PREVALANCE OF HEPATITIS B AND C AMONG OUT PATIENTS ATTENDING DUTSE GENERAL HOSPITAL

CHAPTER ONE

1.0  INTRODUCTION

Hepatitis involved inflammation of the liver cells and damage to the liver. The liver is a vital organ that processes Nutrients, filters the blood and fights infections when the liver inflamed or damaged it's functions can be affected (WHO, 2017). Hepatitis is commonly caused by a viral infection but there are other possible causes of hepatitis such as heavy alcohol use, toxins some medications and certain medical condition. Hepatitis could also be caused by hepatitis virus which could be easily contracted from a victim through contact of body fluids, this could be either through sexual contact or even saliva; It could also be contracted is by chance a person consumes the waste passed out from a carrier, slight contact with these fluids can transmit the disease (Russell et al., 2019). There are different types and causes of hepatitis, but the symptoms can be similar. Hepatitis B and C viruses a global health problem causing acute and chromic infections that can lead to liver cirrhosis and hepatocellullar carcinoma (HCC). These infections are the leading cause for HCC worldwide and are associate with significant mortality accounting for more than 1.3million death per year (Dane et al., 1970). Owing to its high  incidence and resistance to treatment, liver cancer is the second leading cause of cancer related death worldwide with HCC representing approximately 90% of all primary liver cancer cases. The majority of viral associated HCC cases develop in subjects with liver cirrhosis, however hepatitis B virus infection can promote HCC development without prior end-stage liver disease (WHO, 2015). Thus understanding the role of hepatitis B and C viral infections in HCC development and therapies for this cancer.

Hepatitis refers the inflammation of the liver commonly caused by viral infections with hepatitis B and C being the most significant types According to the world health organization (WHO 2015) globally an estimated 325 million people are living with chronic hepatitis B and C. Chronic hepatitis B affect around 257million people while chronic hepatitis C affects around 71million people worldwide. Hepatitis A and E viruses also contributes to cases of hepatitis, but majority of these infections are acute and resolve without long term consequences (Lin 2H et al., 2011).

The geographic distribution of viral hepatitis is uneven with the highest burden found in low and middle income countries in Africa and Asia (Maucont Boulch D et al., 2018). In these regions the prevalence of hepatitis can be particularly high, often due to transmission from mother to child during birth, unsterile medical procedures and unsafe injections is most common is certain populations such as people who inject drugs or receive blood products.

HEPATITIS B

Hepatitis B viral injection is an infectious- inflammatory disease of the liver caused by the hepatitis B virus (HBV) - a hepadnavirus (Zukeman, 2006). Originally it was known as "serum hepatitis (Bakar et al.,1996) and has caused epidemics in the world (Asia and Sub-saharan Africa) with the disease now being endemic in China (Williams, 2006).

As noted by world health organization (WHO, 2009) about one third of the world's population (> 2billion people) have been infected with HBV virus at one part in their times including 350millions who are chronic carriers (Schilsky, 2013) the virus is transmitted by exposure to infectious blood or body fluids such as semen vaginal fluids (Fairley and Read, 2012) although the viral DNA has been detected in the saliva, tear and urine of chronic carriers.

According to Chang, (2007), the course of hepatitis B infection varies greatly with the clinical manifestation differing in patient with the age, immune status and the stage at which the infection is recognized. At the acute phase infection may produce serious illness characterized by hepatomegally, vomiting jaundice anorexia, fever, body arches and dark urine. Approximately about 0.5% of acute cases terminate in fatal, Fulminant Hepatitis chronic hepatitis B often progresses to liver complications (Cirrhosis and Hepatocellular Carcinome (HCC) in 25% of cases) accounts for the increased morbidity and mortality associated with the disease.

The pathophysiology of the disease shows that replication takes place in the liver (Locarnini, 2004), however the virus spreads to the blood where virus specific proteins (Viral antigen) and corresponding antibodies are expressed. These proteins and antibodies forms diagnostics markers of infection and are utilezed for the diagnosis of the disease. The treatment strategy consists of antiviral drugs supplemented with immune system modulator (Intergeron). Infection is prevented by vaccination (pungpapong et al.,2007).

HEPATITIS C

Hepatitis C is an infectious disease of the liver caused by hepatitis C virus (Ryan and Ray, 2004). It is widely believed that the outcomes of both infection and the pathogenesis of the associated liver diseases are determined by host virus interaction mediated by the immune response (Houghton, 2009). Although shores and Teri, (2011) had noted the difficulty in elucidating the viral-host factors at play in the infection which he attributed to the limited host range (human & chimpanzees) and non existence of cell culture or animal model for the virus.

According to sugden et al.,(2012) the current state of knowledge of the biology and pathogenic mechanism of the virus infection reflect what has been learned about their natural history and immunobiology in humans and chimpanzees as well as information from functional genomics and virologic immunological analysis of closely related flow-viruses infection in their natural host.

1.1 AIM AND OBJECTIVE

1.1.1 AIM

The aim of this research is to determine the prevalence of hepatitis B and C among out patient attending Dutse general hospital.

1.1.2 OBJECTIVE

- To determine the occurrence of hepatitis B and C among out patient attending dutse general hospital in both different sex group and ages.

- To determine the population at risk

- To determine infections rate among both sex group and ages.

- To observe the occurrence of infections under the record of 3years from January 2020 to December 2022 among out patient attending Dutse general hospital.

1.2 STATEMENT OF THE PROBLEM

Hepatitis refers to the inflammation of the liver which can be caused by various factors including viruses alcohol abuse, certain medications toxins and auto immune diseases. It can lead to serious liver damager scarring (cirrhosis) liver failure and in some cases even death.

1.3 SIGNIFICANCE OF THE RESEARCH

• To serve as guideline for further research

• To find way out in reducing the incidence among people

• To ensure proper care of the patient.

1.4 JUSTIFICATION OF THE RESEARCH

In this research am justifying  that the patient  does not know they are affected  with this type of infection  talkless of taking prevention.  So this my research  want to help people that are infected with  this infection  to know how they can be prescribe and those  that are not with the infection to know how to prevent  themselves  from this types of viral  infection.

1.5 SCOPE AND LIMITATION

The scope of this research will focuses only on prevalence of hepatitis B and C among out patient attending dutse general hospital during the study time. And any patient attending other hospital a part from dutse general hospital is outside the scope of the study, hence is the limitation of the research.