CHAPTER FOUR

4.0 RESULT

4.1 Sex Distribution of the Seroprevalence of HBsAg among Patients Attending Wuro
Hausa Primary Health Care

Seroprevalence of HBsAg Based on sex of patients attending Wuro Hausa Primary Health Care
shows that out of the eighty seven (87) patients sampled, 14 tested positive to Hepatitis B virus,
which gives a prevalence rate of 16.09%. The prevalence rate was higher among male patients 9
(10.34%) than female patients 5 (5.75%). The total negative samples were 73 (83.91%) (Table
1).

Table 1: Sex Distribution of the Seroprevalence of HBsAg among Patients Attending Wuro
Hausa Primary Health Care

Hepatitis B virus infection

Sex Total (%)
Positive Negative

Male 9 (10.34%) 40 (45.98%) 49 (56.32%)

Female 5 (5.75%) 33 (37.93%) 38 (43.68%)

Total (%) 14 (16.09%) 73 (83.91%) 87 (100%)

4.2 Seroprevalence of HBsAg among Patients attending Wuro Hausa Primary Health Care
based on age

The age distribution of the seroprevalence of HBsAg among patients attending Wuro Hausa
Primary Health Care shows that out of the fourteen (14) patients that tested positive to HBsAg, 2
(2.29%) were of age brackets 0-20years, 11 (12.64%) were of age bracket 21-40years, 1 (1.15%)
was of age bracket 41-60years (Table 2).

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 Table 2: Age distribution of the seroprevalence of HBsAg among patients attending Wuro
Hausa Primary Health Care

Hepatitis B Age (Years)

Total (%)
virus infection 0-20 21-40 41-60 >60

Positive 2 (2.29%) 11 (12.64%) 1 (1.15%) 0 (0.00%) 14 (16.09%)

Negative 11 (12.64%) 61 (70.11%) 0 (0.00%) 1 (1.15%) 73 (83.91%)

Total (%) 13 (14.94%) 72 (82.76%) 1 (1.15%) 1 (1.15%) 87 (100%)

4.3 Association between Age and Sex in the Distribution of HBsAg among Patients
Attending Wuro Hausa Primary Health Care

The association between sex and age based on positive results of patients in the
seroprevalence of HBsAg shows that out of eighty seven (87) patients sampled, 1(7.14%)
were males of age bracket 0-20, 8(57.14%) were males of age bracket 21-40 / 1(7.14%) were
females of age bracket 0-20, 3(21.43%) were females of age bracket 21-40, 1(7.14%) were
females of age 41-60.Attending Wuro Hausa Primary Health Care .

Table 3: Association between Age and Sex in the Distribution of HBsAg among Patients

AGE (years)
SEX TOTAL
0-20 21-40 41-60 >60

MALE 1(7.14%) 8(57.14%) 0 (0.00%) 0 (0.00%) 9(64.29%)

FEMALE 1(7.14%) 3(21.43%) 1(7.14%) 0(0.00%) 5(5.71%)

TOTAL 2(14.29%) 11(78.57%) 1(7.14%) 0 (0.00%) 14(100%)

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Discussion

Table 1:

  Male     Female

Age Frequency Percentage (%) Frequency Percentage (%)

1-20Years 110 9.7 80 20.3

21-40Years 765 67.2 207 52.5

41-60Years  253 22.2 82 20.8

61-80Years  10 0.9 25 6.3

Total  1138 100.0 394 100.0

Table 1: Sex and age distribution of subjects.

Table 2 shows result by sex distribution of the study population. For males, 38(3.3%) were
positive to anti-HAV and 7(0.6%) tested positive to anti-HAV in the females. This shows that
HAV is more in males than in females. Transmission of HAV occurs more through faecal-
oral route and spread more in unhygienic places. This could mean that the female subjects of
the study population adhere to their personal hygiene more than their male counterparts.

Results Male   Female  

  Frequency Percentage (%) Frequency Percentage (%)

Positive 38 3.3 7 0.6

Negative 1100  96.7 387 34.0

Total 1138 100.0 394 34.6

Table 2: Result by sex distribution.

Table 3 shows the result by age distribution. The subjects within the age bracket 21-40 years
had the highest positive result of 32(2.2%) which is in accordance with the work done in

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Wuro Hausa Primary Health Care with the highest prevalence on the 21-30 years age group
84(5.5%) kobah et al. reported a prevalence of 55.2% in a study of children from a Nigerian
rural community of lower social economic background. Hepatitis A virus infection is often
asymptomatic in childhood and its morbidity and fatality increase by age. In a study on newly
hired employees of a care center in Riyadh in 2006, 67% were seropositive; whereas, 86% of
seropositivity was shown by Fathalla et al among 11674 healthy population of Eastern Saudi
[11,12]. More attention should be given to the subjects in the age group 21-40 years who are at
their reproductive age and the major work force of the country.

   Positive      Negative

Age Frequency Percentage (%) Frequency Percentage (%)

1-20Years 5 0.3 185 12.4

21-40Years 32 2.2 940 63.2

41-60Years 8 0.5 327 22.0

61-80Years - - 35 2.4

Total 1443 100.0 1487 100.0

Table 3: Result by age distribution.

