Prevalence of Hepatitis B Virus HBV Among the Adults Attending General Hospital Hunkuyi, Kudan Local Government Kaduna State
Chapter One
General objective.
The general objective of the study is to assess the knowledge, attitude and perception on hepatitis B virus infection among adults in Hunkuyi of Kaduna state.
Specific objectives.
In order to achieve this goal (general objective), the study addresses the following specific objectives;
- To determine the knowledge level of Hepatitis B virus infection among adults in Hunkuyi in Kaduna state.
- To explore the attitude and practices of adults in Hunkuyi in the Kaduna state towards Hepatitis B virus
- To examine the perception about Hepatitis B virus infection among adults in Hunkuyi in Kaduna state of
- To determine the association between participants’ demographic characteristics and their knowledge and attitude towards the
CHAPTER TWO
LITERATURE REVIEW
Introduction
This chapter describes key information regarding issues of the occurrence of hepatitis B under study based on individuals’ studies, textbooks, manuals, internet and publications of annual reports. It also gives a brief overview of the epidemiology of Hepatitis B Virus infection, and finally discusses the literature on knowledge, perception and attitudes of people regarding Hepatitis B virus infection. The chapter therefore begins with the definition of hepatitis B, historical perspectives, epidemiology, signs and symptoms, mode of transmission, diagnostic investigations, management/treatment and complications which are all review of theoretical empirical considerations of some individual researches in the prevention and treatment of hepatitis B virus infection.
Historical perspective of hepatitis B virus infection
In order to understand the management and prevention of Hepatitis B which is an inflammatory disease of the liver caused by the hepatitis B virus (HBV), it is imperative to see the disease in its historical context. The etiological agent for the HBV infection was discovered in 1965 (Zanetti et al., 2005). It was discovered when Blumberg and co-workers found the hepatitis B surface antigen, which was originally called the Australia antigen because it was found in serum from an Australian patient (Blumberg et al, 1965, 1977).
Dr Baruch Samuel Blumberg was awarded the 1976 Noble Prize in Physiology or Medicine for this discovery. The virus was fully described in the 1970s (Morrow et al., 197I). In recent times,
the rapid and continuous discoveries of the viral disease around the whole world have improved our understanding of the complexity of this unusual virus. Although there has not been any substantial decrease in the overall prevalence of HBV infection, there is the hope that the next generation will see a decline in both the worldwide carrier rate and the incidence of new HBV infections if current HBV vaccinations are intensified.
Hepatitis B virus infection is a major health problem with a characteristic geographic distribution (Lavanchy, 2005). The major risk factors associated with HBV infection include poor sterilization technique and contact with infected blood and body fluids (Goldstein, 2002). All health care workers in contact with blood and body fluids should know their antibody status and be vaccinated for HBV if they have not previously had HBV infection and should adhere to universal protective measures (Fry, 2007).
Global epidemiology of hepatitis B.
The threat posed by the global HBV epidemic continues to assume alarming proportions in areas of public health and national development. Globally, two billion people have been infected with HBV at some point in time in their life time and 360 to 400 million people which represents more than 5% of the world’s population are chronic carriers with an estimated 600,000 deaths each year due to consequences of HBV (WHO, 2012). It is estimated to be the tenth cause of deaths worldwide (WHO, 2008). Hepatitis B virus mostly affects the liver and can cause liver cancer. The disease is 50 to 100 times more infectious than the deadly human immunodeficiency virus (HIV) and can remain on part of the body for close to seven days (Hepatitis Foundation International, 2006).
The incidence of acute hepatitis B varies greatly from country to country as a result of insufficient reliable data and also, comparisons between countries is often difficult due to different reporting systems with limited quality (Grob,1995). The WHO has therefore demarcated the world according to chronic hepatitis B prevalence into three major blocks which include high, intermediate and low prevalence. High prevalence areas have a prevalence of chronic hepatitis B infection that is equal to or greater than eight (8%) made up of countries from North America, South America, Sub-Saharan Africa and most Asian countries. Intermediate prevalence areas have a prevalence rate which ranges between 2% and 7% and include countries from South America, North Africa, Western Europe, Eastern Europe and the Indian subcontinent. Low prevalence areas are estimated to have a prevalence of chronic infection less than (2%) which includes most of the North American countries, Australia and most of Western Europe including the United Kingdom (UK).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter presents a comprehensive account of how the study was conducted. It describes methods and materials that were used in this study to assess the knowledge, attitude and perception about Hepatitis B virus infection among adults in Hunkuyi in Kaduna state. The chapter also describes the study area, study design/type, study population, ethical consideration, sampling procedure, instrument as well as tools for data analysis.
Study design
A study design is procedural plan that is adopted in a study to answer questions validly, objectively, accurately and economically (Kumar, 2011). The study design was a descriptive cross-sectional survey. According to Gay & 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. They also argue that it is only descriptive studies that lead to generalization beyond the given sample and situation. This type of study design was chosen because, considering the purpose of this study, the research questions and the target population, it is the most appropriate design that suits the aim/objectives of the study and to collect data from respondents.
Walker (1985) described descriptive survey as the type of study design that determines and report the way things are. This research design has a number of advantages. The design has the advantage of eliciting responses from a wide range of people. It involves asking the same set of questions to large number of individuals through mails, telephone and by hand on the basis of data gathered at a point in time. It is also appropriate when there is attempt to describe some aspects of a population by selecting unbiased samples of individuals who are asked to complete questionnaire, interview and test Silverman (2006).
The descriptive survey is not without weaknesses or disadvantages. Dey (2007) contended that errors and inadequacies of a survey research in education at many points appear the way problems are initially chosen and defined through the selection of population and sample to items construction and analysis of resulting data. Also, getting a sufficient number of the questionnaire completed and returned so that meaningful analysis can be made is another weakness of descriptive survey (Higgins, 1996). Despite these shortcomings, the descriptive design is most appropriate to providing answers to many research questions and achieving the purpose of the study.
