The Level Of knowledge and practice of hepatitis b screening Among University Students

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Last Updated on November 27, 2020 by admin

CHAPTER ONE
INTRODUCTION
1.1. BACKGROUND
Hepatitis B is an infectious disease caused by the hepatitis B virus (HBV) that affects the Liver (WHO, 2014). It can cause both acute and chronic infections. Many people have no symptoms during the initial infection. Some develop a rapid onset of sickness with vomiting, yellowish skin, tiredness, dark urine and abdominal pain (WHO, 2014). Often these symptoms last a few weeks and rarely does the initial infection result in death (Raphael Rubin; David S. Strayer, 2008 and WHO, 2014).
   It may take 30 to 180 days for symptoms to begin (WHO, 2014).  In those who get infected around the time of birth 90% develop chronic hepatitis B while less than 10% of those infected after the age of five do (CDC, 2011)  Most of those with chronic disease have no symptoms; however, cirrhosis and liver cancer may eventually develop (Chang MH, 2007).  These complications result in the death of 15 to 25% of those with chronic disease (WHO, 2014).
   The virus is transmitted by exposure to infectious blood or body fluids (WHO, 2014). Infection around the time of birth or from contact with other people’s blood during childhood is the most frequent method by which hepatitis B is acquired in areas where the disease is common (WHO, 2014).  In areas where the disease is rare, intravenous drug use and sexual intercourse are the most frequent routes of infection (WHO, 2014).  Other risk factors include working in healthcare, blood transfusions, dialysis, living with an infected person, travel in countries where the infection rate is high, and living in an institution (CDC, 2011) Tattooing and acupuncture led to a significant number of cases in the 1980s; however, this has become less common with improved sterility (Thomas HC, 2013).  The hepatitis B viruses cannot be spread by holding hands, sharing eating utensils, kissing, hugging, coughing, sneezing, or breastfeeding (CDC, 2011) The infection can be diagnosed 30 to 60 days after exposure (WHO, 2014).  The diagnosis is usually confirmed by testing the blood for parts of the virus and for antibodies against the virus (WHO, 2014).  It is one of five known hepatitis viruses: A , B, C , D , and E .
The infection has been preventable by vaccination since 1982 (Pungpapong S, et al, 2007). Vaccination is recommended by the World Health Organization in the first day of life if possible.  Two or three more doses are required at a later time for full effect.  This vaccine works about 95% of the time. About 180 countries gave the vaccine as part of national programs as of 2006 (Williams R, 2006). It is also recommended that all blood be tested for hepatitis B before transfusion and condoms be used to prevent infection. During an initial infection, care is based on the symptoms that a person has. In those who develop chronic disease, antiviral medication such as tenofovir or interferon may be useful; however, these drugs are expensive. Liver transplantation is sometimes used for cirrhosis (WHO, 2014).
About a third of the world population has been infected at one point in their lives, including 343 million who have chronic infections (WHO, 2014 and GDB, 2015).
   Another 129 million new infections occurred in 2013 (Global Burden of Disease Study 2013). Over 750,000 people die of hepatitis B each year (WHO, 2014). About 300,000 of these are due to liver cancer (GBD 2013). The disease is now only common in East Asia and sub-Saharan Africa where between 5 and 10% of adults are chronically infected (WHO, 2014) Rates in Europe and North America are less than 1% (WHO, 2014). It was originally known as “serum hepatitis”(Barker LF, et al 1996). Research is looking to create foods that contain HBV vaccine (Thomas, Bruce, 2002). The disease may affect other great apes as well (Plotkin, Stanley A. et al 2013).
     The term ‘hepatitis’ simply means inflammation of the liver. Hepatitis may be caused by a variety of viruses or other infections, medications, or a toxin such as alcohol. Hepatitis viruses that can cause injury to liver cells in addition to hepatitis B include the hepatitis A and hepatitis C viruses. These viruses are not related to each other or to the hepatitis B virus, and they differ in their structure, the ways they are spread among individuals, the severity of symptoms they can cause, the way they are treated, and the outcome of the infection. Other hepatitis viruses (hepatitis D, hepatitis E, and hepatitis G) cause disease much less commonly.
