الفهرس 
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Abstract
Hepatitis or inflammation of the liver caused by viral agent, occurs alanning frequency and because of the ease of transmission of most hepatitis, it has become a public health problem of major concern. Hepatitis B virus infection is a global challenge with an estimate of million chronic carriers world-wide. In addition it has been long )gnized as an occupational risk among health professionals who are currently exposed to patient’s blood and others body fluids. This work was performed to determine the prevalence and enninants of hepatitis B infection among nurses working in surgical departments at Alexandria hospitals and to study their knowledge, attitude practice towards HEV infection and preventive measures. A total of 150 nurses and 150 matched for age female clerical tools were taken from hospitals related to Ministry of Health, Health :urance, Curative Organization and Alexandria University by using Irortional allocation random sampling technique. Both groups were sed to an interview for collection of basic epidemiological data, ,knowledge regarding agent of the disease, modes of transmission of ,atitis B and signs and symptoms of hepatitis B . While nurses were exposed to another interview regarding sterilization and disinfection, their knowledge towards hepatitis B and their behaviour related to hepatitis B precautions . Also nurses were observed for certain practices as wearing Ives and the sanitary methods of dealing with used needle. Blood was collected from both groups. Sera were tested for :(1) Hepatitis B surface antigen (HBsAg). (2) Antibodies to hepatitis B surface antigen (Anti HBs). (3) Sera samples which were not positive to HBsAg andJor anti HBs were tested for antibodies to hepatitis B core antigen (anti HBc IgM). Preliminary analysis of knowledge showed massive lack of knowledge among nurses regarding hepatitis B and it is precautions. The researcher felt an urgent need to start a training program regarding hepatitis B among nurses tailored according to their needs. The program carried out for 101 nurses was composed of four sequented phases: 1- Pre planning phase which contain the arrangement of the program in studied hospitals. 2- Planning phase:- preparing the general and specific objectives, teaching methods which included discussion and demonstration in addition to poster prepared to explain modes of transmission of hepatitis B and WHO hand out about sterilization and high level of disinfection. 3- Implementation of the program in all studied hospitals. Nurses were divided into groups, each group included 2-10 nurses according to the number of nurses in the affiliated hospital. Two eductional session were devoted to each group. The first session was about the modes of transmission, the second session was about preventive measures. 4- Evaluation: - The nurses were interviewed again after one month from the end of the program to evaluate their knowledge about hepatitis B infection. study revealed the following main results: The mean age of nurses was 31.1:i:8.24 years while the mean age of oontrols was 29.9:i:9.25 years. line majority of nurses have a diploma degree and were working in technical nursing jobs (71.30/0, 67.8 percent) respectively. All controls were working in clerical related jobs. Nearly one third (32.0 percent) of nurses were positive for HBsAg compared to 16.7 percent among the controls. less than half (45.3 percent) of nurses were positive for anti Hbs compared 1020.7 percent among controls. The results indicated that nurses have almost 2 times the risk to be positive to hepatitis B surface antigen compared to controls. Only 10 percent of the nurses were positive for antibodies to hepatitis B core antigen compared to 2.2 percent among the controls. The work in the hospital for a period of more than 20 years, history of wrgery, history of blood transfusion, history of dental surgery, were not risk factors for developing viral hepatitis B markers. Persons having a history of needle prick injury were significantly at more risk to be positive to hepatitis B markers. ,There was a significant difference between nurses knowledge and their controls regarding the agent of the diseases, modes of transmission and signs and symptoms of hepatitis B. IThe nurses attitude towards hepatitis B were positive. Almost seventy percent (70.7 percent) of nurses mentioned that they can nursed hepatitis B patients in addition to some protective measures. Also they had a positive behaviour related to hepatitis B precautions, while their practice was inagreement with their behaviour regarding to observed practice of nurses, none washed their hands Ul between patients, wore gloves during injection or during washing equipments. There was a significant difference between nurses knowledge before and after the training program regarding the agent of the disease, modes of transmission of hepatitis B, sterilzation and high level of disinfection. dllsion: Nurses have a higher risk to be positive to HBsAg and anti HBs. lowledge of nurses regarding hepatitis B is significantly much more than controls. But nurses still have lack of knowledge for that training gram could be effective in developing their knowledge. cording to the results and conclusions reached in the present study rteservice and inservice training programs should be provided to nurses Ul all hospitals and health care centers related to hepatitis B infection and related issues. Adequate and appropriate supplies to all nurses at all times must be ~rovided with protective clothes and plastic bags. The employment vaccination must be offered free of charge to all nurses Ul addition to availability of HBV post exposure prophylaxis for health care workers at least at a central level. provide the hospitals with libraries including reading materials in Arabic and English about infectious diseases and tmiversal precautions. Nursing curriculum at schools and faculties of nursing must stress on the concept of tmiversal precautions with great emphasis on its application Ihrough adequate training and supervision of students in the clinical settings. Regulations should be taken against non compliant nurses to universal precautions.Health education campaign for the whole population especially for health care workers, should be carried out including simple preventive measures for disease control through proper syringe disposal. Further studies are required to development a system of epidemiological surveillance for hepatitis on a national scale in order to obtain additional mfonnation about the disease and to guid plans for prevention and control.