Sero-prevalence and associated risk factors of Hepatitis B among adults attending selected government hospitals in Nigeria
Keywords:
Hepatitis B Virus, Hepatitis B surface antigen, Risk factors, Sero-prevalence, Socio-demographic data
Abstract
Hepatitis B virus (HBV) infection is one of the major public health problems globally. This study aims to determine the frequency of occurrence of HBV infection and associated risk factors for acquisition of the disease in clinically-ill adult patients attending selected government hospitals in Ondo State, Nigeria. Seven hundred and sixty-seven (767) ill adult individuals attending five medical out-patient Departments of the hospitals who consented to the study were recruited for the investigation. A structured questionnaire which covered sociodemographic characteristics and risk factors were used for primary information. Positivity for HBV was determined using a quality assured commercial enzyme linked immunosorbent assay (ELISA) kit for the detection of Hepatitis B surface antigen (HBsAg). Of the 767 patients, 11.0% were positive for HBsAg. The prevalence rate for HBsAg positivity was higher in the males (13.5%) than the females (9.3%) (pv = 0.043). The study also revealed the highest prevalence rate of HBsAg infection among the age group 19 – 39 years with mean percentage of 17.5%. Alcohol consumption, history of HBV in the family, multiple sex partners, history of injections in road side chemist shops, and intake of traditional herbs showed significant association respectively (p < 0.05), however no significant association among individuals with history of HBV vaccination, blood transfusion and tattoo/tribal mark (p > 0.05). Conclusively, this study gives information on the prevalence rate of HBV in the community sampled to be 11.0%. This shows that HBV is endemic in Ondo State, Southwest Nigeria.
References
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25. Olayinka AT, Oyemakinde A, Balogun MS, Ajudua A, Nguku P, Aderinola M, et al. Seroprevalence of Hepatitis B Infection in Nigeria: A National Survey. Am J Trop Med Hyg. 2016; 95(4): 902-907.
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27. Fomulu NJ, Morfaw FL, Torimiro JN, Nana P, Koh MV, William T. Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde‑Cameroon: Is perinatal transmission of HBV neglected in Cameroon? BMC Pregn Childbirth. 2013; 13: 158.
28. World Health Organization. Hepatitis B Global Infection rate. 2006. Available from: http://www.pkids.org/files/pdf/phr/02‑09 globalhbv.pdf [Last accessed on 2013 Dec 22].
29. Kiire CF. African Regional Study Group. Hepatitis B infection in sub-Saharan Africa. Vaccine. 1990; 8(Suppl 1): 107-112.
30. Martinson FEA, Weigle KA, Royce RA. Risk factors for horizontal transmission of hepatitis B in a rural district in Ghana. Am J Epidemiol. 1998; 147: 478-487.
31. Burnett RJ, Francois G, Kew MC. Hepatitis B virus and human immunodeficiency virus co-infection in sub-Saharan Africa: a call for further investigation. Liver Int. 2005; 25: 201-213.
32. Gogos CA, Fouka KP, Nikiforidis G, Avgeridis K, Sakellaropoulos G, Bassaris H, et al. Prevalence of hepatitis B and C virus infection in the general population and selected groups in South-Western Greece. Eur J Epidemiol. 2003; 18: 551-557.
33. Wang CS, Chang TT, Yao WJ, Chou P. Comparison of hepatitis B virus and hepatitis C virus prevalence and risk factors in a community-based study. Am J Trop Med Hyg. 2002; 66: 389-393.
34. Vilibić-Cavlek T, Kucinar J, Ljubin-Sternak S, Kaić B, Lazarić-Stefanović L, Kolarić B. Prevalence of viral hepatitis in Croatian adult population undergoing routine check-up, 2010-2011. Cent Eur J Public Health. 2014; 22: 29-33.
35. Koulentaki M, Ergazaki M, Moschandrea J, Spanoudakis S, Tzagarakis PE, Drandakis PE, et al. Prevalence of hepatitis B and C markers in high-risk hospitalized patients in Crete: a five year observation study. BMC Pub Hlth. 2001; 1: 17.