Globally it is estimated that about 400 million individuals are chronic carriers of hepatitis B virus (HBV) and that more than a million people die annually from  HBV related causes (Hazmi, 2015) . Hepatitis B Virus (HBV) is the blood-borne communicable disease and the ninth leading cause of death worldwide (Bhat, et al 2012). Though, a major public health issue, the prevalence is higher in the developing countries than the developed. There is an average carrier rate of 10 – 20% in sub-Saharan African general   population and 9 to 39% in Nigeria (Emechebe et al, 2009).
    According to Kesieme, Uwakwe, Irekpita,Dongo, Bwala&Alegbeleye (2011) hepatitis B infection is an important occupational hazard for HCWs, and that it is generally easy to assume that health workers by virtue of their proximity to the health facility should have adequate knowledge about the disease and its mode of prevention but that does not seem to be the case. The high carrier rate and hepatitis B being an endemic disease in Nigeria reveal the associated risk of infection among nurses and midwives who have frequent contact with infected blood through invasive procedures. The most frequent route of transmitting Hepatitis B Virus is through needle stick injury.   HBV is also a hospital acquired infection which could be transmitted from an infected health-care provider to patients or vice visa which calls for precautionary measures to be put in place to reduce the mortality associated with this disease.
Hepatitis B screening involves testing a small sample of blood for antigens and antibodies to determine whether the individual has been infected with viral hepatitis B. Antigens are foreign substances, such as microorganisms (e.g., bacteria, fungi, parasites, viruses) or chemicals, which invade the body. When the body is exposed to antigens, it produces antibodies as a part of its immune response. Antibodies are proteins that bind to the antigens to try to clear them from the body. Hepatitis blood tests look for antigens or antibodies specific to each type of hepatitis virus. The screening test for hepatitis B surface antigens detects the presence of HBV in the blood. The antigens are detectable 4-10weeks after exposure to HBV. A positive test result means the person is currently infected and can pass the infection to others.
1.2 PROBLEM STATEMENT.
Hepatitis B is a major cause of human suffering in the world despite a true understanding of its transmission and prevention. More than 300 million people have chronic liver infections globally and about 600,000 people die annually from acute or chronic complications of hepatitis B infection(WHO,2009). The highest prevalence of hepatitis B infection is in Sub-Saharan Africa and East Asia (WHO,2009). Majority of the people in these regions become infected during childhood and between 5-10% of the adult population is chronically infected (WHO,2009).
Another 129 million new infections occurred in 2013 (Global Burden of Disease Study 2013). Over 750,000 people die of hepatitis B each year (WHO, 2014). About 300,000 of these are due to liver cancer (GBD 2013). The disease is now only common in East Asia and sub-Saharan Africa where between 5 and 10% of adults are chronically infected (WHO, 2014) Rates in Europe and North America are less than 1% (WHO, 2014). It was originally known as “serum hepatitis”(Barker LF, et al 1996).
Hepatitis B infection is a public health issue which constitutes a high morbidity among the people. There is paucity of information regarding knowledge and practice of hepatitis B screening among students in Nigeria. This study provided baseline information about knowledge and practice of Hepatitis B virus infection among University undergraduate Students.
1.3 JUSTIFICATION.
This study will potentially lead to an increase in knowledge and practice aiding early detection for the prompt management of the disease and enhance the quality of life of hepatitis B patients.
This study will expose the level of knowledge and practice of hepatitis B screening among  university students. It will also identify gaps which will be recommended for corrections through interventions. This study could be used to monitor trends concerning knowledge and practice of hepatitis B among University students. It will also provide reference materials for the academic society as well as further research. And result from the study would be use for the use of health education intervention program.
1.4 General Objective
To determine the knowledge and practice of Hepatitis B screening among  students
Specific Objectives: …..

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