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Product Code: 00001391

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The study investigates Nurses  Knowledge and Preventive Measures of Hepatitis B Virus with focus on LASUTH  and Ikeja General Hospital. In this study, some relevant and extensive literatures were reviewed under relevant sub-headings. The descriptive research survey was used to assess the respondents’ opinions using the questionnaire and the sampling technique. In this study, 50 (fifty) respondents were selected and used as samples to represent the population of the study. Four (4) null hypotheses were formulated and tested in this study. Also, the statistics of analysis of variance (ANOVA) was used to test and analyses the null hypotheses at 0.05 level of significance, at the end of the exercise, the following results were obtained: Hypothesis one revealed that Knowledge will significantly influence the perception of health workers on the effect of Hepatitis B virus; Hypothesis two also indicated that there is a significant difference in the attitude of health workers towards hepatitis B infection; Hypothesis three further  indicated that there is a significant difference in the risk perception of hepatitis B virus infection among health workers and Hypothesis four finally indicates that there is a significant difference in the prevalence of hepatitis B virus infection among health workers. Based on the findings from the study the following conclusions were drawn that   Hepatitis B virus is an important occupational hazard for health workers. This study seems to buttress that by the fact that a majority of the respondents demonstrated a high level of knowledge of hepatitis B infection, the routes of transmission of the infection, the ways of preventing the infection and the fact that the infection can be transmitted as a nosocomial infection. Recommendations were made on the basis of the findings of this study which include the following: Nationwide vaccination campaign against hepatitis B in high risk groups especially HCWs. Nigeria government has greatly improved in vaccination of children against HBV, the next step could be to consider adults at risk, such as HCWs, hairdressers, motorist, etc and targeted vaccination should be done for such group; Nigeria government should further ensure that there should be a written policy on hepatitis control in all hospitals; hence, they should be encouraged to adopt standard precautions, to use safety devices and other personal protective equipments there is need for health workers to take standard precaution against this deadly virus and Government should ensure that Post-exposure management be put in place in hospital settings so that it can be centrally initiated, promptly, as and when required. Similar to HIV prophylaxis there must be a centralized counselling, testing, vaccination, and treatment facility that is widely advertised, and the location and contact numbers must be displayed at most visible sites of the hospital premises and made available round the clock.


Keywords: Nurses, Knowledge, Preventive Measures, Hepatitis B, Virus 






Title Page                                                                          i

Certification                                                                     ii

Dedication                                                                       iii

Acknowledgments                                                                  iv

Abstract                                                                                     v

Table of Contents                                                                    vi


Background of Study                                                                     1

Statement of the Problem                                                             4

Purpose of the Study                                                                   6

Research Questions                                                               6

Research Hypotheses                                                                6

Significance of the Study                                                          7

Delimitation of the study                                                   7                  

Scope of the Study­                                                                        8

Definition of Terms                                                                      8



Introduction                                                                                    10

Concept of Hepatitis B Virus                                                        10

Discovery of Hepatitis B Virus                                              15

Transmission of Hepatitis B Virus                                          25

Risk of Hepatitis B viral infection                                             27

The Prevalence of Hepatitis B Virus Infection among Health Workers   29

Knowledge about Hepatitis B Infection among Health Workers      36

Prevalence of Hepatitis B Vaccination among Health Care Workers in Nigeria        41

Barriers to HBV Vaccination among Health Care Workers in Nigeria    47

Factors that Can Enhance Vaccine Completion among Health Care Workers in Nigeria   37



Research Design                                                                    50

Population and Sampling Procedures                                  51

Research Instrument                                                                51

Data Collection Techniques                                                     52

Validation of Instrument                                                          52

Reliability of Instrument                                                           53

Method of Data Analysis                                                          53


Introduction                                                                           54

Descriptive Analysis of Respondents’ Gender and Age Range        54

Hypotheses Testing                                                           60

Summary of Findings                                                              63

Discussion of Findings                                                             63



Introduction                                                                            68

Summary of the Study                                                          68

Conclusions                                                                            69

Recommendations                                                               71

Suggestion for Further Studies                                              71

References                                                                               73
Appendix                                                                                77





Background of study

Hepatitis B (HB) is a global public health problem and is one of the most common infectious diseases in the world. HB infects nearly 2 billion people around the globe, out of which 350 million suffer from chronic, lifelong infection. Around 15%–40% of chronic HB patients are susceptible to develop liver cirrhosis and hepatocellular carcinoma (Lok & Mcmahon, 2007). In the United States, 804,000-1.4 million persons are estimated to be infected with the HBV, with majority being unaware of their status.