36. Khokhar, Nasir, Gill, Lateef M. Serological profile of incidentally detected asymptomatic HBsAg positive subjects. J Coll Physicians Surg Pak. 2004; 14(4): 208-210.
37. Adoga MP, Gyar SD, Peculano S, Bashayi OD, Emasegen SE, Zungwe T, et al. Hepatitis B virus infection in apparently healthy urban Nigerians: data from pre-vaccination tests. J Infect Dev Countries. 2010; 4(6): 397-400.
38. Islam MDU, Ahmed RU, Kibria SG, Nossain MT, Biswas MK, et al. Clinical significance of Serum HbeAg Among HbsAg Positive Patients. Faridpur Med Coll J. 2010; 5 (2): 50-52.
39. Pereira LM, Martelli CM, Hamann EM, Merchán-Hamann E, Montarroyos UR, Maria LCDL, et al. Population-based multicentric survey of hepatitis B infection and risk factor differences among three regions in Brazil. Am J Trop Med Hyg. 2009; 81: 240-247.
40. Obi SN, Onah HE, Ezugwu FO. Risk factors for hepatitis B infetion during pregnancy in a Nigerian obstetric population. J Obstet Gynaecol. 2006; 26: 770-772.
41. Akani CI, Ojule AC, Opurum AC, Ejimele AA. Sero-prevalence of hepatitis B surface antigen (HBsAg) in pregnant women in Port Harcourt, Nigeria. Niger Postgrad Med J. 2005; 12: 266-270.
42. Olokoba AB, Salawu FK, Danburam A, Olokoba LB, Midala JK, Badung LH. Hepatitis B virus infection amongst pregnant women in North-Eastern Nigeria- A call for action. Nigerian J Clin Pract. 2011; 14(1): 10-13.
43. Eke AC, Eke UA, Okafor CI, Ezebialu IU, Ogbuagu C. Prevalence, Correlates and pattern of Hepatitis B surface antigen in a low resource setting. Virol J. 2011; 8: 12.
44. Okonko IO, Udeze AO. Detection of Hepatitis B surface antigen (HBsAg) among pregnant women attending Antenatal Clinic at OLA Catholic Hospital, Oluyoro, Ibadan, Oyo State, Southwestern Nigeria. Nat Sci. 2011; 9(11): 54-60.
45. Agarry OO, Lekwot GZ. Prevalence of hepatitis B virus and hepatitis C virus in ante-natal patients in Gwagwalada- Abuja, Nigeria. Report and Opinion. 2010; 2(7): 48-50.
46. Tawk HM, Vickery K, Bisset L. The impact of hepatitis B vaccination in a Western country: recall of vaccination and serological status in Australian adults. Vaccine. 2006; 24: 1095-1106.
47. Hong Z, Qingmei L, Jie S, Chunyan W, Qing G, Xiangwei F, et al. Seroprevalence and Risk Factors for Hepatitis B Infection in an Adult Population in Northeast China. Int J Med Sci. 2011; 8: 321-331.
48. Kuszewski K, Czarkowski MP. Hepatitis B in Poland in 2001 [in Polish]. Przegl Epidemiol. 2003; 57: 117-123.
49. Stroffolini T, Mele A, Tosti ME, Gallo G, Balocchini E, Syklo A, et al. The Impact of the Hepatitis B Mass Immunisation Campaign on the Incidence and Risk Factors of Acute Hepatitis B in Italy. J Hepatol. 2000; 33: 980-985.
50. Kupek E. Transfusion risk for hepatitis B, hepatitis C and HIV in the state of Santa Catarina, Brazil, 1991-2001. Braz J Infect Dis. 2004; 8: 236-240.
51. Al-Nassiri KA, Raja'a YA. Hepatitis B infection in Yemenis in Sana'a: pattern and risk factors. East Mediterr Health J. 2001; 7: 147-152.
