Factors associated with knowledge level.

BackgroundHepatitis B and C viral (HBV and HCV) infections are endemic in Ghana. Also, the National Policy on Viral Hepatitis stipulates that there is unreliable data, limited knowledge, and a deficiency in research on viral hepatitis, especially among some high-risk workers in the eastern part of the country. This study therefore assessed the knowledge level and occupational practices of street beauticians and barbers in the transmission of HBV and HCV in the Volta Region of Ghana.MethodsA cross-sectional mixed methods study was conducted in Volta Ghana from April to June 2021. An in-depth interview was used to collect data from five environmental health officers who were selected as key informants in the qualitative stage. Structured questionnaires/checklists and direct observations were employed to collect data from 340 street beauticians and barbers in the quantitative stage. During the qualitative stage, the process of coding, and mind mapping via thematic analysis was carried out. Furthermore, descriptive and inferential analyses were performed using Stata version 17.0 at a 95% significance level in the quantitative stage.ResultsMost street beauticians and barbers reported poor knowledge levels about HBV and HCV (67.0%), although the awareness of this viral hepatitis was high (88.2%). While almost one-third of the participants observed safe occupational practices (31.5%), about 29.0%, 49.4%, and 55.3% of them also followed hand hygiene protocols, wore protective clothes/gloves, and sterilized or disinfected tools after use respectively. Street beauticians and barbers with higher (tertiary) education (AOR = 6.15; 95%CI = 1.26–29.9; p = 0.024), those who had heavy workload of more than 20 customers per day (AOR = 3.93; 95%CI = 1.26–12.3; p = 0.019), and those who had work experience of at least four years (AOR = 1.65; 95%CI = 1.02–2.69; p = 0.040) were more likely to have good knowledge level about viral hepatitis. Additionally, beauticians were more likely to adhere to safe occupational practices as compared to barbers (AOR = 11.2; 95%CI = 3.46–36.3; pConclusionParticipants showed high awareness but limited knowledge about HBV and HCV infections. The general safety practices among the participants were poor. Our study results suggest possible viral transmission through the activities of street beauticians and barbers which could be attributed to the lack of regulatory systems and training of these cosmetologists. Policy-makers and regulatory bodies should institute and enforce rigorous policies and guidelines on job-related safety measures and health practices including regular training, monitoring, screening, and vaccination programs for these high-risk community workers in Ghana.

背景：乙型病毒性肝炎（Hepatitis B viral, HBV）与丙型病毒性肝炎（Hepatitis C viral, HCV）在加纳呈地方性流行态势。此外，该国《病毒性肝炎国家政策》明确指出，当前病毒性肝炎相关数据可靠性不足、公众认知水平有限且研究存在缺口，尤其在该国东部部分高风险职业人群中更为突出。因此，本研究针对加纳沃尔特地区的街头美容师与理发师展开调研，评估其对HBV与HCV传播相关的认知水平及职业操作规范。
方法：本研究于2021年4月至6月在加纳沃尔特地区开展横断面混合方法研究。质性研究阶段，通过深入访谈收集了5名被选为关键信息提供者的环境卫生官员的调研数据。量性研究阶段，采用结构化问卷与核查表、直接观察法，收集了340名街头美容师与理发师的调研数据。质性研究阶段，通过主题分析法完成编码与思维导图梳理工作。量性研究阶段，采用Stata 17.0统计软件进行描述性与推断性统计分析，检验水准设定为95%。
结果：尽管参与者对病毒性肝炎的总体知晓率较高（88.2%），但67.0%的街头美容师与理发师对HBV与HCV的认知水平较差。仅约31.5%的参与者落实了安全职业操作规范，分别有29.0%、49.4%、55.3%的参与者落实手卫生规范、穿戴防护衣物/手套、使用后对工具进行灭菌或消毒。
经多因素分析，接受高等教育的街头美容师与理发师（调整优势比（Adjusted Odds Ratio, AOR）=6.15；95%置信区间（Confidence Interval, CI）=1.26~29.9；p=0.024）、日均服务顾客超过20名的高工作量从业者（AOR=3.93；95%CI=1.26~12.3；p=0.019）以及拥有至少4年工作经验的人员（AOR=1.65；95%CI=1.02~2.69；p=0.040），其对病毒性肝炎的认知水平更优。此外，与理发师相比，美容师更易遵守安全职业操作规范（AOR=11.2；95%CI=3.46~36.3；p
结论：参与者对HBV与HCV感染的知晓率较高，但认知水平有限。参与者的整体安全操作规范落实情况较差。本研究结果提示，街头美容师与理发师的相关操作可能引发病毒性肝炎传播，这可归因于针对这类美容从业者的监管体系缺失与培训不足。加纳的政策制定者与监管机构应制定并实施严格的职业安全措施与健康操作相关政策及指南，包括为这类高风险社区从业者开展定期培训、监测、筛查与疫苗接种项目。