Survey on HBV Immunisation Status among the Dental Practitioners

Introduction: There are more than 2 billion people worldwide who have evident recent or past HBV infection and chronic cases. Hepatitis B, C and D are transmitted by parental contact with infected body fluids including blood, semen, saliva , sweat and tears , invasive medical procedures using equipment which are contaminated with the virus , vertical transmission. Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with immunisation such as from AIDS/HIV and those born premature. It is also recommended that health-care workers be vaccinated. In healthy people routine immunisation results in more than 96% of the people being protected. Aim: The aim of this study is to know the immunisation status and knowledge and awareness among dental practitioners. Materials and Methods: A survey was designed to analyse the result. The questionnaire was prepared in Google Forms (online survey link) and was distributed to 100 dental practitioners. The responses were then collected and statistically analysed using SPSS software. Original Research Article Kishore and Muralidharan; JPRI, 33(47B): 391-403, 2021; Article no.JPRI.74455 392 Results and Discussion: After discussing the results of the present study, it was seen that many were aware of hepatitis B vaccine. Limitations of this are that the population is small. Limitations seen in this study can be included in future research for better spread of awareness among the general public. Conclusion: From the study we can conclude that the majority of the dental practitioners are aware of hepatitis B vaccine and are aware of their vaccination status of hepatitis B.


INTRODUCTION
Hepatitis B (HBV) is caused by a doublestranded DNA virus of the hepadnaviridae. This virus will survive within the body for a minimum of seven days. Seven sorts of liver disease virus square measure known as infectious hepatitis clothe that F is theoretic and viral hepatitis remains the foremost serious sort with risk of death from liver disease and cancer. measure billions of people worldwide and agencies have proof of recent or past HBV infection and chronic cases [1]. Viral hepatitis, C, and D are mainly transmitted by parental contact with infected body fluids together with blood, semen, saliva, sweat, and tears, invasive medical procedures and instrumentality that are contaminated with the virus [2], vertical transmission. Hepatitis-B vaccine, developed for the interference of hepatitis-B viral infection, could be a noncommunicable recombinant DNA vaccinum created from genetically designed yeast named brewer's yeast.
Although there has been modification within the production of the vaccine since its initial development in 1981, the entire vaccination still remains the uptake of the three-doses, with the second and third doses being given at one and six months intervals of the initial dose [3]. Despite the provision and recommendation on hepatitis-B vaccination, the vaccination rates among dental professionals have remained systematically low in developing countries. the explanations for the suboptimal hepatitis-B vaccination rates among physicians embrace lack of chance, lack of motivation, lack of knowledge, lack of awareness, non-availability, high price of the vaccinum, worry of facet effects, worry of being recognized as a hepatitis-B carrier, lack of perceived would like for the vaccinum, and error of non-susceptibility to the infection [4].There conjointly existed no accord regarding vaccination rates among dental professionals within the literature as dental surgeons had higher vaccination rates than dental auxiliaries in some studies whereas dental auxiliaries had higher vaccination rates than dental surgeons in others [5].
Dental practice employees apart from clinical employees, like receptionists and managers, might need immunization if committed medical aid or sterilisation of apparatus and disposal of clinical waste. The immunity/carrier standing of employees are exposed and prone procedures are to be determined to shield patients against the danger of non inheritable viral hepatitis from an infected aid employee [6] [7]. Access to an activity health service capable of providing recommendation and help in immunization and manufacturing applicable documentation would be beneficial, thus fulfilling the employers' obligations beneath health and safety legislation, furthermore as compliant with the new GDC registration procedures. Our team has extensive knowledge and research experience that has translate into high quality publications  The main aim of the study is to know the immunisation status and knowledge and awareness among dental practitioners.

Study Design
A survey was conducted among dental undergraduates to evaluate their knowledge and awareness on the status of hepatitis B vaccination among dental practitioners. The sample size of the study was 100. The participants did the survey voluntarily and no incentives were given to them. The study was conducted in the month of, Feb, 2020.

Survey Instrument
The survey instrument which was a questionnaire was prepared after extensive review of the existing literature. The questionnaire was reviewed and amendments were made to improve clarity of the questions to eliminate ambiguous responses. The questionnaire consisted of a total of 11 questions. The questionnaire was shared to the dental practitioners.

Data Analysis
Only completed surveys were taken for analysis and the incompleted surveys were eliminated. The statistical test used is descriptive statistics.
All the responses obtained were tabulated and reliability of the data was checked. The statistics done using SPSS software, correlation test was done to check the association and p value of 0.05 was said to be statistically significant. figure 1 depicts the population of participants who practice dentistry. 98.00% said yes (green) that they practice dentistry and 2% said no (blue) that they don't practice dentistry Represents the association between the dental students exposed to needle stick injury transmission and their year of study, where X axis represents the 'year of study' and the Y axis represents the 'number of responses'. Blue represents maybe and green represents no and yellow represents yes . Majority of 57% were not exposed to needle stick injury among them 50% were 3rd year students and 7% were final year students . The association showed p value of 0.026 <0.05 which was statistically significant(chi square test)

