1
|
Mendlowitz AB, Mandel E, Capraru CI, Hansen BE, Wong D, Feld JJ, Janssen HLA, Biondi MJ, Arif A, Yim C. Factors associated with knowledge and awareness of Hepatitis B in individuals of Chinese descent: Results from a mass point of care testing and outreach campaign in Toronto, Canada. CANADIAN LIVER JOURNAL 2024; 7:28-39. [PMID: 38505784 PMCID: PMC10946186 DOI: 10.3138/canlivj-2023-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/22/2023] [Indexed: 03/21/2024]
Abstract
Background Migrants from hepatitis B virus (HBV) endemic regions are at high risk of having chronic infection. Despite this, HBV knowledge and awareness programming, and low-barrier screening methods such as point of care (POC) testing, among this group have yet to become routine. Methods We conducted a mass HBV POC screening and knowledge and awareness campaign for individuals of Chinese descent in Toronto, Canada. POC screening was administered, then participants completed a knowledge questionnaire. Logistic regression identified associations between demographic factors and participants' level of HBV knowledge. Results From 2015 to 2018, 33 outreach events resulted in 891 individuals completing testing and the knowledge questionnaire. Individuals averaged 64.4 years old. Most, 62% (N = 552), were female, and 73.6% (N = 656) have been in Canada for <30 years. The average questionnaire score was 70.7% correct, with 65.2% (N = 581) demonstrating a high level of HBV knowledge. Post-secondary education (OR: 2.19, 95% CI: 1.41, 3.39), income of $50,000 to <$75,000 (OR: 2.74, 95% CI: 1.39, 5.43), and having familial history of HBV (OR: 1.72, 95% CI: 1.06, 2.78) were associated with high knowledge. The observed prevalence of HBV was 1.5%, with 13 individuals testing positive on the POC test and confirmatory laboratory testing. Conclusions Improving knowledge and awareness of HBV is critical to empowering people, especially migrants who experience barriers to care, to pursue vaccination, testing, and treatment. Combining knowledge outreach and POC test campaigns, enabled discussion and screening for HBV with large numbers of people, and can be tailored for optimal effectiveness for specific groups.
Collapse
Affiliation(s)
- Andrew B Mendlowitz
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
| | - Erin Mandel
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
| | - Camelia I Capraru
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
| | - Bettina E Hansen
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
- Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - David Wong
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - Jordan J Feld
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
- Sandra Rotman Centre for Global Health, University of Toronto, Toronto, Ontario, Canada
| | - Harry LA Janssen
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
- Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Mia J Biondi
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada
- School of Nursing, York University, Toronto, Ontario, Canada
| | | | - Colina Yim
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Morgan CE, Thahir S, Ngimbi P, Mwandagalirwa MK, Ntambua S, Matondo J, Tabala M, Mbendi C, Kaba D, Yotebieng M, Parr JB, Banek K, Thompson P. Participant perspectives to improve tenofovir adherence in the prevention of mother-to-child transmission of hepatitis B virus in Kinshasa, DRC. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.30.23287808. [PMID: 37034729 PMCID: PMC10081418 DOI: 10.1101/2023.03.30.23287808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Prevention of mother-to-child transmission (PMTCT) programs for hepatitis B virus (HBV) are critical to reach the World Health Organization's 2030 HBV elimination goals. Despite demonstrated feasibility utilizing HIV infrastructure, HBV PMTCT programs are not implemented in many African settings, including in the Democratic Republic of Congo (DRC). In a previous pilot of HBV PMTCT implementation in DRC's capital, Kinshasa, we observed low TDF metabolite levels at delivery among women with high-risk HBV who were given tenofovir disoproxil fumarate (TDF) antiviral therapy. As such, we conducted qualitative interviews with women who received TDF to understand facilitators and barriers of medication adherence. We used a modified Information-Motivation-Behavioral Skills model (IMB+) as a framework for thematic content analysis. We found that trust in healthcare workers, familial support, and improved awareness of the disease and treatment options were important facilitators of TDF adherence; pill size, social stigma, and low HBV knowledge were barriers to adherence. While overall acceptance of TDF was high in this pilot, improved TDF adherence is needed in order to reach efficacious levels for preventing transmission from mothers to newborns. We suggest ongoing HBV sensitization within existing maternity and HIV care infrastructure would address gaps in knowledge and stigma identified here. Additionally, given the trust women have towards maternity center staff and volunteers, scaled HBV PMTCT interventions should include specific sensitization and education for healthcare affiliates, who currently receive no HBV prevention or information in DRC. This study is timely as TDF, particularly future long-acting formulations, could be considered as an alternate rather than adjuvant to birth-dose vaccination for HBV PMTCT in sub-Saharan Africa.
