Occupational exposure to needlestick injuries and hepatitis B vaccination coverage among medicine and dentistry students

Needlestick injuries (NSIs) pose significant occupational hazards for healthcare workers and students, increasing the risk of hepatitis B virus (HBV) transmission. Medicine and dentistry students are particularly vulnerable due to limited clinical experience. This study assessed the prevalence of NSIs and the correlation with HBV vaccination coverage among medicine and dentistry students in Ghana. This was a cross-sectional study conducted among 264 clinical-year (Years 4 - 6) medicine and dentistry students of Kwame Nkrumah University of Science and Technology from February to March 2023. Data on NSIs, HBV vaccination status, and associated factors were collected by means of questionnaire administration and analyzed using IBM SPSS Version 26.0 and GraphPad Prism 8.0. All statistical results obtained were considered significant at p < 0.05. The prevalence of NSIs was 27.7%, with a higher prevalence among dentistry students. HBV vaccination coverage (≥1 dose) was 83.0%, however, only 50.7% of these vaccinated participants had completed their vaccination (≥3 doses). About 17% had never received a single dose, with over half (51.1%) stating “no specific reason” for non-vaccination. Higher levels of study (p = 0.033) and extended clinical exposure (P = 0.040) were associated with an increased risk of NSIs. Advancing age (p = 0.005), level of study (p < 0.001), and program of study (p = 0.045) were significantly associated with vaccination status among the study participants. The high prevalence of NSIs alongside suboptimal HBV vaccination coverage highlights a critical gap in infection control. Medical and dental schools should implement mandatory HBV vaccination and enhance training on universal precautions to mitigate NSI risks.

Methods
Study Design, Population, and Setting
This was a cross-sectional study conducted among students pursuing a Bachelor of Science in Human Biology (Medicine) (MBChB) and Bachelor of Dental Surgery (BDS) at Kwame Nkrumah University of Science and Technology (KNUST), Ghana, from February to March 2023. Following three years of pre-clinical studies (covering pathology, anatomy, pharmacology, microbiology, etc.), these students had commenced their three-year clinical training (Year 4 - 6) at Komfo Anokye Teaching Hospital (KATH) to receive training in general surgery, paediatrics, internal medicine, psychiatry, etc.

KATH is situated in Kumasi, Ashanti Region, Ghana, and it is the second largest hospital in Ghana and the only tertiary health institution in the region with a 1,200-bed capacity. The hospital is involved in the training of medical students, junior doctors, and nurses and provides well-equipped medical and laboratory facilities [21].

Sample Size Calculation
The sample size was determined to be 256 using the Raosoft sample size calculator at a 95% confidence level, 5% margin of error, and a response distribution of 50% [22]. To account for potential non-responses and ensure robust subgroup analyses, we increased the final sample size to 264, ensuring statistical reliability.

Ethics approval and consent to participate
Approval for this study was obtained from the Committee of Human Research, Publication, and Ethics (CHRPE) of the School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST). This was part of a bigger study with reference number: CHRPE/AP 331/23. Written informed consent was obtained from all the participants before their recruitment into the study after the objectives and procedures of the study had been explained to them. Participants were assured of anonymity, confidentiality, and the right to decline participation at any point within the survey without penalty.

Inclusion Criteria
Students reading medicine or dental surgery programs in Year 4, Year 5, or Year 6 who consented to participate in the study were included.

Exclusion Criteria
Students reading medicine or dental surgery programs in Year 1, Year 2, or Year 3 were excluded from the study. Students who were unavailable during the data collection phase of the study could not participate.

Data Collection and Sampling Procedure
Data for this study were collected using a structured, investigator-designed questionnaire administered. The questionnaire was developed, piloted, and validated for this study. The survey consisted of multiple sections assessing participants’ demographic characteristics, history of needlestick injuries (NSIs), hepatitis B vaccination status, and associated risk factors.

We ensured voluntary participation, confidentiality measures, and the right to withdraw at any time. Participants could only proceed with the survey after providing consent.

The questionnaire was designed to be anonymous, with no personally identifiable information collected to maintain confidentiality. Data collection was conducted over a period of two months, from February to March 2023.