Hepatitis B virus (HBV) is a major cause of morbidity and mortality worldwide causing 620,000 deaths per year. It is responsible for approximately 1.5 million deaths worldwide each year, two-thirds of which are due to hepatocellular carcinoma. The World Health Organization estimated the hepatitis B surface antigen (HBsAg) prevalence in the Eastern Mediterranean region, which includes Middle East to be from 1%–10%, making it a region of intermediate to high endemicity. Safe and effective vaccine is available for prevention of HB, the first anticancer vaccine to be developed. Physicians, dentists, nurses, laboratory staff, and other hospital staff are at high risk of acquiring infection via the contact with blood and other body fluids (Centers for Disease Control and Prevention, 2007).

Hepatitis B is a small envelope DNA virus. It was originally known as ‘serum hepatitis. It is transmitted through contact with the blood or body fluids (saliva, sweat, semen and vaginal fluid) of an infected person. Other risk factors for HBV infection include working in a healthcare setting due to the risk of needle pricks, contact with infected blood; blood transfusions, dialysis, sexually transmitted, acupuncture, use of contaminated needles among injecting drug users, sharing of razor blades, tattoo, flared toothbrushes which can breech the oral mucosa and travel in countries where it is endemic ( Kew,2010).

HBV infection is highest in sub Africa and hyper endemic in Nigeria with 14% of the population in Nigeria bein­g exposed to HBV. 2–5% of the general population in the Middle East and the Indian subcontinent have been found to be chronically infected. This proportion is larger compared to less than 1% of the population in Western Europe and North America that are chronically infected ( WHO, 2015).

The World Health Organization has classified Ireland as a country of low prevalence for HBV, i.e. prevalence of HBsAg<2%. In Europe, the total percentage of people infected with HBV varies between different countries, with higher rates in the southern part of Europe. The country with the highest prevalence (>4%) is Romania followed by medium prevalence countries (>1-2%), Spain, (parts of) Italy, and Greece. Belgium, Finland, Germany, Ireland, Sweden and Slovak have been identified as countries with a low prevalence of HBV (ECDPC, 2010).

Approximately one health care worker dies each day from hepatitis B. Hence, HBV accounts for a major occupational hazard for health care workers due to their regular exposure to blood, blood products and body fluids, although, the concentration of hepatitis B virus in different body fluids varies. It is high in blood, serum, wound exudates; moderate in semen, vaginal fluid, saliva, and low/not detectable in urine, faeces, sweat, breast milk, tears which are all the working medium of health care workers especially doctors, nurses, medical laboratory scientists ( OSHA,2011).

More so, the risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6-30%. According to Rampal, Zakaria, Sook and Zain (2010), the risk exposure varies among the HCWs but exposure rate is higher among the nurses due to a number of activities they are involved in more than others. This is also in line with Ndakoda (2014), who reveals that the prevalence of HBV tends to be high among personnel with high proximity to blood and body fluids. Elmulkasfi (2012), has also established the fact that there is association between occupation and type of department and the rate of getting HBV. In the industrialised world, occupational surveillance assess and monitor the health hazards related to blood borne pathogens and preventive measures to reduce the risk of transmission but this is in contrast to what we have in the developing countries where exposure and health impacts are rarely monitored and much remains to be done to protect health workers from such risk that causes infection (Ndako, 2014).

According to Okwara (2012), there’s is poor adherence to safety practices among health care personnel in Nigeria which contribute to the risk of Needle Prick Injuries and majority of health care workers who have had needle prick injuries never take post exposure prophylaxis (PEP) despite the fact that they are aware of this PEP. Hepatitis B is preventable with the currently available safe and effective vaccine, usually a recombinant type. The vaccine has been available since 1982 and it’s effective in preventing infection and its chronic denouement. It was the first vaccine against a major human cancer. World Health Organization recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24hours. If missed, the child can take it 6weeks after, as part of pentavalent regime. For adults, the recommended outright vaccination still remains a three-dose regimen, with the second and third doses at 1and 6 months after the first dose. A post vaccination test is required to verify the effectiveness and a booster dose is needed after 5years (Poland and Jacobson, 2004).

Those to be vaccinated include: Everyone but especially health-care workers, people who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations, people interned in prisons and internally displaced persons in camps, injecting drug users; people with multiple sexual partners and travellers. Travellers who have not completed their hepatitis B vaccination series should be offered the vaccine before leaving for endemic areas (Odusanya and Meurice, 2007). It is on this note that the study examines a perception of health workers on hepatitis B virus.


Statement of the Problem

Hepatitis B is the most important infectious occupational disease that health workers are exposed to (Samuel, Aderibigbe, Salami, &Babatunde, 2009). The risk of being infected is dependent on the prevalence of the virus carriers in the environment, the frequency of exposure of the health worker to blood and body fluid and the infectivity of the hepatitis B virus. Health workers, in Nigeria are particularly at increased risk because Nigeria is a holoendemic area, with a hepatitis B virus carrier rate of 15.37%.

