Perception and Attitude of Pregnant Women Towards Hepatitis B Infection in Selected Clinics in Chanchiga LGA Niger State
CHAPTER ONE
Objective of the Study
The purpose of the study was to investigate: the perception and attitude of pregnant women in the Chanchiga L.G.A on hepatitis B and its prevention and the relationship between pregnant women’ knowledge and their practices on the prevention of hepatitis B.
CHAPTER TWO
LITERATURE REVIEW
Meaning of Hepatitis B Disease and the Virus
The etiological agent for the HBV was discovered in 1966 (Ocama et al., 2005). Hepatitis B infection is a major health problem with a characteristic geographic distribution (Halfon et al., 2005). Hepatitis B, caused by HBV is a serious liver disease. The disease’s transmission is through human body fluids such as blood and serum. Worldwide, it is an alarming public health problem. Its methods of transmission include through mother-to-baby (perinatal), the use of improper injection techniques and sexual contact. The functional integrity of the liver could directly or indirectly be affected by Hepatitis B infection in the infected hosts (Altiparmak et al., 2005).
The liver, as a homeostatic organ, plays a pivotal role in modulating intracellular and extracellular cycles of lipid metabolism. It is involved in the sequestration, remodeling (synthesis or recycling), and redistribution of lipid metabolites, including lipoproteins such as very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and their corresponding apolipo proteins – ApoB, and Apo A1, triglycerides (TG), and total plasma cholesterol. Thus, the extracellular circulating levels of these lipids in plasma of hepatitis B-infected patients depend significantly on the functionality of the host liver (Altiparmak et al., 2005).
More than two billion amongst the population alive today would have been infected at some time or other in their lives by HBV and 350 million of them approximately are the carriers of the chronically infected disease (Kane, 2005). 25-30% out of these would die as a consequence of the infection (WHO, 2003). These carriers are at high risk of this serious illness and death from cirrhosis of liver and/or primary liver cancer would kill more than one million of them, per year. From generation to generation, they also constitute a reservoir of infected individuals, who perpetuate the infection.
For most biomedical researchers over the past decade, the nature and extent of association of chronic hepatitis B disease and serum transaminases and lipid dysregulation has become the subject of interest. Dyslipidemia in liver diseases, as reported by most researchers, has been largely attributed to the decrease in the biosynthetic and bioprocessing capacity of the liver in the diseased state, as with chronic hepatitis B infection (Maynard et al., 2008). Reports on the profile of lipids in cases of liver diseases have been very diverse, showing slight to marked variations in plasma lipoprotein and apolipoprotein patterns. In one study of the dyslipidemia in chronic hepatitis, liver cirrhosis and hepato-cellular carcinoma (HCC), the TG and cholesterol levels decreased while LDL – cholesterol fraction increased with HDLfraction remaining fairly unchanged (Altiparmak et al., 2005). Altogether, the increased LDL-Cholesterol and the normal plasma HDL-Cholesterol may pose increased cardiovascular risk to patients with liver disease.
Pathophysiologically, there are two main stages of chronic hepatitis B infection – chronic symptomatic and chronic asymptomatic stages with their attendant pathological manifestations (WHO, 2008). However, most studies of chronic hepatitis B infection have not investigated the relationship of these stages on serum transaminases and lipid profile of infected hosts.
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
The study employed descriptive cross-sectional survey design. According to Gay and Airasian (2006), the descriptive survey is concerned with the conditions or relationships that exist, such as determining the nature of prevailing conditions, practices and attitudes; opinions that are held; processes that are going on; or trends that are developed. This type of study design was chosen because, considering the purpose of this study, it was the appropriate design.
Population
The population of the study is all the pregnant women of the towns in the Chanchiga L.G.A. These pregnant women are young adults who are mostly between the age brackets of 18 to 25. According to the Nurses, Of three clinics, the total population of the clinics are 1502 pregnant women.
Sampling Procedure
A sample size of 300 was sampled from a population of 1502 involving all towns. According to Krejcie and Morgan (1970) in their table of determining sample size, they revealed that as population increases the sample size increases at a diminishing rate and remains constant at slightly more than 380 cases. Due to time and resource constraints, the researcher decided to use a sample size of 300 since that will enable the sampling of equal number of pregnant women from each hospital. According to Krejcie and Morgan (1970), calculating 20% of any given population is enough to make representation. In order to sample a proportional number of pregnant women from all three clinics, 20% of the pregnant women in each hospital was calculated and the results was added to arrive at the sample size of 300. Sample size of 300 was therefore chosen since it represents about 20% of the entire population which is a fairly good representation of the entire population.
CHAPTER FOUR
RESULTS AND DISCUSSION
The purpose of this study was to investigate the perception and attitude of Pregnant women in the Chanchiga L.G.A on hepatitis B and its prevention and also ascertained the relationship between pregnant women’ knowledge and their practices on the prevention of hepatitis B. The present chapter deals with the presentation, interpretation and discussion of the results based on the research questions.
