Incidence of Hepatitis B Surface Antigen (HBsA.
Infection and Its Relationship with Risk Factors at Janitors at Regional General Hospital dr.
Dunda Limboto Gorontalo Indra Elisabet Lalangpuling1.
Zumrotul Abidah Dakio1.
Nikma2.
Dwi Setiyo Prihandono3.
Lendawati4 Department of Medical Technology Laboratory.
Politeknik Kesehatan Kementerian Kesehatan Manado.
Manado.
Indonesia Department of Medical Technology Laboratory.
Politeknik Kesehatan Kementerian Kesehatan Ternate.
Ternate.
Indonesia Department of Medical Technology Laboratory.
Politeknik Kesehatan Kementerian Kesehatan Kalimantan Timur.
Samarinda.
Indonesia Department of Medical Technology Laboratory.
Politeknik Kesehatan Kementerian Kesehatan Tanjung Karang.
Bandar Lampung.
Indonesia Correspondence:
Indra Elisabet Lalangpuling.
Politeknik Kesehatan Kemenkes Manado.
Jalan R.
Monginsidi Malalayang II Manado.
Indonesia Zip Code: 95263 Email: indra_elisabet@yahoo.
Received: November 24, 2022 Revised: March 30, 2023 Accepted: April 17, 2023 Published: April 29, 2023 DOI: 10.
33086/ijmlst.
Abstract Hepatitis B is an inflammatory liver disease caused by the Hepatitis B virus, which can be acute or chronic.
The outer membrane protein of Hepatitis B Virus (HBV) is known as Hepatitis B Surface Antigen (HBsA.
Janitors are employees who are tasked with cleaning the hospital environment to keep it clean, because of the the dangers that exist in hospitals, such as disease transmission, can occur if the hospital environment is not kept clean.
The purpose of this study was to describe the results and their relationship to risk factors of the Hepatitis B examination on janitors at the Regional General Hospital (RSUD) dr.
Mansyoer Mohammad Dunda Limboto Gorontalo.
This study used a descriptive method with an accidental sampling technique.
The sample in this study amounted to 33 respondents who met the inclusion criteria.
Specimen were examined using the rapid test method.
The data were presented descriptively and statistically to see the relationship between work and the incidence of Hepatitis B infection.
The results obtained were as many as 33 respondents by conducting an HBsAg examination, with the results obtained being 2 reactive people and 31 non-reactive people.
The results of statistical tests on the relationship between infection status and age showed a p-value of 0.
019 and the relationship between infection status and symptoms showed a p-value of 0.
The studyAos findings revealed that there was a substansial correlation between the respondentsAo reported symptoms and their infection status .
% of respondents teste for Hepatitis B).
Keywords HbsAg.
Janitors.
Rapid Test Method.
Regional General Hospital dr.
Dunda Limboto.
Citation: Lalangpuling IE.
Dakio ZA.
Nikma N.
Prihandono DS.
Lendawati L.
Incidence of Hepatitis B Surface Antigen (HBsA.
Infection and Its Relationship with Risk Factors at Janitors at Regional General Hospital dr.
Dunda Limboto Gorontalo.
Indones J Med Lab Sci Technol.
:68Ae78.
DOI: 10.
33086/ijmlst.
This is an open access article distributed under the Creative Commons Attribution-ShareAlike 4.
0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A2023 by author.
Indra Elisabet Lalangpuling, et al.
INTRODUCTION
The liver is the center of the body's chronic Hepatitis B, liver cirrhosis and primary liver cancer .
metabolism, which serves a variety of Based on the type, the causes of hepatitis purposes and is critical to sustaining life.
The are divided into two categories: infectious reserve capacity is very large, with only 10-20% of liver tissue that is still functioning, infectious hepatitis, inflammation of the liver it is enough to maintain the body of the occurs due to non-infectious causes, such as The ability of the liver to replace dead chemicals, alcohol, and drug abuse.
Non- tissue with new tissues .
is also infectious hepatitis, including drug-induced quite large.
Because of this, the removal of hepatitis, is not classified, as an infectious some diseased or damaged liver tissue is disease, because the cause of hepatitis is not swiftly followed by the growth of new tissue.
caused by infectious agents such as fungi.
