ARBAMINCH UNIVERSITY

COLLEGE OF NATURAL AND COMPUTATIONAL

SCIENCES
DEPARTEMENT OF BIOLOGY
PREVALENCE AND ASSOCIATED RISK FACTORS OF
HEPATITIS DISEASE IN ARBAMINCH GENERAL
HOSPITAL, SOUTHERN ETHIOPIA FROM 2019 – 2023 G.C
Prepared by:
Hawi Dereje NSR /1233/13
Student 2
Student 3
Student 4
Adivisors:
Mr. Lecture 1
Mr. Lecture 2

Submitted to: Department of Biology

February 2024, Arba minch, Ethiopia

1
Acknowledgement
We would like to express our genuine gratitude to Arba Minch University College of Natural
and Computational Sciences specifically our Biology department for giving us this ideal
opportunity. Next, we would like to present great thanks to our advisor Mr. for his guidance
on each footstep while preparing this proposal.

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Table of Contents
Acknowledgement............................................................................................................2
Abbreviations and acronyms............................................................................................5
Summary............................................................................................................................ 6
1. Introduction...................................................................................................................7
1.1Background..............................................................................................................7
1.2 Statement of the problem.......................................................................................9
1.3. Significance of the study.....................................................................................10
2. Literature review.........................................................................................................11
2.1. Conceptual frame work............................................................................................14
3. Objectives of study...................................................................................................15
3.1 General Objective.................................................................................................15
3.2 Specific Objectives: ........................................................................................15

4. Methods and materials...............................................................................................16

4.1 Study area and period............................................................................................16
4.2 Study design...........................................................................................................16
4.3 Study Population.........................................................................................17

4.3.1 Source population............................................................................................17

4.3.2 Study population.............................................................................................17
4.3.3 Study unit.........................................................................................................17
4.3.4 Eligibility criteria..............................................................................................17
4.4 Sample size.............................................................................................................18
4.5 Sampling technique................................................................................................18
4.6 Study variables.......................................................................................................19
4.6.1Dependent variables.........................................................................................19
4.6.2 Independent variables.....................................................................................19
4.7 Operational definitions..........................................................................................19
4.8 Data Collection procedure.....................................................................................20

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 4.8.1 Data Analysis..................................................................................................20
4.8.2. Data quality control........................................................................................20
4.9 Ethical Consideration.............................................................................................21
4.10 DISSEMINATION OF RESULTS...............................................................................21
5. Work plan....................................................................................................................21
6. Work Budget...........................................................................................................22

7. Data Collection tool...........................................................................................23

7. References...................................................................................................................25

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Abbreviations/Acronyms
WHO - World Health Organization

AHO – African Health Organization

CDC - Center of Disease Control

HBV - Hepatitis B virus

HBsAG - Hepatitis B virus surface antigen

HCV - Hepatitis C virus

AMGH - Arba Minch General Hospital

SPSS - Statistical Package for Social Science

DM - Diabetes mellitus

HIV - Human Immunodeficiency Virus

STI - Sexually Transmitted Disease

Anti HCV AB - Anti Hepatitis C antibody

ID - Identification Number

List of Tables
Tables Pages

Table1.1Workplan……………………………………………………………………………21

Table 1.2 Budget breakdown to assess prevalence and associated RFs of Hepatitis
Disease……………………………………………………………………………………….22

Table 1.3 Budget breakdown to Transport and communication………………….……….…22

Table 1.4 Budget Summary…………………………………………………………………..22

Table 1.5 Check list for data collection………...……………………………………..……..23

Table 1.6 Known Causes of Hepatitis disease…………………………………………….....24

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Summary
Hepatitis is a multi - etiologic disease that affects significant amount of people in the world.
Viral Hepatitis particularly HBV and HCV are responsible for the majority of Hepatitis
disease development, progression, complication and hepatitis associated death. Types B and
C viruses lead to chronic disease in hundreds of millions of people and together are the most
common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths (WHO, 2016).
According to WHO, HBV is the 10th leading cause of death worldwide. In Africa, infections
with HBV play a major role in the aetiology of most liver diseases (1). According to various
community‐based studies conducted in Ethiopia, the prevalence of HBs Ag ranges from 5.4%
to 12.7% (Belyhun Y, Melanie M, Andargachew M, Ermias D, 2016) (2).

