Community Based Seroprevalence of HBV and HCV Infection in Bauchi

S O Gut and Gastroenterology p s e s n Acce RESEARCH ARTICLE Community Based Seroprevalence of HBV and HCV Infection in Bauchi State, Nigeria Alkali M1, Okon KO2, Jibrin YB1, Umar S1, Abdulrazak Toyin3 1Department of Internal Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria 2Department of Medical Microbiology, Federal Medical Centre, Makurdi Nigeria 3Department of Chemical Pathology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria Abstract Epidemiological data on Community-based seroprevalence of HBV and HCV are limited, thus create a information gap on apparaently healthy individual unaware of their status in the community. The study determine the seroprevalence of HBV and HCV and associated risk factors among apparently healthy individuals in three semi -urban communities of Bauchi state, Nigeria. The cross-sectional study was conducted in three communities of Bauchi state between July and August 2017. A well-structured questionnaire and informed consent was administered, and rapid diagnostic kits was employed for sero detection of HBsAg and anti- HCV. Appropriate statistical package employed for data analysis. Of the 637 participants, comprised of 284 (44.6% ) males and 353(55.6%) females, overall prevalence of 23.7%, HBsAg was detected in 20.7% (n=354) , Anti-HCV in 3.1%(n=93),and no co-infection. Statistical significant association was observed between socio-demographic variables and seroprevalence (p<0.05) except Anti-HCV and marital status. Increased HBsAg prevalence was observed with the age-group, and male participants. Similar prevalence among participants with tertiary and non-formal educational background, married and single, and civil servants. Overall risk factors analysis revealed statistical significant association between the risk factors and seroprevalence with HBV (7 out of the 12) (p<0.05), HCV (1 out of the 12) with unknown alcohol consumption (p<0.05). The study findings furthered affirmed high prevalence of HBV and HCV in the communities, constituting a serious public health problem. Therefore, there is need for public health education, awareness and knowledge, and mass vaccination of the populace to stem down the tide of high prevalence rate. Keywords: HBV, HCV, Risk Factors, Community-Based Seroprevalence, Bauchi State. Introduction Asia, responsible mother of child transmission [9]. The HBV infection prevalence and progression depends on the age at HBV and HCV infections remains a serious public health infection. Though, majority of infection is acquired at birth, it problem, particularly in endemic region of subsaharan Africa is also capable of resolving immnologically through tolerance and Asia with low health care expenditure for treatment and and clearance, and progress from acute to chronic state management approach. The disease prevalence and burden depending on exposure to the risk factors [10]. Since the WHO is furthered compounded by high level of illiteracy, linked to introduction of HBV vaccination into Expanded Immunzation poor public health education, awareness and knowledge of programme, globally, the vaccination programme had changed associated risk factors, and high level of poverty in endemic HBV epidemiology resulting reduction in prevalence rate. region of subsaharan Africa and Asia [1]. The infection Example, is the report from Saudi Arabia, with prevalence prevalence rate is disproportionately distributed among all age reduction from 6.7% to 0.3% [11], Malaysia 1.6% to 0.3% group, gender and geographical location depending on mode [12] and China, from 9.7% to 1.0% [13]. However, data on of transmission and exposure to the risk factors [2], with HBV vaccination programme in African countries are limited, but and HCV prevalence of 240- 350million and 150-170 million few studies had reported non-serodetection among vaccinated infections reported globally [3, 4]. children in the south eastern Nigeria [14, 15]. Both HBV and HCV are major risk factors of chronic liver In Africa, HBV prevalence ranged between 4.6-8.5% [16] disease, cirrhosis and hepatocellular carcinoma (HCC) with 4-44% prevalence of pooled studies in Nigeria [17]. For cases, HCC accounts for 70-90% of primary liver cancers HCV, it ranged between 0-5%, [18] and 0.4-5% in Nigeria [19]. and as the third leading cause of cancer- related deaths [6]. Despite, lack of comprehensive national surveillance data on In sub-saharan Africa, both shared same commonest mode of transmission via vertical and horizontal means that is contact with contaminated blood/products, sharing of unsteriled sharp Correspondence to: Okon KO, Department of Medical Microbiology, objects, local surgical procedures and sexual activitites [7, 8]. Federal Medical Centre, Makurdi Nigeria, contact: 