There are four different types of liver bacteria, microorganisms and viruses .
the formation and excretion of HBV transmission can also occur through bile, metabolism of substances important for blood transfusions contaminated with HBV the body, body defense, and vascular function .
Hepatitis B is an inflammatory liver In addition.
HBV can enter the disease caused by the Hepatitis B Virus body through cuts or abrasions to the skin and (HBV), which can be acute or chronic.
Active mucous membranes, for such as needle sticks chronic forms can lead to cirrhosis, liver or sharp object wounds, ear piercings, tattoos, cancer, to death.
Hepatitis B is difficult to needle stick treatment .
, self- recognize because the symptoms are not injection habits, and the use of unsterile immediately felt and some may not appear at The use of medical equipment and For this reason, many people do not dental care equipment that is not properly realize that they have been infected.
This sterilized can transmit HBV .
HBV that virus usually takes 1-5 months from exposure enters the bloodstream through a portal of to the virus until the appearance of the first entry, such as lymph vessels enters the symptoms appear.
Hepatitis B Virus Surface Antigen (HBsA.
is the outer envelope circulation, the virus will spread throughout protein of HBV, and is a sign that the the body and finally reach the target organ, individual has been infected with HBV.
namely liver cells.
The entry of the HBV HBsAg positive can be found in healthy particle occurs through a receptor-mediated people .
ealthy carrie.
, acute Hepatitis B.
Virions enter the cytoplasm, open non-infectious After Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 the nucleocapsid, and then enter the Indra Elisabet Lalangpuling, et al.
hepatocyte nucleus.
The incomplete double- India with thirteen million sufferers, while in stranded viral DNA sequence becomes Jakarta it is estimated that one in twenty covalently intact DNA with the help of host people suffer from Hepatitis B.
Most of the cell enzyme activity, which not only population is infected with the HBV since "perfects" the viral DNA but also releases A number of countries in Asia, 8- DNA polymerase virus.
This DNA then 10% of the population suffer from chronic becomes the template for forming RNA Hepatitis B .
Indonesia is a country with polymerase II, which produce RNA for the endemic Hepatitis B in 2007, it was 0.
6% of translation of proteins important to viruses.
hepatitis cases and increased to in 2013 by These proteins are then used for the 2% of hepatitis cases .
According to encapsulation process and the formation of Riskesdas data in 2018, districts / cities in new viruses .
Gorontalo Province, had a prevalence of Based on the 2013 World Health hepatitis cases of 10,997, with a percentage Organization (WHO) report, two billion 55% .
Data from regional public people in the world suffer from hepatitis, 240 hospital (Rumah Sakit Umum Daaerah, million of them suffer from chronic hepatitis RSUD) of Dr.
Dunda Limboto showed B and 1.
46 million of them die.
Deaths from the prevalence of reactive hepatitis cases in this disease are comparable to HIV deaths 2019 was 2 reactive cases, 11 reactive cases .
3 millio.
TB deaths .
2 millio.
, in 2020, and 19 reactive cases in 2021.
malaria deaths .
5 millio.
However.
Hospitals are places that have complex hepatitis has not received the same level of potential hazards for workers.
They produce serious attention as the three diseases.
Data large amounts of waste, some of which is Liver Research hazardous to health in their environment.
National Hospital activities will produce waste, both Consensus for the Management of Hepatitis solid, liquid, and gaseous waste containing B in Indonesia shows that the prevalence rate pathogenic germs, chemical substances and of Hepatitis B in Indonesia is between 4.
Based on data from the Ministry of dangerous to the environment .
Association Indonesian (PPHI) Health in 2013, nationally there were Hospital are one of the places of 2,981,075 .
2%) of the population in employment that are at danger since there is Indonesia suffering from hepatitis.
This a chance that patients, staff members, and condition had doubled from 2007 .
even visitors could contract infectious Indonesia is the third- most country Hepatitis diseases there.
Examples of infectious B in with the world sufferers, after China and diseases that can occur in hospitals includes Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 Indra Elisabet Lalangpuling, et al.
Tuberculosis (TB).
Hepatitis B.
Hepatitis C, the factors that cause workers to be reluctant and HIV/AIDS.