Exposure to hepatitis virus sub types, genetic and metabolic risk factors, alcohol use, toxins
and medications exposure and autoimmune development risks are considered as main risk
factors for the worldwide hepatitis disease progression and death (1).

Hepatitis disease is one of the major public health problems worldwide. Understanding the
major associated risk factors and explaining the regional and countrywide prevalence and
significance of Hepatitis disease is relevant for planning prevention and control strategies by
government and international health sectors.

The major objective of the study is to investigate the prevalence and associated risk factors of
hepatitis disease among patients attending Arba Minch General Hospital. It will be conducted
in the Arbaminch town, Arbaminch General Hospital from //2016 to //2016 E.C with a total
cost of birr. Hospital based retrospective study design will be used. Source of population is
patients admitted in AMGH medical ward. The study unit population will be selected from
patients who have been admitted with hepatitis disease in AMGH medical ward from January
2019 to January 2023. The data will be collected by kobo tool box and the result analyzed by
research software apps like SPSS.

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Introduction
Background
Hepatitis is an inflammation of the liver that is caused by a variety of infectious agents such
as viruses, bacteria or parasites and non-infectious agents like alcoholic hepatitis, non-
alcoholic fatty liver disease, autoimmune hepatitis, drug or toxin induced hepatitis and
metabolic hepatitis leading a large population of individuals to a range of health problems,
some of which can be fatal. Among the listed causes, viral hepatitis takes the largest
proportion of the disease load, acute and chronic complications and associated mortality.

Five distinct viruses referred to as hepatitis A, B, C, D and E are known to cause viral
hepatitis, all of which have different routes of transmission, geographical distribution,
prevention methods; and cause varying courses of disease (WHO, 2016) (1). Other rare
causes of viral hepatitis are Cytomegalovirus and Epstein - Barr virus. Of these viruses,
hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial
proportion of liver diseases worldwide. An estimated 78% of all cases of liver cancer and
57% of those of cirrhosis are caused by chronic hepatitis B or C virus infections (AHO,
2015). Mortality is very high in those people who develop these conditions (3).

Most viral hepatitis deaths in 2015 were due to chronic liver disease and primary liver
cancer. In particular, types B and C viruses lead to chronic disease in hundreds of millions of
people and together are the most common cause of liver cirrhosis, liver cancer and viral
hepatitis-related deaths. According to WHO, HBV is the 10th leading cause of death
worldwide (1).

Globally, in 2015, an estimated 257 million people were living with chronic HBV infection,
and 71 million people with chronic HCV infection. The areas with highest prevalence of
hepatitis B are western Africa and eastern and central Asia. A similar pattern is observed for
hepatitis C, although the prevalence is extremely high in a few countries, most notably Egypt
and Pakistan, where the incidence rates remain high (4).

In Africa, infections with HBV play a major role in the etiology of most liver diseases. It is a
continent with the second largest number of individuals with chronic HBV infection, with an
estimated 6.1% of the adult population infected.

It was estimated that over 5 million people are living with chronic HBV infection among the
general population of Ethiopia. The World Health Organization reports that liver disease
accounts for 2.7% of total deaths in Ethiopia (5). Additionally, according to its report, Liver
disease prevalence, clinical profiles, and outcomes in Ethiopia are not well-documented, and
is observed as a country with no countrywide plan for investigation, deterrence, and control
of viral hepatitis. Overall, Ethiopia is categorized under the geographical regions with
intermediate to hyper endemic viral hepatitis infections (Samson Erkabu, Bisrat Demeke,
Hailu Desallegn, Selam Getachew, 2021) (6).

