SERO-PREVALENCE OF HEPATITIS B VIRUS AMONG OUTPATIENT ATTENDING DUTSE GENERAL HOSPITAL

CHAPTER ONE

1.0 Introduction

Hepatitis B virus (HBV) is a significant global health issue, with approximately 257 million people chronically infected worldwide. The prevalence of HBV varies across regions and populations. This project aims to determine the sero-prevalence of Hepatitis B virus among outpatients attending a Dutse General Hospital, which will help in assessing the burden of the disease and guide healthcare policies and interventions.

Hepatitis is known as an infection causing swelling and inflammation of the liver. Its chronic form may lead to cirrhosis or cancer. People, sometimes contact hepatitis with limited or no symptoms but usually it leads to jaundice, anorexia, poor appetite and diarrhea. Causative agents of hepatitis include; alcohol, poison, drugs and autoimmunity but most cases of hepatitis are caused by viruses. Hepatitis B virus (HBV) is among the principal causes of severe liver disease, including hepatocellular carcinoma and cirrhosis-related end-stage liver disease (Mujeeb, et al., 2002). The World Health Organization (WHO) estimates that there is 350 million people with chronic HBV infection worldwide. Hepatitis B is estimated to result in 563000 deaths annually (Ali et al., 2009).

Hepatitis B is one of the major health problems worldwide especially in Asia, Africa, southern Europe and Latin America (Ilyas et al., 2012).

Hepatitis B virus is transmitted through blood and blood products, sexual contacts. Interfamilial transmission is also reported. The major modes of HBV transmission in Nigeria are use of contaminated needles and instruments in medical practice, unsafe blood and blood product transfusion, intravenous drug use, face and armpit shaving with unsterilised instruments by barbers, ear and nose piercing, poor personal hygiene habits and treatment especially outpatient procedures (practice by non-qualified people) (Previsani, and Lavanchy, 2002).

Individual seeking outpatient may be healthy or suffering from dreadful diseases like hepatitis B or may be carriers that cannot be easily identified (Samaranayake, 1993). Such patient may act as a source for spreading such infection among Dutse General Hospital workers and other patients in Hospital. The major route of cross infection in outpatient surgery is via infection through intact skin or mucosa due to accidents involving sharps or direct inoculation onto cuts and abrasions in the skin (Girdler, et al., 1987) and (Verrusio, et al., 1989). Outpatient treatment procedures frequently cause bleeding and exposure to infected blood and saliva which are known means of infectious disease transmission. Routine use of barrier techniques such as disposable gloves, disposable syringes, spectacles and of course effective sterilization has been reported to be important in preventing the three routes of transmission (Doctor to patient, patient to Doctor and patient to patient) in Dutse General Hospital (Adel, et al., 1997).

Jigawa valley is one of the places worst hit by Hepatitis B infection, already declared as an epidemic by experts. Unfortunately in some villages of Dutse area, more than 50% population has tested positive. Similarly many villages have been tested positive in Dutse area, as are some areas in downtown. As per survey made by Directorate of Health Services, Jigawa, workers malpractice done by unqualified workers quacks on patients is an important source of spread of hepatitis B in the valley. This as per reports has been due to use of ungloved hands to treat problems, contaminated syringes and unsatisfactory methods of sterilizing instruments (Rehman, 2016).

There is no detailed published data on hepatitis B infections among patients attending Dutse General Hospital in Jigawa State and no Sero-prevalence study is available. This study is therefore attempt at finding out the Sero-prevalence of HBV infection (using HBsAg rapid kits) among patients as a marker of infection in those attending the Dutse General Hospital in Jigawa State. This study also highlights the potential hazards of HBV to the doctors associated health workers as well as to patients attending Hospital.

1.1 Statement of the Research Problem

Hepatitis B Virus- can cause a chronic infection and puts people at high risk of death from cirrhosis and liver cancer. It can separate through direct contact with infection body fluids like blood, saliva, vaginal fluids and semen. It can also be passed from a mother to her baby

1.2 Aim and Objectives of the Study

1.2.1 Aim:

To determine the Sero-prevalence of Hepatitis B virus among outpatients attending Dutse General Hospital.

1.2.2 Objectives:

The specific objectives of the study are as follows:

      i.         To determine the sero-prevalence of HBV among outpatients attending a Dutse General Hospital.

     ii.         To assess the association between HBV sero-prevalence and demographic factors (age, gender, occupation, etc.).

   iii.         To identify potential risk factors for HBV transmission among the outpatient population.

1.3 Significance of the Research

 Disease burden: Hepatitis B is a significant public health issue worldwide. Understanding the sero-prevalence of this virus is crucial for estimating the burden of the disease in a particular geographic region or population. It helps healthcare professionals and policymakers design effective prevention and control strategies to reduce transmission and associated morbidity and mortality.

. Identification of high-risk groups: By studying the sero-prevalence of Hepatitis B in patients attending general hospitals, it is possible to identify high-risk groups, such as individuals with specific medical conditions, behaviors, or demographics, who are more susceptible to acquiring the infection. This knowledge can be used to target prevention efforts towards these vulnerable populations and provide appropriate interventions, such as vaccination programs and education campaigns.

3. Early diagnosis and treatment: Identifying the sero-prevalence of Hepatitis B among hospital patients allows for early detection and appropriate management of infected individuals. Timely diagnosis is crucial for initiating antiviral therapy, monitoring disease progression, and preventing the development of chronic liver diseases like cirrhosis and hepatocellular carcinoma. Identifying the infection status of patients attending general hospitals can help healthcare professionals offer appropriate counseling, testing, and treatment to prevent further transmission and related complications.

4. Infection control in hospital settings: Hospitals are a potential source of nosocomial infections. Understanding the sero-prevalence of Hepatitis B among patients attending general hospitals helps to assess the risk of transmission within healthcare settings. By implementing appropriate infection control measures, such as ensuring universal precautions, proper sterilization techniques, and vaccination of healthcare workers, the risk of healthcare-associated transmission can be minimized, protecting both patients and healthcare providers.

5. Monitoring and evaluation of vaccination programs: Hepatitis B vaccination is a key preventive measure against the virus. Assessing the sero-prevalence of Hepatitis B in patients attending general hospitals allows for evaluating the effectiveness of vaccination programs in the population under study. It provides valuable data on the coverage and impact of vaccination efforts, helping public health authorities fine-tune vaccination strategies and increase awareness about the importance of immunization.

1.4 Scope and Delimitation of the Study

The scope of this study will be limited to outpatients attending a Dutse General Hospital within a specified geographic region or community. The sero-prevalence of HBV will be determined through blood samples collected from participants, and serological markers will be analyzed using standard laboratory methods. The research will primarily focus on the sero-prevalence of HBV and its association with demographic factors and potential risk factors among outpatients.