In addition to infectious to use personal protective equipment include diseases, hospitals also have other risks or difficulty to use, discomfort, lack of hazards, such as explosion, fires, accidents understanding of the importance of safety caused by electrical installations, radiation equipment, and indiscipline in use.
The aim exposure, toxic and hazardous chemicals, of this research is to describe the results and their relationship to risk factors of the ergonomic related disorders.
All of the Hepatitis B examination on janitors at the potential hazards mentioned above can Regional General Hospital (RSUD).
dr M.
clearly interfere and cause a feeling of Dunda Limboto Gorontalo.
insecurity and discomfort for workers, environment .
One type of work that is MATERIALS AND METHODS Study Design and Area prone to accidents and occupational health The type of research used is descriptive- problems is janitors work.
Janitors are at high The study was conducted from risk of experiencing health problems because February to May 2022.
Sampling and they are directly exposed to garbage disposal, thus putting them at risk of being exposed to laboratory of the Regional General Hospital the HBV .
Janitors are employees who Dr.
Dunda Limboto Gorontalo.
are tasked with cleaning the hospital Respondents in this study were janitors.
environment to keep it clean and minimize Approval for this study was obtained from disease transmission.
The job of cleaning the the Health Research Ethics Committee of hospital environment makes the janitors Manado Health Polytechnic Ministry of vulnerable to exposure to hazards that can Health No.
KEPK.
01/05/080/2022.
interfere with their health.
According to Rita Sample Size Determination and Sampling .
it is explained that, when HBsAg was Techniques examined on 30 samples in Kendari City The sample used was the total population (Indonesi.
, 6.
66% of the samples were that met the inclusion criteria.
there were as This proves that janitors in hospitals many as 33 respondents, selected using the are very much at risk of being infected with accidental sampling technique.
Primary data diseases due to things that are not taken into consideration when working, one of which is respondents and the results of laboratory the use of personal Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 HBsAg equipment when beginning work.
Some of Indra Elisabet Lalangpuling, et al.
secondary data was obtained from journals Data Analysis and literature related to this study.
The data were collected, processed.
Data Collection Tool and Methods analyzed descriptively, and stasistically using The tools and materials used in this study tourniquets, centrifuges, 1 mL mini pipettes.
SPSS relationship between variables then presented in tabular form, narrated, and concluded.
timers, masks, 3 mL disposable syringes, alcohol swabs, dry cotton.
HBsAg strips and The materials used in this study were was carried out on 33 respondents who were immunochromatography test or rapid test taken from the janitors of RSUD.
Sampling was carried out in the Dunda Limboto.
The results of the laboratory morning after filling out the questionnaire.
examination of the respondents showed a Specimen Collection and Processing reactive result of 6% (Table .
The HBsAg examination in this study Whole
RESULTS
venipuncture using vacutainer tubes, with (BD VacutainerA anticoagulant EDTA).
Serum samples were taken after kept at 4A for 30 minutes and the examined in the laboratory of the Regional General Hospital Dr.
Dunda Limboto.
Serological Test Table 1.
Frequency of HbsAg Test Result
Frequency Frequency Result
(%)
(N)
Occurence Reactive Non-Reactive Total According to research findings based on The examination method used was the gender, respondents were predominantly Immunochromatography test or Rapid Test female, numbering up to 21 .
%) and men, method, where the serum sample was numbering up to 12 .
%).
See Table 2 for observed for the results through the presence more information.
or absence of a red line.
The results were then interpreted as Reactive interpretation if two Table red lines were formed in the control (C) and test (T) areas.
and Negative if a red line was Gender formed in the control area (C).
If no line was Man Woman Total formed on the strip, it was declared invalid Frequency (N) Percentage (%) and the test had to be repeated.
Distribution of Respondents According to Gender Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 Indra Elisabet Lalangpuling, et al.
Based on Table 3, the majority of Table.
respondents were in the age range of 21-30 and 31-40 with a total of 61% each.
Table Table 3.
Distribution of Respondets by Age
Age
Group
21 - 30
31 - 40
41 - 50
Total Frequensy (N) According majority of respondents .
%) did not Pencentage (%) feel any symptoms of hepatitis.
Table 4.