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The prevalence of viral hepatitis and other causes of hepatitis is not clearly known in Arba
Minch town, but most of the patients admitted in AMGH with liver disease are due to viral
hepatitis, especially hepatitis B and C (7).

The major associated risk factors of hepatitis disease as defined by WHO, CDC or other
international and regional health institutions are variable according to the specific causes. In
general, exposure to hepatitis virus subtypes, genetic and metabolic risk factors, alcohol use,
toxins and medications exposure and autoimmune development risks are considered as main
risk factors for the worldwide hepatitis disease progression and deaths (1). From the viral risk
factors, hepatitis B and C share similar risk factors like unprotected sexual intercourse,
parenteral transmission due to blood donation, and occupational exposure like needle stick
injury (A Mueller, L Stoetter, S Kalluvya, 2015), injected drug use, and perinatal
transmission risk for children born from HBV and HCV infected mothers (Farshadpour F,
2021).

In a study in United States, An estimated 30% of sexual partners of patients infected with
HBV also contract HBV infection. In contrast to hepatitis B, approximately 5% of the sexual
partners of those infected with HCV contract hepatitis C (CDC, 2014). The vast majority of
HBV cases around the world result from perinatal transmission. Perinatal transmission of
HCV occurs in 5.8% of infants born to mothers infected with HCV (8).

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Statement of the Problem
Hepatitis disease with several of its causes is one of the major public health problems
worldwide. Even if viral hepatitis shows a decreased prevalence in the last few decades due
to the increased vaccine provision to countries with higher prevalence rate targeting perinatal
transmission of the viruses, especially HBV; other risk factors are still significantly
contributing to the transmission, disease development, progression, acute and chronic
complications and its mortality. Other non-viral causes of hepatitis disease like chronic
alcohol use, metabolic disorders like Obesity and DM, toxin and medication exposure have
also additional contribution to the existing high prevalence of the disease.

Ethiopia as a part of sub-Saharan Africa has high burden of HBV and HCV infection (5).
These viruses are known as the most common causes of liver cirrhosis, liver cancer and viral
hepatitis-related deaths (WHO, 2016) (1). Alcohol induced hepatitis is not as common as
viral hepatitis in the country despite the absence of such comparative studies (5).

The major cause of the increased rate of hepatitis disease in the country is mostly related to
the incomplete distribution and accessibility of vaccines and treatment against HBV, the
increasing rate of sexually transmitted disease including HIV, the increasing use of injected
drugs among young individuals, the insufficient awareness of the society about the major risk
factors, transmission pathways, disease progression and its prevalence and furthermore, the
poor availability of screening programs, disease prevention strategies and interventions.

In addition to these, the limited studies and research findings about the prevalence, major risk
factors, genetic and racial distribution by Gender, Age and other parameters of the disease is
a major problem to international health institutions, NGOs and other health sectors trying to
intervene on the disease prevention and control in the country (WHO, 2016) (1). This can be
illustrated by the lack of strong government policies and strategies targeting hepatitis disease
prevention and control.

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Significance of the study
This study will assess the prevalence and associated risk factors of hepatitis disease among
patients admitted in AMGH for the last 5 years and will put a summary note of the results
that can be used by the hospital leaders, the city administration, zonal and regional health
bureaus and also Arba Minch University to describe the existing facts about the major risk
factors and prevalence rate of hepatitis disease in Arba Minch town. It specifically targets the
major causes of Hepatitis disease in the country; viral hepatitis, especially HBV and HCV
infection. The results of this research with proper evaluation can be generalized to country
level to formulate intervention health policies and strategies about the disease and can be
used as one of the few research guides available. Moreover, it can be a reference for
additional coming studies throughout the country.

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Literature Review
The Global hepatitis report 2017, describes, for the first time, the global and regional
estimates on viral hepatitis in 2015. The report focuses on hepatitis B and C, which are
responsible for 96% of all hepatitis mortality. It stated that viral hepatitis is a major public
health problem in need of an urgent response. The major findings of the report were as
follows.