Study population
This refers to individuals, organization, groups or communities from which the required information about a research problem is obtained. In other words, it is the full set of individuals who could be included and around which the findings can be generalised. The target population for the study were people of Hunkuyi and sample units were people between 15 and 40 years both male and females of the district.
CHAPTER FOUR
RESULTS
Introduction
This chapter presents the analysis of the data that was collected from the respondents. It is presented largely descriptively in the form of tables. The results is organized into five thematic areas comprising; demographic characteristics of respondents, knowledge of respondents concerning Hepatitis B Viral infection, attitude / practice of respondents towards Hepatitis B Virus infection, perception of Hepatitis B Virus infection among respondents and ways of improving knowledge, attitude and perception of respondents towards Hepatitis B Virus infection.
CHAPTER FIVE
DISCUSSION OF FINDINGS AND CONCLUSION
Demographic characteristics
Finding from the study showed that, Majority (64%) of the respondents were between the ages of 15-25 years. This findings could be attributed to the fact that the population pyramid of the district has higher population at the base between age 0-20 years and less population from the middle towards the pick thus; 40 years and above) (Nigeria Statistical Service, 2010 Population and Housing Census). Majority of the respondents falling within the ages of 15-25 years is not surprising in the study since it is in line with the district population pyramid with the higher population among the target group (15-40 years) (Hunkuyi profile, 2015). Also, in the national population pyramid, the age range of 15-25 years is more populated than those above 25 years, that is; high population at the base and less at the pick (Nigeria Statistical Service, 2010 Population and Housing Census).
Majority (58.5%) of the respondents were males. The low female population in the study could be due to the fact that most females could have been engaged in household chores and other trading
activities hence could not participate in the exercise. Results from the study further revealed that majority (50%) of the respondents were students with most (35%) of them attaining tertiary status.
Knowledge of respondents on hepatitis B virus infection
According to the World Health Organization (WHO, 2012), hepatitis B is the world’s most common liver infection, which is caused by a DNA-virus, the hepatitis B virus (HBV). The virus is highly contagious, 50-100 times more infectious than HIV, and is transmitted between people through blood, semen, vaginal fluids and mucous membranes. There are more than 2 billion people world-wide having evidence of recent or past HBV infection and 350 million are chronic carriers. The secret killer hepatitis B, though a major threat to health globally, is yet to catch the attention of health institutions, policy makers, the general public and decision makers in Nigeria. It is important that people be made aware of the disease so they can take measures to prevent themselves from contracting the condition because poor knowledge concerning prevention of HBV infection is associated with increased occupational and daily risk.
Prevention is considered as one best way to safeguard populations’ health. Prevention against any disease is proportional to knowledge and practice of the population and is reflective of the importance that is paid to health related issues by the society.
Conclusion
Theoretically, this study has provided some empirical evidence on knowledge, attitude and perception on Hepatitis B Virus (HBV) infection among adults of the Hunkuyi in Kaduna state. The findings showed that majority of the people were aware of HBV infection. There was also a high level of knowledge among the people on HBV infection. Most of the people perceived that there is efficient treatment of Hepatitis B Virus infection and exercising regularly and eating healthy food boost one’s immunity against Hepatitis B Virus infection. Few perceived that infected persons should be isolated away from the people to prevent spread.
The study also showed that the respondents’ attitude towards Hepatitis B Virus infection is not the best, though most of them were able to answer questions correctly in relation to attitude, but failed to patronize the vaccine which is the best way of preventing the infection. They indicated that healthy people need vaccination against HBV, and thought that people of their own age need vaccination. They were also willing to be tested for Hepatitis B Virus infection. Despite the good knowledge of the people on HBV infection and willingness to go for the test, only few of them had ever been vaccinated against the disease, which was low.
Recommendations
The following recommendations were made from the study. They are categorized into two blocks which include; recommendations for researchers and recommendations for policy makers, educational institutions and health care providers.
The Researchers
More studies need to cover large numbers of rural and urban areas to investigate the level of knowledge attitude and perception about HBV infection among them and if possible investigate the prevalence of the disease in the Hunkuyi in Kaduna state. Also, further studies are required to measure other factors that may contribute to the poor attitudes and mix-feelings of adults towards the HBV infection in the district.
Policy makers, educational institutions and health care providers
- The integration of knowledge about hepatitis B within formal and informal school programs: Conscious efforts should be made by Nigeria education service to blend HBV education into the curriculum or extracurricular activities in schools.
- Health education campaigns about the disease and its complications: NGOs and the mass media to increase the awareness of the adults as well as vulnerable and high risk groups to help in modification of their different risk behaviors and also intensify the campaign on stigma on chronic
- The health authorities should carry out a program of compulsory free vaccination of people who were born before HBV vaccine introduction in It should be backed by a national comprehensive immunization policy and should cover the screening of pregnant women, risk groups and the general public.
- Formulation of a Legislative Instrument to enable the Nigeria Hepatitis B foundation functions as a The autonomy of this foundation will enable it have a budgetary allocation which will eventually lead to an increase in funding for hepatitis B activities and research. Since the foundation cannot work in isolation, there should be effective collaboration between it and key stakeholders such as health care workers, schools, government of Nigeria and its immunization development partners.
- HBV immunization should be covered as part of preventive services in the NHIS:
The exclusion of HBV treatment in the list of diseases covered by NHIS in the country denied a lot of chronic carriers from seeking treatment because of its high cost of treatment. Its inclusion will offer the vulnerable/ poor access to treatment.
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