Relationship Between Status Infection with Age
Result
Positive Negative Total
21-30 (%)
Age .
31-40 (%) 20 .
41-50 (%) 0 .
Total
(%)
p-Value Table 5.
Distribution Respondents Based on Disease Symptoms Symptomps of Hepatitis Feel Symptomps No Feel Symptomps Total Frequency (N) Table 6 shows the infection status along The Percentage (%) relationship between infection status and the symptoms experienced.
Table 6.
Relationship Between Infection Status with Symptom Result Positive Negative Total Symptom Yes (%) 2 .
No (%) 0 .
Total
(%)
p-Value *signifikan if p-value <0.
DISCUSSION
Limboto General Hospital, is a hospital owned by the Gorontalo district government M Dunda Limboto, originally named located in the administrative area of Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 Regional General Hospital (RSUD).
Dr.
Indra Elisabet Lalangpuling, et al.
Gorontalo Regency, founded on November age of 26 - 30.
Research conducted by Indarti 25, 1963, now accredited B.
showed that the majority of respondents This study began with filling out were between the ages of 21-30 years, informed consent.
In this study, the sample indicating that most of the workers were used was a venous blood sample, which was dominated by young people .
Human age taken by performing a phlebotomy with an can be classified into several groups, each of open system.
Three milliliters of blood were which describes a stage of human growth.
transferred to an immunology tube and then One of the age group divisions or age centrifuged for 10-15 minutes.
The method categories issued by the Ministry of Health of Immunochromatography the Republic of Indonesia on its official method by looking at the red lines in the website, namely depkes.
id as follows:
Control Area (C) and the Test Area (T).
infancy, childhood, early adolescence, late Janitors are at risk of being infected with adolescence, early adulthood, late adulthood, infectious diseases due to small factors that early elderly, late old age and old Age.
At the are not taken into consideration when age of 20 years and over, the maximum working, such as the use of personal oxygen capacity in the body will gradually protective equipment when starting work and At the age of around 50-60 years, whether the janitors has previously suffered the ability of muscle strength will decrease, from hepatitis.
resulting in a decrease in the body's physical The results of this study are contradicted ability to do work .
Research conducted research conducted by Rita .
where the in China showed that 90% of cases of HBV majority of respondents were male, at 60%.
were experienced by the population over the This research is in line with the proposed by age of 20 years .
Bertelli .
that the female sex is more All age groups can be at risk of susceptible to the effects of infection due to experiencing Hepatitis B infection, as the low level of cell-mediated immunity in transmission of the virus can occur through actions, behaviors, or habits.
Table.
4 shows compared to men.
Research conducted on no significant relationship between infection status and the respondent's age.
Research materials shows that they occur mostly in conducted by Amtarina et al .
showed that female workers who have low education and respondents who had Hepatitis B infection employed in the health sector .
were typically 20 years of age or older.
Research conducted by Rita .
showed Hepatitis B in children can occur acutely or that the highest cleaning service at from the chronically, and transmission can occur Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 Indra Elisabet Lalangpuling, et al.
vertically through childbirth and intra- .
-4 time.
The Hepatitis B vaccine However, the incidence of acute (Recombivax HB.
Comvax, and Engerix-B).
Hepatitis B infection in children and which is a vaccine made from an inactivated virus, can be given three or four times within administration in childhood .
six months .
Vaccines are one way to Based on the results of interviews with prevent infections by germs such as bacteria respondents, it was shown that none of the and viruses from entering our bodies .
respondents had received the Hepatitis B Since 1997, the government has supported Similarly, research conducted by the national immunization program as a Samiun .
found that most respondents had menas of preventing the spread of Hepatitis not received the Hepatitis B vaccine Workers in the health industry, including compared to those who had received the cleaning officers, should have received the.
According to these findings, people Hepatitis B vaccine is given to prevent the who have never received a Hepatitis B occurrence of Hepatitis B .
vaccination have a higher risk of contracting Not everyone who is infected with HBV the disease.
This is in line with the theory that develops symptoms of hepatitis.
Between 30 the administration of the Hepatitis B vaccine and 40 percent of people infected with this can prevent both Hepatitis B and illnesses virus do not experience any symptoms.
like liver cancer and cirrhosis that are brought there are symptoms.