Conclusion and Implications

The seroprevalence (2.94%) of HAV among the subjects of this study is considerably lower
than the previous reports from Nigeria. The lower prevalence in this study could be due to the
higher socioeconomic status of the subjects, who were mainly professionals and their family
members. The reduced prevalence could be due to improved food hygiene, immunization and
greater awareness among the subjects of the study group. Improvement in hygienic and socio-
economic conditions has resulted in a decrease in the prevalence of the disease.

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 CHAPTER FIVE

5.0 DISCUSSION, CONCLUSION AND RECOMMENDATIONS

5.1 DISCUSSION

Hepatitis B virus (HBV) is a major cause of liver disease morbidity and mortality worldwide,
accounting for over 360 million cases of chronic hepatitis and 620,000 deaths per year. It is
hyperendemic in Sub-Saharan Africa (SSA) and a major cause of chronic liver disease.
Hepatitis B is the commonest cause of chronic liver disease in Nigeria. In southern parts of
the country, up to 58.1% of patients with chronic liver disease were found to be HBsAg
positive.

In this study, a prevalence rate of 5.0% was reported. This is in agreement with the findings
of Eric et al. (2017) who were working on the screening of blood donors in Ghana. They
suggested that a remarkable achievement in the area of increasing access to counselling and
testing services for sexually transmitted diseases, routine screening of antenatal attendants for
HIV, Syphilis and hepatitis B infections through the Prevention of Mother-to-Child
Transmission programme, and the expansion of school based HIV education campaign, to
reduce the incidence of sexually transmitted diseases in the general population is responsible
for the low prevalence observed among the population.

The prevalence rate was observed to be higher among males than females and among those
patients between the ages of 21-40 years. This is contrary to the findings of Eric et al.,
(2017). They found that hepatitis B virus infection was common among female blood donors
and those over 30 years of age. However the difference could be due to the nature of subjects
recruited for the study, sample size and differences in geographical location of the study
areas.

Analysis of the seroprevalence of hepatitis B virus infection in relation to age and sex of
patients indicated that male patients between the ages of 21-40 years recorded the highest rate
of infection. Similar findings were reported by Eric et al., (2017) who reported that the
highest prevalence was among those over 30 years old. They observed that there was no
donor less than 20 years old who tested HBsAg positive. This finding is inconsistent with
other studies (Dongdem et al., 2012; Uneke et al., 2005; Rodenas et al., 2006) where the
prevalence was highest among younger individuals. Low HBsAg detected among younger

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donors in this study might most probably be due to the fact that transmission of HBV is
through heterosexual contact rather than vertical transmission from mother-to-child. Our
finding is however in consonance with other studies from varied populations. This could
suggest that this category of individuals may not have been vaccinated against hepatitis B, a
situation observed to be common among developing countries (Dongdem et al., 2012).

It further shows sex and age distribution of the subjects. A total of 1138 subjects participated
in the study. For males, age group of 21-40 years had the highest frequency of 765(67.2%),
followed by age group 41-60 years with frequency of 253(22.2%), followed by 1-20 years
with frequency of 110(9.7%) and 61-80 years had the least frequency of 10(0.9%). For the
females, age group 21-40 years has the highest frequency of 207(52.5%), followed by age
group 41-60 years with frequency of 82(20.8%), followed by 10-20 years with frequency of
80(20.3%) and 61-80 years had the lowest frequency of 25(6.3%). This shows that those in
the age group of 21-40 years had the highest number of participation in the study. This
infection can be easily transmitted through fecal-oral route, by close contact with infected
person, and contaminated food and water and even blood products. Prevalence of HAV
infection is not the same in different parts of the world (varies between 15% and 100%), and
depends on geographic area, sanitary levels and socioeconomic conditions [4-7]. Meanwhile,
a shifting epidemiological pattern from high to intermediate and low seropositivity has been
shown in many countries, some of which are underdeveloped and developing countries.

5.2 CONCLUSION

In this study, the overall prevalence rate of Hepatitis B virus was 87%. Males recorded the
highest prevalence of HBsAg (10.34%) than females (5.75%) and the age group of 21-40
had the highest prevalence of (78.57%), 0-20years (14.94%), with least among patients 41-
60years and >60years (1.15%). A total of 1138 subjects participated in the study. For males,
age group of 21-40 years had the highest frequency of 765(67.2%), followed by age group
41-60 years with frequency of 253(22.2%), followed by 1-20 years with frequency of
110(9.7%) and 61-80 years had the least frequency of 10(0.9%). For the females, age group
21-40 years has the highest frequency of 207(52.5%), followed by age group 41-60 years
with frequency of 82(20.8%), followed by 10-20 years with frequency of 80(20.3%) and 61-
80 years had the lowest frequency of 25(6.3%). This shows that those in the age group of 21-
40 years had the highest number of participation in the study

5.3 RECOMMENDATION

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The following recommendations can therefore be made

i. The government and employers of labour should supplement the cost of the effective
vaccine against hepatitis B & A virus to reduce the cost so as to make it valuable and
affordable for the vaccination of individuals with high risk of exposure in relation to
work or behavior in our society.

ii. Campaigns and health education should be carried out to educate the populace on the
dangers of hepatitis B & A virus and certain practices that could expose one of getting
infected with the virus.

iii. Routine screening of blood for transfusion should be employed and infected blood
should be carefully incinerated in order to prevent transmission.