Research Question 1: What is the Attitude of Pregnant women in Chanchiga L.G.A towards Hepatitis B and its Prevention?
The research question sought to find out the attitude of pregnant women in the Chanchiga L.G.A towards hepatitis B infection. Table 1 shows the attitude level of the respondents towards Hepatitis B and its prevention. Many of the pregnant women, almost 85% (n = 241), had positive attitude towards Hepatitis B and its prevention. Pregnant women’s positive attitude towards Hepatitis B and its prevention could be the result of their high knowledge about Hepatitis B and its prevention.
Notwithstanding the positive attitude shown by many of the respondents, about 15% (n = 43) of the respondents exhibited negative attitude towards Hepatitis B and its prevention.
CHAPTER FIVE
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
The purpose of this study was to investigate the perception and attitude of Pregnant women in the Chanchiga L.G.A on hepatitis B and its prevention. The study also sought to ascertain the relationship between pregnant women’ perception and their practices on the prevention of hepatitis B.
Summary
Hepatitis B is a major public health threat globally. Despite the fact that there is a vaccine against HBV since 1982 that gives 90-100% protection against infection, there are in the world today more than 350 million people living with chronic hepatitis B. The consequence of this is approximately 600 000 HBV related deaths every year around the world, where the cause is primary liver cirrhosis or liver cancer.
There seems to be not much attention given to it by policy makers, health institutions, the general public and decision makers in spite of the long history of the disease in the country; there have not been any bold and pragmatic measures put in place to curb the disease in the country. In the light of the lukewarm attitude shown towards Hepatitis B and due to acts of selective prevention of infectious diseases by health professionals including HB, the disease is said to be spreading fast with an estimated number of four million people as carriers. There has also been an increase in the number of deaths associated with the disease in the country.
Although hepatitis B screening and vaccination is carried out in some few health facilities in Nigeria, it is not a national policy and is not incorporated into national health policies like the free counseling and testing for HIV or the mass immunization of children against measles.
A quantitative descriptive research, employing a cross-sectional survey design, was adopted for the study. The reference population consisted of all pregnant women (pregnant women) in the towns in the Chanchiga L.G.A. The study population however, consisted of all pregnant women of three clinics in the Chanchiga L.G.A.
Key Findings
The findings are:
Pregnant women’ attitude towards Hepatitis B among the towns in the Chanchiga L.G.A was positive, but few of the pregnant women also had negative attitudes towards Hepatitis B and its prevention.
The practices of pregnant women of the towns in Chanchiga L.G.A towards hepatitis B were good. However, few pregnant women showed poor practices towards Hepatitis B and its prevention.
There was a statistically significant relationship found between pregnant woman perception about Hepatitis B and practices towards Hepatitis B prevention.
Conclusions
Based on the findings, the following conclusions have been drawn;
There is a good perception among the pregnant women in the Chanchiga and this is likely to help the pregnant women to impart positively on the children they are going to teach. The good perception will also enable them to put up good preventive practices.
There is positive attitude exhibited by the pregnant women and this is likely to help impart upon the children the right attitude towards the prevention of Hepatitis B.
There is significant relationship between pregnant women’ perception and their practices and this is likely to influence the behaviour of the children they teach.
Recommendations
Based on the key findings and conclusion, the following recommendations were made;
There should be rewarding scheme to reward those pregnant women who show good perception, positive attitude and good practices to spur others on.
Screening in the Towns must be made compulsory with education attached.
Although there was 56% of the pregnant women who exhibited good practices about hepatitis B, about 44% among them also showed low practices about hepatitis B, therefore, there is the need to improve upon their way of practice towards its prevention.
REFERENCES
- Abongwa, L. E., & Kenneth, P. (2016). Assessing prevalence and risk factors of hepatitis B surface antigen amongst pregnant women attending antenatal clinic in the Northwest Region of Cameroon. European Journal of Research in Medical Sciences, 4, 32-43.
- Adjei, A., Armah, B., Gbagbo, F., & Ampofo, K. (2006). Prevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus Syphilis among prison inmates and officers at Nsawam and Accra, Nigeria. Journal of Med Microbiology, 55, 593-597.
- Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting behaviour. Englewood Cliffs, NJ: Prentice-Hall.
- Ajzen, I. (1985). From intentions to actions: A theory of planned behaviour. Berlin, Germany: Springer Berlin Heidelberg.
- Ajzen, I. (1991). Theory of planned behaviour. Organizational Behaviour and Human Decisions Processes. Massachusetts, United States: Academic Press.
- Ajzen, I. (2002). Perceived behavioural control, self-efficacy, locus of control and the theory of planned behaviour. New Jersey, United States.
- Journal of Applied Social Psychology, 32, 665–683.
