, Ethiopia [9]. This might be related to the fact that nurses who had knowledge about HBV vaccines were more inclined to use vaccines because they were more aware of the safety and effectiveness of the vaccines. Thus, to increase the rate of HBV vaccination for nurses, the Ministry of Health and health centers should offer advocacy, communication, and social mobilization in accordance with Ethiopia’s national strategy plan for the prevention and control of viral hepatitis, 2021–2025 [39].

This study also shows that nurses who had tested for the HBV were more likely to be fully vaccinated compared to those who had not tested for the hepatitis B virus. This finding is supported by a study conducted in Cameroon [37]. This might be related to the fact that those nurses who had tests for the HBV were well-informed about the vaccine’s significance during HBV screening, which increased their knowledge and perception of the vaccine. Therefore, the Ministry of Health should encourage screening and provide viral hepatitis rapid testing in all health centers for nurses according to the access to diagnostic, treatment, and care services strategic plan of 2021–2025 [39] to increase HBV vaccination coverage for this population group.

Limitations of the study

This study has a couple of limitations. First, the use of cross-sectional design does not allow inferring causality. Prospective and experimental studies are warranted. Second, the study did not include nurses who were working in private health facilities. Third, there is a lack of comparative studies because most of the studies done in Ethiopia were among HCWs. A study on HBV vaccination coverage among nurses in different parts of the country and different levels of health facilities is recommended. Fourth, HBV vaccination coverage was assessed based on self-reported rather than HBsAg status, which could bring certain biases to the study outcome. Assessment of HBV vaccination coverage with HBsAg status is warranted.

Conclusion

This study revealed that 36.9% of nurses working in health centers in Addis Ababa, Ethiopia, had full HBV vaccination status. Factors associated with the full vaccination coverage of nurses were sex, monthly salary, training on infection prevention, knowledge about the HBV vaccine, and HBV screening. Therefore, the Ministry of Health and health centers should provide the HBV vaccine free of charge, especially to female and lower-salary nurses, and offer infection prevention training, advocacy, communication, and social mobilization. They should also encourage screening and rapid testing for viral hepatitis in all health centers to increase HBV vaccination coverage among nurses.

Data availability

Datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AOR:

Adjusted Odd Ratio

BSc:

Bachelor of Science

CDC:

Centers for Disease Control and Prevention

CI:

Confidence Interval

COR:

Crude Odd Ratio

ETB:

Ethiopian Birr

HBsAg:

Hepatitis B surface antigen

HB:

Hepatitis B

HBV:

Hepatitis B virus

HC:

Health center

HCWs:

Health care workers

HIV:

Human immunodeficiency virus

IRB:

Institutional review board

SD:

Standard Deviation

SPSS:

Statistical Package for Social Science

SRS:

Simple random sampling

USA:

United State of America

WHO:

World health organization

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Acknowledgements

We are grateful to Addis Ababa University for the provision of financial support for this research project. We would like to thank the study participants, data collectors, and supervisors for their contributions and commitments throughout the study period.

Funding

The study was funded by Addis Ababa University.

Author information

Authors and Affiliations

  1. Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

    Leta Bayissa

  2. School of Nursing and Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia

    Debela Gela

  3. School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia

    Abdissa Boka

  4. Tikur Anbessa Specialized Hospital, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia

    Tiruneh Ararsa

Authors
  1. Leta Bayissa
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  2. Debela Gela
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Contributions

LB, DG, AB, and TA made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data. LB writes the background and methods sections and analyzes and interprets the patients’ data. DG revised the background, method results analysis, and conclusion part, wrote in the manuscript, and gave final approval of the manuscript. AB and TA were commenting, editing, and taking part in the manuscript writing.

Corresponding author

Correspondence to Debela Gela.

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Ethical consideration

The ethical clearance was obtained from the Institutional Review Board (IRB) of the School of Nursing and Midwifery, the College of Health Sciences, Addis Ababa University (Protocol No. 13/SNM/15). An official letter was written to the Addis Ababa City Administration Health Bureau from the School of Nursing and Midwifery. The official letter to conduct the study was written by the Addis Ababa City Administration Health Bureau to all selected health centers. Permission to conduct the study was obtained from the administration of the health centers participating in the study. Written informed consent was obtained from each selected nurse to confirm their willingness to participate, and the study was conducted following the Declaration of Helsinki.

Competing interests

The authors declare no competing interests.

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Bayissa, L., Gela, D., Boka, A. et al. Hepatitis B vaccination coverage and associated factors among nurses working at health centers in Addis Ababa, Ethiopia: a cross-sectional study. BMC Nurs 23, 600 (2024). https://doi.org/10.1186/s12912-024-02224-0

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BMC Nursing

ISSN: 1472-6955

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