La vaccination antihépatite B aux établissements publics de santé de Sfax (Tunisie)

The authors are reporting the experience of the Service of Occupational Medicine and of professional pathology of Sfax (Tunisia) in active prevention of the viral hepatitis B, through an exhaustive and descriptive study concerning all the staff of the university hospitals of Sfax. It is about a balance of 18 years of vaccination made in the two university hospitals of Sfax. The period of study spreads out from January 1st, 1990 till December 31, 2007. The objectives of our study were to evaluate the diffusion of a recommended vaccination, to study the efficiency of this vaccinal campaign and to analyze the adhesion of the staff of health in their own prevention. This work concerned 2160 members of hospital staff that is 1223 men (46.9%) and 1387 women (53.1%). Only 1730 members, 756 men (61.8%) and 974 women (70.2%), participated in this campaign. The study of prevaccination serology allowed to identify: 72 bearers of the HBs antigen (4.2%); 436 agents immunized (25.2%); 1222 candidates for the vaccination (70.3%) among which 1124 were vaccinated (92.0%). According to rank, prevalence of the vaccination is higher among superior technicians (73.5%). The prevalence of the postvaccination seroconversion was of the order of 87.9%. About 12.1% were selected as having bad responses and were candidates for a 4th injection. Only 48.5% benefited from it, among which 48.5% developed antibody defenders. At the end of the first year of vaccination, 82.3% (923/1124) applicants at the vaccination had participated, while the participation rates to boosters in 5, 10 and 15 years have been respectively 79.5%, 57.2% and 48,4%.