Collapse
Affiliation(s)
| | - Sahal Thahir
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Patrick Ngimbi
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Sarah Ntambua
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Jolie Matondo
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Martine Tabala
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Charles Mbendi
- University Hospital, Kinshasa, Democratic Republic of Congo
| | - Didine Kaba
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Jonathan B Parr
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kristin Banek
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Peyton Thompson
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
3
|
Afolabi IB, Aremu AB, Maidoki LA, Atulomah NO. Dynamics of Hepatitis B infection prevention practices among pregnant women attending antenatal care at Lubaga Hospital Kampala, Uganda using the constructs of information-motivation-behavioural skills model. BMC Public Health 2022; 22:2243. [PMID: 36457005 PMCID: PMC9714095 DOI: 10.1186/s12889-022-14723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is considered a significant global public health challenge with infectivity as well as estimated potential for transmission more than 50 to 100 times that of HIV. Over time, numerous empirical studies have shown that majority of HBV-related yearly global deaths are secondary to carcinoma of the liver. It is also known that HBV infected Women have the potential to transmit the infection vertically to their infants during pregnancy. This accounts for the WHO reported 3.16% prevalence among children less than 5 years of age in Uganda. This study assessed the predictors of HBV infection prevention practices among eligible consenting pregnant women using Lubaga health facility for antenatal care (ANC). METHODS A cross-sectional descriptive study employing quantitative data collection based on the constructs of IMB model was used to capture data on the study variables among 385 randomly selected eligible pregnant women attending antenatal care at Lubaga hospital between September 2020 and October 2020. Data derived from the quantitative instrument was analysed by data reduction and transformation to summaries of descriptive statistics using (SPSS version 26) and regression analysis was performed to establish characteristics of the association between the variables with significance level set as (p < 0.05). Chi-square goodness-of-fit test was employed for significant differences in the proportion of dichotomous responses. RESULTS The findings showed that more than half of the respondents (59%) were between the ages of 18 and 28 and majority of them (42.3%) had secondary education. Furthermore, an average but inadequate knowledge ([Formula: see text] 5.97 ± 6.61; B = 0.57; p < .001), positive perception ([Formula: see text] 17.10 ± 18.31; B = 0.97; p = .014) and good behavioural skills ([Formula: see text] 12.39 ± 13.37; B = 0.56; p < .001) for adopting prevention practices all statistically predicted the averagely acceptable level of prevention practices ([Formula: see text] 15.03 ± 16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. CONCLUSION AND RECOMMENDATION There were observed gaps in their knowledge about some basic features of the infection like transmission and risk factors as well as some misperceptions about vaccination despite the relatively average score level for both, which is likely to influence their prevention behaviours and predispose them to the risk of the infection if actions are not taken. Therefore, personalized health education is needed during antenatal visits and subsequent health campaign in order to inform better prevention practices among this vulnerable population group.