DISCUSSION
From the research survey done, the results were carefully statistically analysed and the results were tabulated using the SPSS software. The Fig. 1 depicts the population of participants who practice dentistry, of the participants majority of the participants that is 96.00% of the participants practice dentistry and the rest of the population that is 2.00% of the participants did not practice dentistry, so the responses of these participants were not included because they don't practice dentistry, their responses were excluded from the study .The Fig 2 depicts Fig. 3 depicts the knowledge among the participants regarding If vaccine is available for hepatitis B virus to which majority of the participants that is 94.00% of the participants said yes that they were aware of the vaccine available for hepatitis B virus and the rest of the population that is 6.00% said no that they are not aware of the vaccine that are available for hepatitis B virus . In Fig. 4 the pie chart depicts the frequency of population of the participants who have taken hepatitis B vaccine and the majority of the participants that is 70.00% said yes that they have taken a vaccination for hepatitis B virus and 24.00% of the participants said no that they haven't taken vaccine for hepatitis B virus and the rest of the participants that is 6.00% of the participants said they don't know if they had taken a vaccine for hepatitis B virus.
In Fig. 5 the pie chart depicts the knowledge among the participants on what age should a child receive a vaccine for hepatitis B and majority of the participating population that is 69.00% of them said 6 -8 months is the correct age for a child to receive a hepatitis B vaccine, 19.00% of the participants said 16 -24 months and the rest of the participants that is 12.00% said 24 months and above is the correct age for a child to receive a hepatitis B vaccine. Similar studies done by Singh also showed similar results as in our study [33]. In Fig. 6 the pie chart depicts the awareness among the participants if they had taken a booster dose and majority of the participants that is 79.00% said no that they had not taken a booster dose following the hepatitis B vaccine and 13.00% of the participants said yes that they have taken a booster following the hepatitis B vaccine and the rest of the population that is 8.00% said that they don't know if they had taken a booster dose following the hepatitis B vaccination. In Fig. 7 the pic chart depicts the frequency of the participating population if they had checked for susceptibility for hepatitis B and majority of the participants that is 51.00% said yes that they have checked for susceptibility test for hepatitis B and the rest of the participants that is 49.00% said that they have not checked for susceptibility for hepatitis B virus.
In Fig. 8, the pie chart depicts the knowledge of the participants on the recommended full dose for hepatitis B vaccine majority of the participants that is around 36.00% said 3 doses are the recommended full dose for hepatitis B vaccine, 34.00% of the participants said 2 doses, 12.00% of the participants said 1 dose and rest of the participants 18.00% said that they don't know about the full recommended full dose for hepatitis B vaccine. Similar studies done by Gambir [34] and showed similar results. In Fig. 9 the pie chart depicts the knowledge among the participants on the side effect of the hepatitis vaccine, 13.00% of the participants said soreness, redness or swelling in the area where the shot was given, 12.00% of the participants said the side effects of the vaccine are headache, 6.00% of the participants said fever as the side effect and the , majority rest of the participants that is 69.00% said all of the reasons above as the side effects of taking hepatitis B vaccine. In Fig. 10 the pie chart depicts the knowledge among the participants on the transmission of hepatitis B virus through aerosol majority of the participants that is 80.00% said yes that it can be transmitted through aerosol, 14.00% of the participants said no that they don't transmit through aerosol and the rest of the participants 6.00% said they don't know the means of transmission for hepatitis B.
In Fig. 11 Fig. 13 Represents the association between the dental students on awareness of recommended full dose of hepatitis B vaccine and their year of study, where X axis represents the 'year of study' and the Y axis represents the 'number of responses'. Blue represents 1dose and green represents 2 doses, yellow represents 3 doses or more and purple represents that they don't know.
The association showed p value of 0.026 <0.05 which was statistically significant(chi square test). Fig 14 Represents the association between the dental students on hepatitis transmission through aerosol and their year of study, where X axis represents the 'year of study' and the Y axis represents the 'number of responses'. Blue represents maybe and green represents no and yellow represents yes.The association showed p value of 0.018<0.05 which was statistically significant(chi square test) . Fig 14 represents the association between the dental students exposed to needle stick injury transmission and their year of study, where X axis represents the 'year of study' and the Y axis represents the 'number of responses'. Blue represents maybe and green represents no and yellow represents yes . Majority of 57% were not exposed to needle stick injury among them 50% were 3rd year students and 7% were final year students. . The association showed p value of 0.026 <0.05 which was statistically significant(chi square test)

CONCLUSION
From the survey done we can conclude that majority of the dental practitioners are aware of hepatitis B and the vaccination status, however from the study we can see that majority are generally aware of hepatitis B virus and have knowledge, majority of the participants did not know the correct age to get vaccinated or recommended full doses from this we can conclude that they have knowledge and awareness but not the actual benefit about hepatitis B vaccine.

LIMITATIONS OF STUDY
The limitations of this study are the sample size of the study is small and no varied population. These are the major limitations of the study and in future similar study can be done with a large population about needle stick injury.

CONSENT AND ETHICAL APPROVAL
Ethical approval and informed consent from the participants were obtained and preserved by authors.

ACKNOWLEDGEMENT
The author would like to thank the study participants for their participation and kind cooperation throughout the study and the management of Saveetha dental college and hospitals for giving a platform to carry out this project.