Prevalence of hepatitis B virus infection among children attending the outpatient clinic of a tertiary health centre in Southwest Nigeria

Evaluating hepatitis B screening, prevalence, vaccination coverage, and linkage to care in Abuja, Nigeria: insights from a cross-sectional study

BACKGROUND

Hepatitis B virus (HBV) is a major global health threat, especially in Sub-Saharan Africa, where Nigeria has a prevalence exceeding 8%. Despite the availability of effective vaccines, inadequate coverage and lack of awareness have resulted in high rates of chronic infections and HBV-attributable liver disease. The study aimed to raise awareness of HBV, enroll participants for HBV screening, determine HBV prevalence across various communities, vaccinate negative cases and link positive cases to care.

METHODS

A cross-sectional study was conducted in 16 districts of Abuja from April 2022 to March 2023. Participants aged 18 and over were screened for hepatitis B, and those testing negative were offered on-site vaccination. Blood samples were collected and tested using HBV immunochromatographic tests and real-time polymerase chain reaction (RT-PCR) for HBV DNA quantification. Data were collected through interviews and analyzed using R software, with descriptive statistics calculated for continuous and categorical variables. Associations between socio-demographic factors and hepatitis B/vaccine status were assessed using the Chi-square test of independence.

RESULTS

Out of 3,245 individuals screened, 141 (4.3%) tested positive for HBV. The highest prevalence was observed in the 20-39 age group (5.9%), with males showing a higher infection rate (5.4%) compared to females (3.7%) [p = 0.02]. The mean age of HBV-positive individuals was significantly lower (30.8 years) than those negative for HBV (36.2 years) [p = < 0.001]. Among 2,506 participants who consented to vaccination, 2,488 received the first dose (99.3%), 1,834 the second dose (73.2%), and 1,100 the third dose (43.9%). Vaccination uptake declined with each subsequent dose, but more older participants completed the third dose. A similar pattern of HBV prevalence was observed across gender and age groups.

CONCLUSION

The study reveals a 4.3% prevalence of hepatitis B, with the highest infection rate among individuals aged 20-39 years, and males showing a higher prevalence than females. Although vaccination uptake was high for the first dose, adherence declined for subsequent doses. These findings highlight the need for targeted public health interventions, particularly among younger adults and males, to improve awareness and vaccination completion. Enhanced community engagement and sustained vaccination efforts are crucial for reducing HBV transmission and achieving better coverage.

Evaluation of a school-based health education program on hepatitis B virus infection prevention practice in rural South-Western, Nigeria

BACKGROUND

Hepatitis B virus (HBV) infection prevention is most effective early in childhood with vaccination programme. However, where this is missed, primary prevention modes of intervention become an alternative recommendation to be considered before the occurrence of risk exposure to the virus. This study sought to evaluate outcomes of a theory-based HBV infection prevention educational intervention among students from four selected secondary schools in Ogun state, Nigeria.

METHODOLOGY

A quasi-experimental design enrolling 256 consenting secondary school students from four schools in Ogun state randomized into three intervention schools consisting teacher-instructed (E1), peer-directed (E2) and combination of the two (E3) respectively with a control group ( C) was implemented. The theory-based educational intervention was for six weeks with follow-up period of 8 weeks. A 66-item validated instrument was used to collect data at three reference points and response items for variables in the study were transformed into weighted-aggregate scores of mean and standard deviation of HBV infection prevention practice of participants. Statistical analysis of ANOVA, paired-sample t-test and Cohen's D Effect Size (ES) was used to quantify the changes produced by the intervention on the outcome variable at 5% level of significance.

RESULTS

At baseline, there was no significant difference (p > 0.05) in the mean HBV infection prevention practice scores between the four groups E1 (17.21 ± 3.03), E2 (15.57 ± 1.90), E3 (17.90 ± 3.10), and C (15.20 ± 2.44). However, at 14th week follow up, there was observed significant differences in mean scores of HBV infection prevention practices between all four groups E1 (23.09 ± 2.4), E2 (22.6 ± 3.6), E3 (23.82 ± 2.3), and C (15.25 ± 2.4). Paired-sample t-test conducted demonstrated significant differences between baseline and 14th week follow up for E1 (17.21 ± 3.07 and 23.18 ± 2.9; p = 0.001), E2(15.57 ± 1.90 and 23.53 ± 3.12; p = 0.001), E3(17.90 ± 3.10 and 25.1 ± 2.6; p < 0.001), but not for C (15.20 ± 2.44 and 15.25 ± 2.4; p = 0.92), with most significant impact (ES(95%CI) on HBV infection prevention practices observed for E2(3.106 95%CI: [2.66 to 3.55; p = 0.001]). Importantly, the participants in E2 showed more improvement in prevention practices than their counterparts from E1, E3, and control. Therefore, the intervention demonstrated proof-of-concept in facilitating behavior modification expected. Peer education can be utilized as a strategy to promote Hepatitis B infection prevention practices among adolescents.