Viral hepatitis caused 1.34 million deaths in 2015, a number comparable to deaths caused by
tuberculosis and higher than those caused by HIV. However, the number of deaths due to
viral hepatitis is increasing over time, while mortality caused by tuberculosis and HIV is
declining. Most viral hepatitis deaths in 2015 were due to chronic liver disease (720 000
deaths due to cirrhosis) and primary liver cancer (470 000 deaths due to hepatocellular
carcinoma). Globally, in 2015, an estimated 257 million people were living with chronic
HBV infection, and 71 million people with chronic HCV infection. The epidemic caused by
HBV affects mostly the WHO African Region and the Western Pacific Region. The epidemic
caused by HCV affects all regions, with major differences between and within countries. The
WHO Eastern Mediterranean Region and the European Region have the highest reported
prevalence of HCV.

An early win in the global response to viral hepatitis was achieved through the effective
scaling up of hepatitis B vaccine. In 2015, global coverage with the three doses of hepatitis B
vaccine in infancy reached 84%. This has substantially reduced HBV transmission in the first
five years of life, as reflected by the reduction in HBV prevalence among children to 1.3%.
However, coverage with the initial birth dose vaccination is still low at 39%. Other
prevention interventions are available but insufficiently implemented. Although injection
drug use is the major route of HCV transmission in some regions, the provision of effective
harm reduction services has been inadequate. Globally, 5% of health-care-related injections
remained unsafe. As a result, an estimated 1.75 million new HCV infections occurred
worldwide in 2015 (4).

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The Centers for Disease Control and Prevention (CDC) conducts national surveillance for
acute and chronic hepatitis infection. For HBV infection, rates of reported acute infections
have been declining since 1990. There were 2791 cases of acute infection in 2014, as
compared to 4519 cases of acute HBV infection reported in 2007. With correction for
asymptomatic cases and underreporting, the true number of cases of acute hepatitis B
infection in 2014 was estimated at 18,100. In the United States, about 250-350 patients die of
HBV-associated fulminant hepatic failure each year. The incidence of childhood HBV
infection is not well established, because more than 90% of such infections in children are
asymptomatic.

The CDC estimates that approximately 850,000 to 2.2 million people in the U.S are
chronically infected with HBV. Of these patients, 4000 die of HBV-induced cirrhosis each
year, and 1000 die of HBV-induced HCC. Over 70% of these infections occurred in foreign-
born individuals, and over half of the chronic infections occurred in individuals identifying as
Asian/Pacific Islanders. The annual number of reported cases of acute hepatitis C increased
steadily between 2010 and 2014. There were 2194 case of acute hepatitis C infection reported
in 2014; after adjusting for underreporting, the CDC estimates that there were 30,500 new
infections in 2014. Approximately 2.7-3.9 million people In the United States have chronic
hepatitis C (8).

According to the greatest current approximations of the Global Burden of Disease study
Africa is the continent with the second largest number of individuals with chronic HBV
infection, with an estimated 6.1% of the adult population infected. Sub ‐Saharan Africa has
one of the highest burdens of disease with over 60 million living with HBV (Global Burden
of Disease study, 2017). The regional prevalence of HBV infection is about 6.1%, with
approximately one in every 15 people (1:15) infected. Nearly 8% of this international load is
in Sub‐Saharan Africa, with over 80,000 new infections happening every year.

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A study about prevalence of the Hepatitis B virus and associated risk factors among adults
patients at Dessie Referral and Kemise General Hospitals done on a total of 1080 adults, out
of which 631 (58.4%) were female patients and 449 (41.6%) were male patients with a mean
age of 34 years founded that the overall prevalence of HBV among adults was 27.4%. The
results of this study showed that age, male, history of hospitalization, family history of HBV,
and jaundice were significant risk factors for Hepatitis B virus (5).

