Awareness, knowledge, disease prevention practices, and immunization attitude of hepatitis E virus among food handlers in Klang Valley, Malaysia

ABSTRACT

Concern about the zoonotic Hepatitis E virus (HEV) is rising. Since, food handlers are at greater risk in contracting HEV, the present study aims to determine awareness, knowledge, prevention practices against HEV, and immunization attitudes. A cross sectional study was conducted among 400 food handlers in Klang Valley, Malaysia from December 2021 to March 2022. A structured questionnaire was employed for data collection and analysis with Statistical Package for Social Science (SPSS) version 29. Approximately 4.5% of the respondents (18) reported having heard of HEV, while the median scores for the knowledge and practice domains were 0/10 and 1/5, respectively. A total of 316 (79%) respondents expressed willingness to obtain vaccination if made available. This study also found that those respondents who completed their tertiary education were significantly possessed better knowledge of the disease [odd ratio (OR) = 8.95, and 95% confidence interval (CI) 4.98–16.10]. Respondents with HEV awareness reported considerably better practices (OR = 8.24, 95% CI 1.72–39.63). Food handlers with one to five years of experience in the industry expressed notable willingness to take vaccination (OR = 7.71, 95% CI 1.79–33.18). Addressing poor HEV awareness and knowledge and poor practices against the disease is crucial in enlightening the policy makers about awareness among food handlers and general population. Nonetheless, a good immunization attitude, significant acceptance toward vaccination even with the vaccine being unavailable in Malaysia, and limited awareness of HEV highlight a promising development.

KEYWORDS:

• Hepatitis E virus
• food handlers
• knowledge
• vaccine
• Malaysia

Acknowledgments

The authors are grateful to the Director General of Health of Malaysia for his permission to publish this article. In addition, the authors would like to thank the Deputy Director General of Health (Research and Technical Support) and the Director of the Institute of Medical Research (IMR), Director of Food Safety and Quality Division for their support and the respondents who willingly participated in this study. We would like to acknowledge the external reviewer of this paper as well.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Conceptualization, S.R., W.L.P. and S.S.A.T.; methodology, S.R. and S.S.A.T.; software, S.R.; validation, S.R. and S.S.A.T.; formal analysis, S.R.; investigation, S.R., Y.V. and S.S.A.T; resources, S.R.; data curation, S.R.; writing – original draft preparation, S.R.; writing – review and editing, S.S.A.T., W.L.P. and Y.V.; visualization, S.R.; supervision, W.L.P and S.S.A.T.; project administration, S.R. All authors have read and agreed to the published version of the manuscript.

Informed consent statement

Informed consent was obtained from all subjects involved in the study.

Institutional review board statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of Medical Research and Ethics Committee, Malaysia (protocol code NMRR-21-1621–60740) for studies involving humans.

Additional information

Funding

This research received no external funding.