52. Rotman Y, Brown AT, Hoofnaggle JH. Evaluation of the patient with hepatitis B. Hepatology. 2009; 49 Suppl 5: S22-S27.
53. Seeger C, Mason WS. Hepatitis B virus-biology. Microbiol Mol Biol Rev. 2000; 64: 51-68.
54. Hicks Rob: Hepatitis B. 2009. http://www.bbc.co.uk/health/physical_health/conditions/hepatitisb1.shtml.
55. Christopher S, William SM. Heptatis B virus Biology. Microbiol Mol Biol Rev. 2000; 64(1): 51-68.
2. Sunbul M. Hepatitis B virus genotypes: global distribution and clinical importance. World J Gastroenterol. 2014; 20(18): 5427.
3. WHO. World health statistics 2016: monitoring health for the SDGs sustainable development goals: World Health Organization; 2016.
4. Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1211-1259.
5. Global Health Estimates. Deaths by cause, age, sex, by country and by region, 2000–2015. Geneva: World Health Organization. 2015; 2016.
6. Kim H, Shin AR, Chung HH, Kim MK, Lee JS, Shim JJ, et al. Recent trends in hepatitis B virus infection in the general Korean population. Korean J Intern Med. 2013; 28(4): 413.
7. World Health Organization. Global Hepatitis Report, 2017. http://apps.who.int/iris/bitstream/10665/255016/1/9789241565455-eng.pdf.
8. Hwang EW, Cheung R. Global epidemiology of hepatitis B virus (HBV) infection. North Am J Med Sci. 2011; 4(1): 7-13.
9. Zhang J, Zou S, Giulivi A. Epidemiology of hepatitis B in Canada. Can J Infect Dis Med Microbiol. 2001; 12: 345-350.
10. Schweitzer A, Horn J, Mikolajczyk RT, Gerard K, Jordis OT. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015; 386(10003): 1546-1555.
11. Nayagam S, Thursz M, Sicuri E, Conteh L, Wiktor S, Daniel L, et al. Requirements for global elimination of hepatitis B: a modelling study. Lancet Infect Dis. 2016; 16: 1399-1408.
12. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age specific HBsAg seroprevalence and endemicity. Vaccine. 2012; 30: 2212-2219.
13. Tegegne D, Desta K, Tegbaru B, Tilahun T. Seroprevalence and transmission of Hepatitis B virus among delivering women and their new born in selected health facilities, Addis Ababa, Ethiopia: a cross sectional study. BMC Res Notes. 2014; 7(1): 239.
14. Degenhardt L, Charlson F, Stanaway JD, Larney S, Alexander LT, Hickman M, et al. Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C and hepatitis B: results from the Global Burden of Disease GBD 2013 study. Lancet Infect Dis. 2016; S1473-3099(16): 1385-1398.
15. Bakthavatchalu S. Hepatitis B Surface Antigen Carrier State among Asymptomatic Pregnant Women and Its Correlation with Vertical Transmission. Int J Res Pharm Sci. 2012; 2(3).
16. Camvulam N, Gotsch P, Langan RC. Caring for pregnant women and newborns with Hepatitis B or C. Am Fam Physician. 2010; 82(10): 1225–1229.
17. Lam N-CV, Gotsch PB, Langan RC. Caring for pregnant women and newborns with hepatitis B or C. Am Fam Physician. 2010; 82(10): 1225-1229.
18. Howell J, Lemoine M, Thursz M. Prevention of materno-foetal transmission of hepatitis B in sub-Saharan Africa: the evidence, current practice and future challenges. J Viral Hepat. 2014; 21(6): 381-396.
19. Lin KW, Kirchner JT. Hepatitis B. Am Fam Physician. 2004; 69: 1863.
20. Jahani MR, Motevalian SA, Mahmoodi M. Hepatitis B Carriers in Large Vehicle Drivers of Iran. Vaccine. 2003; 21: 1948-1951.
21. Alter MJ, Mast EE. The Epidemiology of Viral Hepatitis in the United States. Gastroenterol Clin North Am. 1994; 23: 437-455.