Collapse
Affiliation(s)
- Ismail Bamidele Afolabi
- grid.448732.e0000 0004 0462 7038Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| | - Abdulmujeeb Babatunde Aremu
- grid.442655.40000 0001 0042 4901Faculty of Health Sciences, Department of Human Anatomy, Islamic University in Uganda, Kampala Campus, Kampala, Uganda
| | - Lawal Abdurraheem Maidoki
- grid.448732.e0000 0004 0462 7038Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| | - Nnodimele Onuigbo Atulomah
- grid.448732.e0000 0004 0462 7038Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| |
Collapse
|
4
|
Thahir S, Tulenko SE, Ngimbi P, Ntambua S, Matondo J, Mwandagalirwa K, Tabala M, Kaba D, Yotebieng M, Parr JB, Thompson P. Low knowledge about hepatitis B prevention among pregnant women in Kinshasa, Democratic Republic of Congo. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000450. [PMID: 36962537 PMCID: PMC10021814 DOI: 10.1371/journal.pgph.0000450] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Abstract
Infants infected perinatally with hepatitis B (HBV) are at the highest risk of developing chronic hepatitis and associated sequelae. Prevention of mother-to-child transmission (PMTCT) of HBV requires improved screening and awareness of the disease. This study evaluated existing HBV knowledge among pregnant mothers (n = 280) enrolled in two HBV studies in urban maternity centers in Kinshasa, Democratic Republic of the Congo. All mothers responded to three knowledge questions upon study enrollment. Baseline levels of knowledge related to HBV transmission, treatment, prevention, and symptoms were low across all participants: 68.8% did not know how HBV was transmitted, 70.7% did not know how to prevent or treat HBV MTCT, and 79.6% did not know signs and symptoms of HBV. Over half of participants responded "I don't know" to all questions. HBV-positive women who participated in both studies (n = 46) were asked the same questions during both studies and showed improved knowledge after screening and treatment, despite no formal educational component in either study (p < 0.001). These findings highlight the need for intensified education initiatives in highly endemic areas to improve PMTCT efforts.
Collapse
Affiliation(s)
- Sahal Thahir
- Division of Infectious Diseases, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Samantha E. Tulenko
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Patrick Ngimbi
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Sarah Ntambua
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Jolie Matondo
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | | | - Martine Tabala
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Didine Kaba
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Marcel Yotebieng
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Jonathan B. Parr
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Peyton Thompson
- Division of Infectious Diseases, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
5
|
Afolabi IB, Aremu AB, Maidoki LA, Atulomah NO. Predictors of Hepatitis B Virus Infection Vaccine Hesitancy Among Pregnant Women Attending Antenatal Care at Lubaga Hospital, Kampala, Uganda. Int J Womens Health 2022; 14:1093-1104. [PMID: 35999868 PMCID: PMC9393032 DOI: 10.2147/ijwh.s378000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background While hepatitis B virus infection may be seen as a global threat within the medical and scientific community, primary prevention via vaccination remains the most effective approach towards breaking the chain of transmission of HBV infection. However, vaccination uptake in Uganda has been modest despite a very endemic national figure resulting from the vertical transmission of this infection. This study assessed the predictors of HBV vaccine hesitancy among pregnant women attending Antenatal clinic in Central Uganda. Methodology A hospital-based cross-sectional study employing a five-sectioned pretested interviewer-administered questionnaire was conducted to obtain data from 385 consenting pregnant women. Responses for the antecedent variables were transformed into weighted aggregate scores using SPSS version 26. Multivariable logistic regression analysis was employed to ascertain the predictors of HBV vaccine hesitancy with the cut-off for hypotheses set at 5% level of significance. Results The majority of the respondents (59%) were between the ages of 18 and 28 years. Women with secondary educational attainment were predominant (42.3%). The respondents had mean scores of 5.97±6.61, 17.10±18.31, and 12.39±13.37, respectively, computed for knowledge of HBV infection, perception, and behavioral skills towards HBV prevention. Regarding vaccine hesitancy, three-quarters of the women (74%) hesitated to uptake HBV vaccine. While negative significant associations exist between marital status (AOR = 0.47, 95% CI = 0.22-1.01), knowledge (AOR = 0.79, 95% CI = 0.70-0.89), behavioral skills (AOR = 0.88, 95% CI = 0.81-0.95) and vaccine hesitancy, level of education (AOR = 1.88, 95% CI = 1.08-3.27) and perception (AOR = 1.11, 95% CI = 1.05-1.18) on the other hand, positively predicted vaccine hesitancy. Conclusion The findings reported an extremely high degree of HBV vaccine hesitancy among the expectant mothers discovered to be linked with marital status, educational attainment, HBV-specific knowledge, perception and behavioral skills. This necessitates targeted health education for married women with lower educational attainment to improve their knowledge which will in turn shape their perception and behavioral skills towards satisfactory uptake of HBV vaccine.