8028319022, E-mail: For HBV, perinatal is the commonest mode of transmission [email protected] as a result of high HBeAg positive women in Africa and Received: Nov 3, 2018; Accepted: Nov 6, 2018; Published: Nov 8, 2018 Gut Gastroenterol 1 Volume 1(2): 2018 Okon KO2 (2018) Community Based Seroprevalence of HBV and HCV Infection in Bauchi State, Nigeria HBV and HCV that may be due to cost implication and logistic health importance. We employed the services of the traditional problems. two national surveillance data had been published, and religious leader for smooth administrating of the HBV prevalence of 12.2% [20] and HBV and HCV prevalence questionnaire and blood specimen was collected by medical of 6.7% and 2.5% [21]. While there is relative clarity in laboratory technician involved in the study. Information on the epidemiology and transmission route of HBV, studies the questionnaire includes, socio-demographic variable, age, had observed that associated risk factors of HCV are only sex, marital status, occupation, educational background, recognizable in 50% of the cases, while remaining 50% non- and risk factors associated with viral hepatitis. Criteria of reconizable which may contribute to possible underestimation inclusion, apparently healthy individual without any clinical of prevalence rate [22, 23]. Futhermore, serological assay, manifestation of viral hepatitis, while those with clinical sample preparation and storage, transmission pathway and history of hospital admission, surgery or blood transfusion characterizing of population thus influenced HCV prevalence were excluded. The age of participants enrolled in the study rate outcome [24]. With emerging trend, some hospital-and ranged between 4 to 65years. The sample size was calculated community-based studies had reported high prevalence rate, based on the HBV prevalence of 8.0% reported among blood 10% in Calabar [25], 13.2% in Keffi, [26] 10% among children donors [Alkali], at 95% confidence interval, and 2% degree of in Maiduguri [27]. freedom to give minimum sample size of 637. Bauchi state, the study area is one of the administrative states Three to Five milliliter of venous blood was collected in the northeastern region of Nigeria. Socio-cultural and aseptically from the study participants, dispense into properly religious practices like polygamy, early marriage for females, labeled plain specimen bottle, allowed to color, retract and use of sharp objects for surgical procures as in vulutomy and centrifuged at 15,000rpm for 15 minutes. The serum was circusmion, which are common practices in the communities separated into another labeled sample bottle for batch analysis. are known risk factors of viral hepatitis transmission [20]. Few Sero-detection of viral etiologies was carried out according to studies conducted on HBV and HCV within the study area on the manufacturer’s instruction the HBV and HCV screening high risk population, includes, blood donors], suspected liver utilized the Bio test Hamgzhou (Biotech CO Ltd China) kit, disease patients, pregnant women] and migrant Fulani nomads, control sample was included in each batch analysis to validate with seroprevalence range of 8.0% and -12.5% [28-31]. the study result. According to American society of Gastroenterology advocacy Data analysis of periodical screening in the community with high prevalence Demographic variables and laboratory data were entered into rate, local study becomes imperative aimed at early detection the study database and analyzed using SPSS version 20.0. of apparently healthy individuals unaware of their status and Values were expressed in mean and percentages. Comparison the need for prompt interventional measures such as mass of Categorical variables were determined by the chi-square vaccination taken. Undertaking such study at local level, bridged test, with Significance difference expressed as p<0.05. the information gap on the epidemiology, characteristics of the infection, and complement the national database in evaluating Result situational report, towards effective and efficient management Of the 637 participants enrolled in the study, comprised of the viral infections. To the best of our knowledge, this is the 284(44.6%) males and 353(55.4) female, with the mean age first report of community based study in Bauchi state. Here, of 24.4+10.5 years, ranged between 4 to 65years. The overall we decided to determine the seroprevalence of HBV and HCV seroprevalence of HBsAg and anti-HCV was 23.5%, HBsAg infections and associated risk factors in three communities of detected in 20.4% (n=354) and Anti-HCV in 3.1% (n=93) Bauchi state. and no co-infection. The study area wise prevalence of HBV Methodology vs HCV, Warji (11.0% vs 1.7%) Jamaare (4.8% vs 0.5%) and

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