22. Mast EE, Alter MJ, Margolis HS. Strategies to Prevent and Control Hepatitis B and C Virus Infections: A Global Perspective. Vaccine. 1999; 17: 1730-1733.
23. Miranda J, Cabezas C. Hepatitis B among Health Workers Rev Gastroenterol Peru. 2001; 21: 128-135.
24. Kramvis A, Kew M. Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes. Hepatol Res. 2007; 37(Suppl 1): 9-19.
25. Olayinka AT, Oyemakinde A, Balogun MS, Ajudua A, Nguku P, Aderinola M, et al. Seroprevalence of Hepatitis B Infection in Nigeria: A National Survey. Am J Trop Med Hyg. 2016; 95(4): 902-907.
26. Dongdem JT, Kampo S, Soyiri IN, Asebga PN, Ziem JB, Sagoe K. Prevalence of hepatitis B virus infection among blood donors at the Tamale Teaching Hospital, Ghana (2009). BMC Res Notes. 2012; 5: 115.
27. Fomulu NJ, Morfaw FL, Torimiro JN, Nana P, Koh MV, William T. Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde‑Cameroon: Is perinatal transmission of HBV neglected in Cameroon? BMC Pregn Childbirth. 2013; 13: 158.
28. World Health Organization. Hepatitis B Global Infection rate. 2006. Available from: http://www.pkids.org/files/pdf/phr/02‑09 globalhbv.pdf [Last accessed on 2013 Dec 22].
29. Kiire CF. African Regional Study Group. Hepatitis B infection in sub-Saharan Africa. Vaccine. 1990; 8(Suppl 1): 107-112.
30. Martinson FEA, Weigle KA, Royce RA. Risk factors for horizontal transmission of hepatitis B in a rural district in Ghana. Am J Epidemiol. 1998; 147: 478-487.
31. Burnett RJ, Francois G, Kew MC. Hepatitis B virus and human immunodeficiency virus co-infection in sub-Saharan Africa: a call for further investigation. Liver Int. 2005; 25: 201-213.
32. Gogos CA, Fouka KP, Nikiforidis G, Avgeridis K, Sakellaropoulos G, Bassaris H, et al. Prevalence of hepatitis B and C virus infection in the general population and selected groups in South-Western Greece. Eur J Epidemiol. 2003; 18: 551-557.
33. Wang CS, Chang TT, Yao WJ, Chou P. Comparison of hepatitis B virus and hepatitis C virus prevalence and risk factors in a community-based study. Am J Trop Med Hyg. 2002; 66: 389-393.
34. Vilibić-Cavlek T, Kucinar J, Ljubin-Sternak S, Kaić B, Lazarić-Stefanović L, Kolarić B. Prevalence of viral hepatitis in Croatian adult population undergoing routine check-up, 2010-2011. Cent Eur J Public Health. 2014; 22: 29-33.
35. Koulentaki M, Ergazaki M, Moschandrea J, Spanoudakis S, Tzagarakis PE, Drandakis PE, et al. Prevalence of hepatitis B and C markers in high-risk hospitalized patients in Crete: a five year observation study. BMC Pub Hlth. 2001; 1: 17.
36. Khokhar, Nasir, Gill, Lateef M. Serological profile of incidentally detected asymptomatic HBsAg positive subjects. J Coll Physicians Surg Pak. 2004; 14(4): 208-210.
37. Adoga MP, Gyar SD, Peculano S, Bashayi OD, Emasegen SE, Zungwe T, et al. Hepatitis B virus infection in apparently healthy urban Nigerians: data from pre-vaccination tests. J Infect Dev Countries. 2010; 4(6): 397-400.
38. Islam MDU, Ahmed RU, Kibria SG, Nossain MT, Biswas MK, et al. Clinical significance of Serum HbeAg Among HbsAg Positive Patients. Faridpur Med Coll J. 2010; 5 (2): 50-52.