Collapse
Affiliation(s)
- Ismail Bamidele Afolabi
- Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| | - Abdulmujeeb Babatunde Aremu
- Faculty of Health Sciences, Department of Human Anatomy, Islamic University in Uganda, Kampala Campus, Kampala, Uganda
| | - Lawal Abdurraheem Maidoki
- Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| | | |
Collapse
|
6
|
Ssekamatte T, Isunju JB, Mutyoba JN, Tetui M, Mugambe RK, Nalugya A, Kansiime WK, Kitchen C, Brenda W, Oputan P, Bukenya JN, Buregyeya E, Kibira SPS. Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda. PLoS One 2022; 17:e0267953. [PMID: 35588113 PMCID: PMC9119510 DOI: 10.1371/journal.pone.0267953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule. METHODS A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. RESULTS About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. CONCLUSIONS Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.
Collapse
Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Joan Nankya Mutyoba
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Wagaba Brenda
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Patience Oputan
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| |
Collapse
|
7
|
Maqsood S, Iqbal S, Zakar R, Zakar MZ, Fischer F. Determinants of overall knowledge and health behaviours in relation to hepatitis B and C among ever-married women in Pakistan: evidence based on Demographic and Health Survey 2017-18. BMC Public Health 2021; 21:2328. [PMID: 34969379 PMCID: PMC8719411 DOI: 10.1186/s12889-021-12406-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background In 2019, around 5 million and 10 million people were affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) respectively in Pakistan. On World Hepatitis Day 2019, Pakistan’s Government announced the Prime Minister’s Plan to eliminate HBV and HCV from the country by 2030. In order to achieve this goal, adequate knowledge about HBV and HCV regarding mode of transmission, symptoms of the disease, and awareness about available treatments and vaccines is imperative. The present study aims to investigate the determinants related to overall knowledge about and behaviour in relation to HBV and HCV amongst married women in Pakistan. Methods Secondary data analysis was carried out using the Pakistan Demographic and Health Survey (PDHS) 2017–18. A series of questions regarding women’s knowledge about how to avoid HBV and HCV and their health behaviour in relation to HBV and HCV were posed to 12,364 ever-married women of reproductive age (15–49 years). Bivariate and multivariable logistic and linear regression was applied to examine the effects of sociodemographic characteristics and covariates on women’s overall knowledge and health behaviour regarding HBV and HCV. Results The findings highlight that the majority of women (88.3%) have heard of HBV and HCV. Nonetheless, only 34.8% had comprehensive knowledge about how to avoid HBV and HCV. Few women (11.3%) had been tested for HBV or HCV during the year preceding the survey. Furthermore, the results indicate that women living in urban areas, being older, and having more than 10 years of schooling, reported better knowledge and health behaviours regarding HBV and HCV. Conclusion This study provides evidence that women’s sociodemographic characteristics create differences in their overall knowledge about and attitudes towards HBV and HCV. This research emphasized that there is a need to create awareness about the causes and prevention of HBV and HCV in order to achieve the goal of eliminating these diseases in Pakistan by 2030.
Collapse
Affiliation(s)
- Sidra Maqsood
- Department of Sociology, Government College University, Lahore, Pakistan
| | - Sarosh Iqbal
- Institute of Social & Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Rubeena Zakar
- Institute of Social & Cultural Studies, University of the Punjab, Lahore, Pakistan
| | | | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. .,Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany.
| |
Collapse
|
8
|
Pandey S, Lohani P, Roy R, Bhar D, Ranjan A, Kumar P, Singh CM. Prevalence and knowledge of hepatitis B infection in pregnant women in a primary health center of Patna district, Bihar. J Family Med Prim Care 2021; 10:3675-3681. [PMID: 34934665 PMCID: PMC8653459 DOI: 10.4103/jfmpc.jfmpc_731_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction: There is a risk of chronic hepatitis B virus (HBV)infection to the newborn through perinatal transmission from a hepatitis B surface antigen (HBsAg) positive mother that can later cause liver cirrhosis or hepatocellular carcinoma. This study was undertaken in a primary health center (PHC)in the Patna district to determine the prevalence of HBV among pregnant women and assess their knowledge across different characteristics. Methodology: A cross-sectional study was done among 275 pregnant women attending the PHC for the first time, using consecutive sampling. The study duration was 12 months. Socioeconomic, obstetric, risk history, and levels of knowledge about hepatitis B were collected followed by rapid diagnostic test (RDT)for serum HBsAg. Univariate analysis was used to compare the knowledge levels across different background characteristics. The significance was set at P < 0.05. Results: Hepatitis B-positive pregnant women were 0.4%. Out of the 275 participants, only 43 had heard about hepatitis B. The mean knowledge score was 0.65 (±1.73) with 1.45% having adequate knowledge. The knowledge score was significant across education (P 0.040), category (P 0.022), hepatitis B immunization status (P 0.003), and risk factor (P 0.039). Conclusion: Knowledge was higher in the literate women belonging to the general category and higher social class, who received hepatitis B vaccination. However, the overall level of knowledge among the pregnant women was very poor, so they should be targeted for quality health education. Additionally, identifying the afflicted pregnant women through point-of-contact diagnosis will aid in community prevention of chronic hepatitis B.