Another study on Prevalence and Risk Factors of Hepatitis B and Hepatitis C Virus
Infections among Patients with Chronic Liver Diseases in Public Hospitals in Addis Ababa,
Ethiopia done on a total of 125 patients, 76 (63.3%) males and 44 (36.7%) females with signs
and symptoms of chronic liver disease founded that the prevalence of HBsAg in chronic liver
disease was 43 (35.8%). The prevalence was higher in males (38.2%) than females (31.8%).
The prevalence of HBV was highest, (61%) in the age group of 28–37 years but none (0%) in
age groups above 68 years. Married patients had prevalence of 23 (19.2%), single were 15
(12.5%) and widows, 3 (1.7%).

Among patients with CLD, 27 (22.5%) were positive for anti-HCV-Ab. The prevalence was
higher among females, (29.5%) than males (18.4%). The magnitude of HCV by age group
was high in the age group of 48–57 years and was lowest above 68 years of age.
Seropositivity for anti-HCV Ab was high among widows (50%) and divorced 3/8 (37.5%).
Three (2.5%) of the patients were positive for both HBsAg and anti-HCV Ab seromarkers.
These all were females aged <58 years. All the females who were positive for both
seromarkers had history of circumcision and 2 (66.7%) of them had histories of home
delivery with traditional birth attendants.

The results were concluded as the prevalence of HBV and HCV infections among CLD
patients in the study is high. Dental extraction at health facilities has 2.95 time association of
acquisition of HCV infection than those who do not have history of dental extraction (9).

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 Conceptual Framework

INDEPENDENT VARIABLES

 Socio demographic factors

 Sex
 Age
 Place of residence
 Urban
 Rural
DEPENDENT VARIABLES
 Occupation
 Martial Status

Outcome

Hepatitis Disease

 Clinical Risk Factors

 History of blood transfusion
 Hepatitis B immunization Status
 Alcohol Use
 Toxin and Drug exposure
 Genetic factors
 Antenatal and perinatal exposure to
HBV,HCV
 Injected drug use
 History of STI

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Objectives
General Objectives
To investigate the prevalence and associated risk factors of hepatitis disease among patients
attending Arba Minch General Hospital.

Specific Objectives
1, to assess the prevalence and pattern of hepatitis disease among patients admitted in A rba
Minch General hospital.

2, to compare causes of Hepatitis disease among hepatitis diagnosed patients.

3, to assess the associated risk factors of Viral hepatitis among hepatitis patients including
demographic, clinical, and lifestyle factors.

4, to assess the associated risk factors among non – viral causes of hepatitis disease.

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Methods and Materials
Study Area
The study will be conducted in Arbaminch General Hospital that is located at Arbaminch.
Arba Minch city is the town of Gamo zone that is located in southern Ethiopia region about
454 km far away from Addis Ababa. It is surrounded by Arba Minch zuriya woreda, and two
large lakes which are Abaya and Chamo in the Northeast and south-east respectively.

AMGH was founded by His Majesty Emperor Haile Selassie on December 7,

1961, Ethiopian calendar. It is the only hospital serving a population of 200,747 people per
year in Gamo and other nearby zones. The hospital has over 200 beds with a total of 410
workers. Among these, 251 are health professionals, and 159 are administrative staffs. Even
though it is named as a general hospital it is functioning as a referral hospital with the number
of staffs and several services it is providing.

Study Period
The study will be conducted from to .

Study Design
The study will be conducted based on Retrospective Hospital based study design. The data
collected from the hospital record class and medical ward for the period of 2019 - 2023 will
be used for Observational analysis retrospectively.

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Study Population
Source Population
All charts of patients admitted to Arba Minch General hospital medical ward from 2019 to
2023 G.C

Study Population
All admitted patients to AMGH medical ward with the diagnosis of hepatitis disease from
2019 to 2023 G.C

Study Unit
The study unit for the study will be Patient’s chart.

Eligibility Criteria
Inclusion Criteria
All admitted patients with the diagnosis of Hepatitis disease in AMGH from January 2019
to January 2023.

Exclusion Criteria
- Patients with incomplete medical records.

- Patients with Inadequate investigations.

- Patients with unclear diagnosis.