39. Pereira LM, Martelli CM, Hamann EM, Merchán-Hamann E, Montarroyos UR, Maria LCDL, et al. Population-based multicentric survey of hepatitis B infection and risk factor differences among three regions in Brazil. Am J Trop Med Hyg. 2009; 81: 240-247.
40. Obi SN, Onah HE, Ezugwu FO. Risk factors for hepatitis B infetion during pregnancy in a Nigerian obstetric population. J Obstet Gynaecol. 2006; 26: 770-772.
41. Akani CI, Ojule AC, Opurum AC, Ejimele AA. Sero-prevalence of hepatitis B surface antigen (HBsAg) in pregnant women in Port Harcourt, Nigeria. Niger Postgrad Med J. 2005; 12: 266-270.
42. Olokoba AB, Salawu FK, Danburam A, Olokoba LB, Midala JK, Badung LH. Hepatitis B virus infection amongst pregnant women in North-Eastern Nigeria- A call for action. Nigerian J Clin Pract. 2011; 14(1): 10-13.
43. Eke AC, Eke UA, Okafor CI, Ezebialu IU, Ogbuagu C. Prevalence, Correlates and pattern of Hepatitis B surface antigen in a low resource setting. Virol J. 2011; 8: 12.
44. Okonko IO, Udeze AO. Detection of Hepatitis B surface antigen (HBsAg) among pregnant women attending Antenatal Clinic at OLA Catholic Hospital, Oluyoro, Ibadan, Oyo State, Southwestern Nigeria. Nat Sci. 2011; 9(11): 54-60.
45. Agarry OO, Lekwot GZ. Prevalence of hepatitis B virus and hepatitis C virus in ante-natal patients in Gwagwalada- Abuja, Nigeria. Report and Opinion. 2010; 2(7): 48-50.
46. Tawk HM, Vickery K, Bisset L. The impact of hepatitis B vaccination in a Western country: recall of vaccination and serological status in Australian adults. Vaccine. 2006; 24: 1095-1106.
47. Hong Z, Qingmei L, Jie S, Chunyan W, Qing G, Xiangwei F, et al. Seroprevalence and Risk Factors for Hepatitis B Infection in an Adult Population in Northeast China. Int J Med Sci. 2011; 8: 321-331.
48. Kuszewski K, Czarkowski MP. Hepatitis B in Poland in 2001 [in Polish]. Przegl Epidemiol. 2003; 57: 117-123.
49. Stroffolini T, Mele A, Tosti ME, Gallo G, Balocchini E, Syklo A, et al. The Impact of the Hepatitis B Mass Immunisation Campaign on the Incidence and Risk Factors of Acute Hepatitis B in Italy. J Hepatol. 2000; 33: 980-985.
50. Kupek E. Transfusion risk for hepatitis B, hepatitis C and HIV in the state of Santa Catarina, Brazil, 1991-2001. Braz J Infect Dis. 2004; 8: 236-240.
51. Al-Nassiri KA, Raja'a YA. Hepatitis B infection in Yemenis in Sana'a: pattern and risk factors. East Mediterr Health J. 2001; 7: 147-152.
52. Rotman Y, Brown AT, Hoofnaggle JH. Evaluation of the patient with hepatitis B. Hepatology. 2009; 49 Suppl 5: S22-S27.
53. Seeger C, Mason WS. Hepatitis B virus-biology. Microbiol Mol Biol Rev. 2000; 64: 51-68.
54. Hicks Rob: Hepatitis B. 2009. http://www.bbc.co.uk/health/physical_health/conditions/hepatitisb1.shtml.
55. Christopher S, William SM. Heptatis B virus Biology. Microbiol Mol Biol Rev. 2000; 64(1): 51-68.
Published
2021-03-26
How to Cite
Ajayi, B., Adebolu, T., & Oladunmoye, M. (2021). Sero-prevalence and associated risk factors of Hepatitis B among adults attending selected government hospitals in Nigeria. MicroMedicine, 9(1), 27-36. Retrieved from https://journals.tmkarpinski.com/index.php/mmed/article/view/433
Section
Research Articles
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