Collapse
Affiliation(s)
| | | | - Ria Roy
- Department of CFM, AIIMS, Patna, Bihar, India
| | - Ditipriya Bhar
- Consultant, National Institute of Epidemiology (ICMR), Chennai, Tamil Nadu, India
| | - Alok Ranjan
- Department of CFM, AIIMS, Patna, Bihar, India
| | | | - C M Singh
- Department of CFM, AIIMS, Patna, Bihar, India
| |
Collapse
|
9
|
Nlinwe NO, Lungle D. Risk factors associated with hepatitis B virus infection among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital. PUBLIC HEALTH IN PRACTICE 2021; 2:100160. [PMID: 36101628 PMCID: PMC9461564 DOI: 10.1016/j.puhip.2021.100160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/01/2021] [Accepted: 06/28/2021] [Indexed: 11/03/2022] Open
Abstract
Objectives Approximately 257 million people are infected with hepatitis B virus (HBV) especially in the middle and low-income countries, despite the Global Health Sector Strategy on viral hepatitis 2016–2021 which aims to eliminate viral hepatitis as a public health threat by 2030. Hepatitis B virus (HBV) remains a common public health problem in Cameroon with a high prevalence among pregnant women. Therefore, this study was designed to assess risk factors associated with hepatitis B virus infection among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital. Study design The study was a health facility-based cross-sectional study carried out from March to May 2020. The inclusion criteria were all pregnant women who came for their first visit. Methods A well-structured questionnaire and laboratory test methods were used to collect data from 221 pregnant women who were consecutively enrolled in the study. The OnSite HBsAg Rapid Test (source: CTK Biotech, Inc. REF: R0040), was used to detect HBsAg in serum. Both descriptive statistics and Chi-square (and Fisher's exact) test were used for data analysis. Results The prevalence of HBV infection among pregnant women was 4.98% (11/221). Although knowledge, attitude and practice towards HBV by pregnant women were not significantly associated with the risk of infection, there were higher odds of poor practice (P = 0.0152) and attitudes (P = 0.0016) among those without knowledge on HBV infection. Conclusions Free of charge vaccination for those with negative HBsAg test results and extensive health education campaigns against HBV is recommended among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital.
Collapse
|
10
|
A mixed-methods evaluation of hepatitis B knowledge, attitudes, and practices among migrant women in Thailand. BMC Pregnancy Childbirth 2021; 21:525. [PMID: 34301179 PMCID: PMC8305500 DOI: 10.1186/s12884-021-03914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally 90 % of transmission of Hepatitis B virus (HBV) is from mother-to child and occurs predominantly in resource limited countries where the prevalence of HBV is high. Transmission could be interrupted by timely vaccinations but coverage remains problematic in these areas. Low knowledge or awareness of HBV may play a part in low vaccination coverage. This study examines the provision of antenatal care counselling with a focus on HBV in two different regions of northern Thailand, Sarapee Hospital (SH), Chiang Mai, and Shoklo Malaria Research Unit (SMRU), Tak Province. METHODS A mixed-methods sequential explanatory study design was used to evaluate antenatal services for migrants. Cross-sectional knowledge, attitude and practice (KAP) surveys were conducted immediately after counselling at first ANC contact, at 3-6 months after first ANC contact and at delivery. Surveys provided quantitative data, and qualitative methods included observations, focus group discussions (FGD) and in-depth interviews (IDI); analysed thematically to explore concepts of knowledge and understanding, attitude and practice of pregnant women and providers. RESULTS Between September-2019 and May-2020, 757 women participated to KAP surveys, and 31 observations of counselling, 16 FGD and 9 IDI were conducted. KAP surveys showed in spite of low knowledge about HBV transmission, infection, or vaccination (correct response: SH 5.7 %, 9/157; SMRU 34.0 %, 204/600), most women (≥ 93 %, either site) understood they were screened for HBV and were willing to vaccinate infants for HBV. In explaining KAP survey results, qualitative analysis suggests counselling should: use the appropriate language; be tailored to the local health literacy level, provide only pertinent information, be repeated over the antenatal period; and attempt to ensure patient privacy (where possible). Programme effectiveness benefits from positive attitudes to screening and vaccinations and a high level of trust in the providers nevertheless participants provided good suggestions for improvements of the service. CONCLUSIONS Limited knowledge of HBV among migrant women can be improved by counselling that emphasizes actionable knowledge such as vaccination schedule. Key improvements to the counselling process include training counsellors to conduct interactive counselling sessions in the woman's language, using appropriate visual aids and timely repetition over the course of the antenatal period.