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Sample Size
The sample size was determined by using the single population proportion formula, with the
assumption of 95% confidence interval , and a marginal error of 5%
2
Z p(1− p)
n=
d2
Where, n= Sample size
Z = Confidence interval (1.96)
p = Prevalence
d = margin of error
There is no enough study about the proportion of hepatitis patients among all hospital
admitted patients in AMGH and other areas, but according to a study about prevalence of the
Hepatitis B virus and associated risk factors among adults patients at Dessie Referral and
Kemise General Hospitals, it was founded that the overall prevalence of HBV among adults
was 27.4%.
n = (1.96)2 × (0.27) × (1- 0.27) = 302.8 ~ 303 patients
(0.05)2

Sampling Technique
Simple random sampling will be used to select predetermined sample size. Card
number/registration number of patients enrolled will be obtained from electronic data base.
Using card numbers patient chart will be drowned. Then sampling frame will be developed
by assigning ID.numbers and computer generated random number will be used to recruit the
303 records of study participants.

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Study Variables

Dependent Variables

The incidence of hepatitis disease.

Independent Variables
Socio-demographic variables - Age, sex, occupation, ethnicity, religion, marital status, Educ
ational status.

Health behaviors.

Co-existing medical conditions.

Operational Definitions
Seropositive : having or being a positive serum reaction especially in a test for the presence
of an antibody.

Seromarker: Any biochemical marker characteristic of a specific infection.

Injected drug use: use of illicit drugs by injecting directly to the blood stream.

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Data Collection Procedure

The data will be collected by assigned research group members by visiting AMGH. We will
use kobo tool box, which is a data collection, management, and visualization platform. A
checklist containing the questions about the socio - demographic factors and the presumed
associated risk factors will be used on the platform. Since the study is based on retrospective
hospital based design, the source of the data will be the hospital record class and medical
ward.

Data Analysis Procedures

The collected data will be checked for consistence & completeness, and then exported to
SPSS software version 26 for analysis. Descriptive statistics like frequency, proportion,
mean, standard deviation will be computed to determine the characteristics of study subjects.
Statistically, a significant association will be declared at a p-value <0.05.

Data Quality Control

The data will be collected by reviewing the patient’s medical cards and follow up charts by
group members. All available information on patient records will be checked and an
appropriate data extraction format will be prepared in English. Charts will be retrieved using
the patient’s registration number which is found in data base in electronic system. Then, the
data will be extracted from patients’ charts. The data will be collected by the Investigators
themselves and they will responsible to handle the whole process of the data collection.

Ethical Consideration
A letter of cooperation will be written by Biology department to the administrator of Arba
Minch general hospital. All the information obtained from patient card will be held with
confidentiality and used only for the intended purpose. Patients’ records will be taken by
runners from registry to a separate room where only the data collectors and the investigator
have access. After the data collection, the records will be returned back to the registry and
placed in their shelves without any interference of the routine function of the center. In the
data collection form no mention will be made about the names of the patients, their addresses,
telephone number, the names of the providers or anything related to the study.

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Dissemination of the results

The final report of the study will be presented and submitted to Arba Minch University
College of Natural and Computational sciences for the fulfillment of the requirement.

Work Plan

No Activities Date Responsible Body

1 Proposal development 23/5/2016 -7/6/2016EC Group members

2 Proposal submission 8/6/2016 EC Group members

3 Data collection and analysis //2016-//2016EC Group members

4 Research result writing //2016-//2016EC Group members

5 Research result submission //2016 EC Group members

6 Preparation for defense //2016EC-//2016EC Group members

7 Defense presentation //2016EC Group members

Table 1.1 - Work plan

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Work Budget

Table 1.2 - Budget breakdown to assess prevalence and associated RFs of Hepatitis Disease.