Hepatitis B virus (HBV) infection threatens the health of populations across the globe. An estimated 240 million people are chronically infected and more than 780,000 people die every year due to complications of hepatitis B including cirrhosis and liver cancer (WHO, 2015).Approximately one third of all cases of cirrhosis and half of all cases of hepatocellular carcinoma can be attributed to chronic HBV infection, and the disease is estimated to be responsible for 50,000-700,000 deaths each year (Shepard et al., 2006; WHO, 2004). The risks and preventive measures against occupational exposure of HCWs to blood borne pathogens are well documented. Although, universal precautions were established many years ago to address this problem, their application is difficult in developing countries, owing to organizational problems and lack of necessary materials such as gloves and proper needle disposal facilities (Le Pont et al., 2003).

Reports from studies conducted in health facilities across Nigeria show high prevalence of injury from sharps and accidental exposure to potentially infected blood and body fluids, while use of personal protective equipment was found to be low due to unavailability, inadequate or irregular supply of materials and equipment needed for protective and hygienic practices in most of the health facilities (Adesunkanmi et al., 2003; Ansa et al., 2002). Therefore, the researcher tends to investigate the perception of health workers on the effect of Hepatitis B virus


Purpose of the Study

The purpose of this research is to investigate nurses knowledge and preventive measures of hepatitis B virus with focus on LASUTH  and Ikeja General Hospital .The following objectives are to achieve the purpose of the study.

1.      To identify the knowledge of transmission of hepatitis B among health workers.

2.      To determine the attitude of health workers towards hepatitis B infection.

3.      To examine the risk perception of hepatitis B virus infection among health workers.

4.      To determine the prevalence of hepatitis B vaccination among health workers.

5.      To identify ways of preventing hepatitis B infection among health workers.

Research Questions

The study will raise the following question in the course of the study:

1.      What are the knowledge of transmission of hepatitis B among health workers?

2.      What is the attitude of health workers towards hepatitis B infection?

3.      What is the risk perception of hepatitis B virus infection among health workers?

4.      What is the prevalence of hepatitis B vaccination among health workers?

Research Hypotheses

H01:      Knowledge will not significantly influence the perception of health workers on the effect of Hepatitis B virus

H02:      There is no significant difference in the attitude of health workers towards hepatitis B infection

H03:      There is no significant difference in the risk perception of hepatitis B virus infection among health workers.

H04:      There is no significant difference in the prevalence of hepatitis B virus infection among health workers

Significance of the Study

This study might be useful to health managers and planners to develop appropriate preventive services, allocate resources, decide on priorities and target certain populations as regard hepatitis B virus.

The study may provide information on the routes of transmission of hepatitis B among health workers, attitude of health workers towards hepatitis B infection, the risk perception of hepatitis B virus infection among health workers,the prevalence of hepatitis B vaccination among health workers and the ways of preventing hepatitis B infection among health workers.

Finally, the research will also be of practical relevance to the government, non-governmental organizations and social researchers who may be interested in this field of study.


Delimitation of the study

The study will be delimited to the following study

1.      Descriptive research method

2.      All health care workers in Lagos state

3.      150 respondents will be selected from LASUTH through purposive sampling technique.

4.      Descriptive statistic of frequency count and percentage and inferential statistic of chi-square to test the stated hypotheses

5.      Self-structured questionnaire as instrument for data collection.

Scope of the Study­

The scope of this study is to investigate nurses knowledge and preventive measures of hepatitis B virus with focus on LASUTH and Ikeja General Hospital.

Definition of Terms

Hepatitis B Virus: Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is transmitted through contact with the blood or other body fluids of an infected person.

Infection: An infection is the invasion of bodily tissue by pathogenic microorganisms that proliferate, resulting in tissue injury that can progress to disease.

Transmission: Transmission is the passing of a pathogen causing communicable disease from an infected host individual or group to a particular individual or group, regardless of whether the other individual was previously infected.

Health Workers: Health workers are all people engaged in actions whose primary intent is to enhance health.

Attitude: Attitude is a predisposition or a tendency to respond positively or negatively towards a certain idea, object, person, or situation. Attitude influences an individual's choice of action, and responses to challenges, incentives, and rewards (together called stimuli).

Risk Perception: Risk perception is the subjective judgement that people make about the characteristics and severity of a risk.

Knowledge: Knowledge is a familiarity, awareness or understanding of someone or something, such as facts, information, descriptions, or skills, which is acquired through experience or education by perceiving, discovering, or learning.

Vaccination: Vaccination is the administration of antigenic material (a vaccine) to stimulate an individual's immune system to develop adaptive immunity to a pathogen. Vaccines can prevent or ameliorate morbidity from infection. When a sufficiently large percentage of a population has been vaccinated, this results in herd immunity.

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