Collapse
|
11
|
Mutyoba JN, Surkan PJ, Makumbi F, Aizire J, Kirk GD, Ocama P, Atuyambe LM. Hepatitis B birth dose vaccination for newborns in Uganda: A qualitative inquiry on pregnant women's perceptions, barriers and preferences. J Virus Erad 2021; 7:100039. [PMID: 34026246 PMCID: PMC8122110 DOI: 10.1016/j.jve.2021.100039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa continues with very low hepatitis B (HBV) birth dose vaccination coverage. To guide policy on HBV vaccine for newborns, we explored perceptions, barriers and preferences of pregnant women regarding HBV and the HBV birth dose vaccination. METHODS We conducted eight focus groups discussions (FGDs) among 70 pregnant women, stratified by rural-urban residence, age and education level, using a structured focus group discussion guide to explore birth dose awareness, perceptions, barriers and preferences. Data were transcribed, coded and analysed using framework analysis. RESULTS Perceptions related to HBV and liver cancer causes and prevention were diverse; most FGD participants did not perceive illnesses as distinctly different. Older women-groups, both urban and rural, had never heard about HBV, but were aware of liver cancer, viewing the disease as fatal. No FGD participants were aware of HBV birth dose. Concerns included vaccine safety, its availability to women who deliver outside the health system and mistrust in health-care worker (HCWs) when handling newborns. Rural-dwelling groups perceived absence of HBV services, while FGDs with young participants believed vaccine side-effects hampered birth dose planning. Most women-groups preferred (i) oral to injectable vaccines; (ii) receiving birth dose education during antenatal, to media-based education; (iii) that newborns receive the birth dose immediately after delivery in the mother's presence. CONCLUSION Although the birth dose is acceptable among pregnant women, planners need to continuously engage them as key stakeholders during planning to address concerns, in order to raise confidence, maximize uptake and strengthen HBV eradication efforts.
Collapse
Affiliation(s)
- Joan Nankya Mutyoba
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Fredrick Makumbi
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Jim Aizire
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory D. Kirk
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ponsiano Ocama
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lynn M. Atuyambe
- Department of Community Health & Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| |
Collapse
|
12
|
Mudji J, Madinga B, Horsmans Y. Seroprevalence of Viral Hepatitis B and C and Knowledge of the Hepatitis B Virus among Pregnant Women Attending Prenatal Care in the Democratic Republic of Congo. Am J Trop Med Hyg 2021; 104:1096-1100. [PMID: 33399040 DOI: 10.4269/ajtmh.20-0804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 10/25/2020] [Indexed: 12/17/2022] Open
Abstract
Viral hepatitis B (HBV) and C (HCV) can significantly influence maternal and child health. Although HIV infection, malaria, and syphilis in pregnant women are likely to be systematically screened for and managed according to national guidelines in the Democratic Republic of Congo, there is no plan for HBV and HCV. Furthermore, there is no documentation regarding pregnant women's knowledge about HBV and HCV. This situation has motivated the researchers to undertake the current study, which was designed to estimate the seroprevalence of HBV and HCV. We have also assessed knowledge of the HBV infection among pregnant women who consulted for antenatal care for the first time at Vanga Evangelical Hospital in Vanga. A cross-sectional study was conducted with 457 pregnant women who attended antenatal care. Sociodemographic, obstetric, and previous medico-surgical data, as well as information related to women's HBV knowledge, were collected using a questionnaire. Rapid tests were used to detect HBV surface antigen and HCV antibodies. Most pregnant women were aged 20-24 years. Only 6.8% of respondents had knowledge of HBV, and the main source of this knowledge was health facilities (4.6%). Only 0.7% reported having been tested, whereas 98.5% said that they had not been offered a test. Overall, 18 (3.9%) participants were HBV positive and 22 (4.8%) were positive for HCV. There is limited knowledge about HBV and HCV among pregnant women in rural Vanga. All pregnant women should be screened during antenatal care, and a well-implemented program of management is needed.