They usually appear on by Hepatitis B.
One method of preventing within four to six weeks after infection and the spread of Hepatitis B is vaccination.
can last from several weeks to several Currently, there are two forms of Some people who experience immunization available.
active immunization symptoms of acute hepatitis B feel so sick Active and tired that they cannot do anything for immunization is achieved by administering weeks or months.
If the immune system is the Hepatitis B vaccine, which contains unable to control HBV infection within six purified HBsAg.
This HBsAg is taken from months, symptoms of chronic hepatitis B purified serum of Hepatitis B patients or from may appear.
Not everyone with chronic the recombination of yeast cell DNA.
hepatitis B experiences symptoms.
Some Hepatitis symptoms that go away after a while, while more than 20 years.
The success of the others may experience persistent symptoms.
vaccination is assessed by the detecting Symptoms of chronic Hepatitis B can be completing the Hepatitis B immunization similar to those experienced with acute Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 protection against Hepatitis B infection for Indra Elisabet Lalangpuling, et al.
Hepatitis B.
These symptoms tend to be mild microorganisms that cause infection.
The use to moderate and are usually temporary.
of PPE is very influential in the transmission Additional symptoms may occur, especially of disease.
The risk of nurses contracting in people who have had chronic Hepatitis B for a long time.
These symptoms include increases if the use of PPE is neglected, resulting in a risk of infection.
Hepatitis and characterized by itching, red spots and HIV/AIDS can attack nurses if they do not swellin.
, arthritis .
nflammation of the use PPE due to exposure to body fluids or joint.
, and polyneuropathy .
ingling or puncture needle .
The greatest risk of burning sensations in the arms and leg.
n HIV/AIDS The statistical test results showed that experienced by healthcare workers and there was a relationship between infection cleaning staff in health facillities .
status and the symptoms experienced.
According to research, the causes of workers Histopathologically.
Hepatitis B is classified not using Personal Protective Equipment
into persistent chronic Hepatitis B, chronic
(PPE)
lobular Hepatitis B, and active chronic supervision, sanctions, lack of facilities and Hepatitis B.
All three can develop into infrastructure, carelessness or negligence of cirrhosis and primary liver carcinoma.
The humans, and inconvenience .
Some of the clinical symptoms of Hepatitis B depend on factors that influence workers' reluctance to the severity of the infection.
The course of use personal protective equipment include Hepatitis B infection consists of several difficulty, discomfort, disturbance when phases, namely the incubation phase, the using it.
low understanding of the importance acute phase, the convalescent window phase of safety equipment and indiscipline in its and the healing phase.
HBV is transmitted use .
To improve the health of employees and their families by performing routine checks, containing the virus.
The virus can survive administering vaccinations, wearing PPE at for more than one week on dry surfaces, work and properly disposing of used needles.
thereby increasing the risk of infection .
Employees is also washing hands before and Personal Protective Equipment (PPE) is after working to prevent the spread of disease a set of tools used by workers to protect part in the workplace.
or all of their body from potential hazards or There are several methods of examining work accidents.
PPE is equipment used to the HBV, and the Rapid Diagnostic Test (RDT) method is one that can be used with Ina.
Med.
Lab.
Sci.
Tech.
: 68Ae79 Indra Elisabet Lalangpuling, et al.
good sensitivity and specificity results.
AUTHOR CONTRIBUTIONS
The RDT method is cost-effective .
Indra Elisabet Lalangpuling:
Conseptualization.
Methodology.
Software.
Zumrotul Abidah Dakio: Data curation.
Writing-original draft preparation Software.
potential donors .
Nikma: Validation.
Dwi Setiyo Prihandono:
Supervision.
Lendawati: Writing.
Reviewing CONCLUSIONS and Editing.
Examination of Hepatitis B surface (HBsA.
non-reactive Dunda
RSUD
Limboto %).
CONFLICT OF INTEREST
There The author declars there is no conflict of FUNDING infection status and symptoms reported by the respondents.
The authors are very grateful to the Kementerian Kesehatan Manado.
Indonesia for their financial support.
The financial support for this work did not influence its and Preventive Medicine Archive.
DOI: 10.
53638/phpma.
REFERENCES