Material Unit Quantity Unit cost Total cost

Duplicating Paper Ream
Printing paper Ream
Pen Each 10 10.00 100.00
Pencil Each 10 5.00 50.00
Eraser Each 5 5.00 25.00
Sharpener Each 3 5.00 15.00
Flash disk Each 1 200.00 200.00
Sub total

Table 1.3 - Budget breakdown to Transport and communication

Transport/Travel cost to the study area 200.00

Communication service(Telephone, e 100.00
mail)
Sub total 300.00

Table 1.4 - Budget Summary

No Description Total cost

1 Stationery
3 Data collection 0
4 Transport and communication 300
5 Contingency (5%) 500
6 Grand total

Data Collection Tool

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 Checklists prepared for collection of data on the patients with Hepatitis disease medical
registration chart to assess the associated risk factors of the disease.

Table 1.5 - Check list for data collection

S.no Part I: socio-demographic characteristics

1.1 Date of enrollment DD/MM/YY

1.2 Age …….Year

1.3 Sex 1. Male 2. Female

1.4 1. Never married/ single

2. Married
Marital status
3. Separated/ divorced
4. Widowed
1.5 1. No education
2. Primary
Level of education 3. Secondary
4. Tertiary
5. Not recorded
1.6 Occupation ____________________________

1.7 Address 1. Urban 2. Rural 3. Not recorded

1.8 1.Orthodox 2.Protestant 3.Muslim

Religion
4.Others
Part II:
Clinical
factors
Did the patient had any
1. Yes 3. Not recorded
2.1 history of blood
2. No
transfusion?
Did the patient had any
2.2 1. Yes 2. No
history of STI?
Did the patient has 1. Yes 3. Not recorded
2.3
frequent alcohol use? 2. No

23
 What was the serostatus of
2.4 the motherfor HBV before 1. Positive 2. Negative 3. Unknown
birth?
Did the patient had a
1. Yes 3. Not recorded
2.5 history of Injected drug
2. No
use?
What is the Hepatitis B
2.6 immunization status of the 1.Vaccinated 2.Not vaccinated
patient?
Did the patient had any
2.7 poisoning history or ……………………………
adverse drug effect?

What is the HBsAg test

2.8 1.Positive 2. Negative 3.Not recorded
result of the patient?

What is the HCV AB test

2.9 1.Positive 2. Negative 3.Not recorded
result of the patient?

Did the patients family had

1. Yes 3. Not recorded
2.9 a history of hepatitis
2. No
disease?
Table 1.6 - Known Causes of Hepatitis disease.

N Cause of Hepatitis Disease Number of Pt. Percent %

O
1 Hepatitis B, C
2 Alcohol
3 Autoimmune
4 Metabolic
5 Toxin and drug related
6 Others

References

24
1. WHO. Hepatitis Fact sheet. 2019
2. Belyhun Y, Melanie M, Andargachew M, Ermias D, Uwe GL. Hepatitis viruses in
Ethiopia: a systematic review and meta‐analysis. BMC Infect Dis. 2016;16(1):1‐14
3. Hepatitis in Africa. African Health Organization. 2016
4. World Health Organization. Global hepatitis report 2017. World Health Organization,
2017
5. Mohammed H, Eshetie A, Melese D. Prevalence of hepatitis B virus and associated
risk factors among adults patients at Dessie referral and Kemise general hospitals in
northeastern Ethiopia.
6. Samson Erkabu, Bisrat Demeke, Hailu Desallegn, Selam Getachew. Liver Disease: A
Retrospective Hospital Based Study in Addis Ababa-Ethiopia. 2020
7. Tsegaye Yohanes, Zerihun Zerdo, Nega Chufamo. Seroprevalence and Predictors of
Hepatitis B Virus Infection among Pregnant Women Attending Routine Antenatal
Care in Arba Minch Hospital, South Ethiopia. 2016
8. CDC. Hepatitis Fact Sheet. 2016
9. Abel Girma Ayele, Solomon Gebre-Selassie. Prevalence and Risk Factors of Hepatitis
B and Hepatitis C Virus Infections among Patients with Chronic Liver Diseases in
Public Hospitals in Addis Ababa, Ethiopia. 2013

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