Collapse
Affiliation(s)
- Junior Mudji
- Département de médecine de famille et soin de santé Primaire, Université Protestante au Congo, Kinshasa, Democratic Republic of Congo.,Hôpital Evangélique de Vanga, Kikwit, Democratic Republic of Congo
| | - Blaise Madinga
- Département de médecine de famille et soin de santé Primaire, Université Protestante au Congo, Kinshasa, Democratic Republic of Congo.,Hôpital Evangélique de Vanga, Kikwit, Democratic Republic of Congo
| | - Yves Horsmans
- Hepato-GastroenterologyDepartment, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels Belgium
| |
Collapse
|
13
|
Alotaibi BS, Althobaiti MA, Hazazi AY, Hazazi SY, Nassir RA, Alhaddad MS, Abdelwahab SF. Exploration of Knowledge, Attitude, and Practice Among Residents of Saudi Arabia Toward Hepatitis Viruses. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211059965. [PMID: 34865566 PMCID: PMC8649914 DOI: 10.1177/00469580211059965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background and aim: Data available in the Kingdom of Saudi Arabia (KSA) about public knowledge, attitude, and practice (KAP) toward viral hepatitis infection are scarce. Such information is essential for designing effective intervention strategies for the prevention and control of viral hepatitis. This study aimed to assess the knowledge, attitude, and practice among residents of KSA toward hepatitis viruses. Methods: A cross-sectional descriptive study was conducted among 549 participants in Saudi Arabia. An electronic questionnaire (in Arabic) was used to measure the KAP of the participants. Data were analyzed using SPSS version 23 at significance level of .05. Results: Most of the 549 participants were Saudi citizens (96%; n = 527) and 26.6% (n = 146) of them were males and mostly from the western Saudi Arabia (72.9%; n = 400). Most participants did not hear about hepatitis viruses and showed low level of knowledge on viral hepatitis (42%). On the other hand, a positive attitude was apparent from participants' responses, and their practices were toward protecting their bodies from the infection. Conclusion: The level of knowledge about viral hepatitis was low (42%) among KSA residents, and the practice and attitude of the participants were toward avoiding the infection. Awareness campaigns are required to increase the public knowledge about viral hepatitis.
Collapse
Affiliation(s)
- Bashair S. Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
| | - Maryam A. Althobaiti
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
| | - Amal Y. Hazazi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
| | - Sarah Y. Hazazi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
| | - Rawan A. Nassir
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
| | - Mahmoud S. Alhaddad
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
- College of Medicine, Palestine Polytechnic University, Hebron, Palestine
| | - Sayed F. Abdelwahab
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
- Sayed F. Abdelwahab, PhD Division of Pharmaceutical Microbiology, Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif 21974 Kingdom of Saudi Arabia;
| |
Collapse
|
14
|
Boye S, Shimakawa Y, Vray M, Giles-Vernick T. Limited Awareness of Hepatitis B but Widespread Recognition of Its Sequelae in Rural Senegal: A Qualitative Study. Am J Trop Med Hyg 2020; 102:637-643. [PMID: 31971148 DOI: 10.4269/ajtmh.19-0477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
To achieve the WHO's global strategy of eliminating hepatitis B virus (HBV) infection, it is essential to ensure adequate understanding of hepatitis B disease to facilitate uptake of screening, linkage to care, and adherence to antiviral therapy. Sub-Saharan Africa has the world's highest prevalence of HBV infection, yet less than 1% of HBV-infected people have been diagnosed. Lay populations do not widely recognize "hepatitis B." Hypothesizing that visible signs and symptoms of chronic HBV infection sequelae (jaundice, ascites, or cachexia) might be more easily recognizable, we conducted a qualitative study to determine how rural populations in Senegal understood these sequelae. We led six focus groups and 149 individual interviews with lay populations and formal and informal health workers in three rural study sites in Senegal. Only a third of lay populations (30/105) had ever heard of "hepatitis B," nor did they evoke local language diagnostic terms resembling this illness. Nevertheless, more than two-thirds (71/105) recognized signs and symptoms of end-stage liver disease but considered these physical manifestations to be a consequence of the manipulation of occult forces. Lay populations also contended that traditional healers, not formal medical structures, should treat such illnesses. Formal and informal health workers had limited knowledge about hepatitis B and difficulties identifying terms in local languages to explain the disease. Communication strategies based on the population's widespread recognition of the hepatitis sequelae may enhance awareness of hepatitis, which is a crucial element to increase screening uptake, linkage to care, and commitment to lifelong treatment in African communities.
Collapse
Affiliation(s)
- Sokhna Boye
- Unité d'Epidémiologie des Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Yusuke Shimakawa
- Emerging Diseases Epidemiology Unit, Pasteur Institute, Paris, France
| | - Muriel Vray
- Unité d'Epidémiologie des Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal.,National Institute of Health and Medical Research (INSERM), Paris, France
| | - Tamara Giles-Vernick
- Anthropology and Ecology of Disease Emergence Unit, Pasteur Institute, Paris, France
| |
Collapse
|
15
|
Nankya-Mutyoba J, Aizire J, Makumbi F, Ocama P, Kirk GD. Hepatitis B virus perceptions and health seeking behaviors among pregnant women in Uganda: implications for prevention and policy. BMC Health Serv Res 2019; 19:760. [PMID: 31655575 PMCID: PMC6815411 DOI: 10.1186/s12913-019-4516-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 09/09/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND With most countries in sub-Saharan Africa (SSA) lagging behind schedule to implement a comprehensive viral hepatitis elimination strategy, several barriers to accurate information and hepatitis B virus (HBV) services still exist, that are unique to different regions. In an obstetric population of a high HBV burden SSA setting without antenatal HBV services, we systematically evaluated perceptions and prevention behavioral intentions in relation to HBV and liver cancer. METHODS Eligible consenting pregnant women were recruited from public health care facilities in the central and northern regions of Uganda, between October 2016 and December 2017. Standardized procedures and instruments based on the health belief model and theory of planned behavior were used to collect data on socio-demographic characteristics, HBV perceptions and behavioral intentions. Descriptive analysis using Chi-square tests was done to obtain distribution of respondents by levels of perceived risk of HBV and liver cancer for themselves, their child under 5 years and their spouse. Modified Poisson regression analyses were used to evaluate relationships between perception variables and different behavioral outcomes (intention to screen, vaccinate and treat HBV). RESULTS Perceived risk (PRR = 0.95(0.90-1.00), p = 0.055) was inversely associated with intention to screen for HBV. Conversely, perceived self-efficacy showed a consistent association with intention to screen for HBV (PRR = 1.18(1.10-1.23) p = 0.005), to vaccinate (PRR = 1.20(1.05-1.36) p = 0.006) and to seek treatment for HBV (PRR = 1.40(1.18-1.67) p < 0.001). Women from the north, compared to the central region (PRR = 1.76 (1.13-2.72) p = 0.012), and those who self-identified as Catholic (PRR = 1.85 (0.99-3.56) p = 0.056), and as Protestant, (PRR = 2.22 (1.22-4.04) p = 0.002), were more likely to have higher perceived self-efficacy, compared to Muslims. Age and education were not related to perceived self-efficacy. CONCLUSION Women in both regions hold incorrect perceptions of HBV and liver cancer risk, with women from the central reporting higher perceived risk than those from the north. High perceived self-efficacy influenced intention to participate in HBV prevention. Programs and policies geared towards enhancing HBV prevention in this sub-population may consider socio-cultural factors observed to influence prevention behaviors. These findings may guide HBV interventions aimed at improving capacity to seek HBV prevention services, thereby promoting HBV micro-elimination in this sub-population.
Collapse
Affiliation(s)
- Joan Nankya-Mutyoba
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - Jim Aizire
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Fredrick Makumbi
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Ponsiano Ocama
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Gregory D Kirk
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|