Abstract

Hepatitis is an inflammation of the liver which can be self-limiting or can progress to fibrosis (scarring), cirrhosis, or liver cancer. Among the types of hepatitis viruses are Hepatitis B viruses which cause Hepatitis B.

Hepatitis B is blood borne pathogen with primary mode of transmission direct blood-blood contact with an infected person. Numerous studies reported prevalence rates among health care professionals of 4.98% in the Fako division of the south west region (Ngekeng et al., 2018) and 11.00% in Yaoundé.

This study is to determine the prevalence of hepatitis B infection in the Buea municipality. This cross descriptive study was carried out in Solidarity clinic and Diligent Clinic Malingo, Buea Cameroon, from November 2020 to July 2021. There are other health centers in Buea but they made their data unavailable. Hepatitis B records were exploited in the two clinics to obtain data pertaining to hepatitis B.

The plasma of collected samples was tested for presence of HBsAg using a commercial hepatitis B surface antigen test kit, (Fastep Hepatitis B test kit). Sex was not associated with hepatitis (p=0.359), both sexes are equally exposed to the infection.

From standard theoretical studies, p-value obtained as being less than 0.05 shows a statistical significantly higher rate of hepatitis B infection. The results, (24.1%) p= 0.036, obtained from this studies shows that people within the age group of 21-30 years are infected with Hepatitis B virus.

CHAPTER ONE

INTRODUCTION AND LITERATURE REVIEW

1.1 INTRODUCTION

Hepatitis is an inflammation of the liver that can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis (WHO 2019).

There are 5 main types of hepatitis viruses: A, B, C, D and E with hepatitis B virus (HBV), and hepatitis C virus (HCV) being the  most common chronic viral infections of public health importance and with great socio-economic impact worldwide (Muriuki et al., 2013). These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread.

Hepatitis B is an infection of the liver caused by the hepatitis B virus. The virus is most commonly transmitted from mother to child during birth and delivery(WHO 2020), as well as through contact with blood or other body fluids, including sex with an infected partner, sharing needles, syringes or exposures to sharp instruments.

For some people, hepatitis B is mild and last for a short time (acute) (Ciancio et al., 2014).  It can become chronic and if that happens, it can cause scarring of the liver and can be life-threatening.

In 2015, hepatitis B resulted in an estimate of 887 000 deaths, mostly from cirrhosis and hepatocellular carcinoma (i.e. primary liver cancer) (WHO 2016). As of 2016, 27 million people (10.5% of all people estimated to be living with hepatitis B) were aware of their infection, while 4.5 million (16.7%) of the people diagnosed were on treatment (WHO 2017).

According to the latest WHO estimates, the proportion of children under five years of age chronically infected with HBV dropped to just under 1% in 2019 down to around 5% in the pre-vaccine era ranging from the 1980s to the early 2000s(WHO 2020).

Hepatitis B is a major concern in Africa, especially in HIV-infected patients who have a greater risk of liver failure, cirrhosis, hepatocellular carcinoma, and death (Sureau et al., 2016). Of the 36.7 million people living with HIV worldwide in 2015, approximately 2.7 million (7.4%) were co-infected with hepatitis B virus (HBV) (Béguelin et al., 2017) and nearly three quarter of the latter resided in Africa.

In a recent meta-analysis, the prevalence of HBV infection in people living with HIV was estimated at 8.4% worldwide and up to 12.4% in West and Central Africa (Ciancio et al., 2014). Cameroon had a wide disparity in the prevalence of HBV infection within the country (Noah et al, 2015).

A study carried out on the general population in 2015 reported variable rates per region, ranging from 22.82% in the Far North, 21.53% in the North, 12.75% in the Adamawa, 14 .00% in the East and 5.22% in the South for an overall prevalence of 13.01%.

Numerous other studies reported prevalence rates among health care professionals of 4.98% in the Fako division of the south west region (Ngekeng et al ., 2018) and 11.00% in Yaoundé . Since the implementation of “The mother to child transmission prevention strategy” against hepatitis B (PMTCT-HBV) in Cameroon( Loriette et al., 2015), studies have been carried out in order to better control the outcome, most often fatal in children( Loriette et al., 2016).

These initiatives are of valuable importance in view of the high probability of chronic carriage in children (Mohamed et al., 2015). Dionne-Odom et al. in a study conducted among blood donors in four large Hospitals of the Cameroon Baptist Convention Health Services reported a 4.40% prevalence of HBV among blood donors( Jodie et al., 2016) .Frambo reported a 9.7% prevalence of hepatitis B infection among pregnant women in Buea (Frambo et al., 2014).

1.2 Literature Review

1.2.1 Epidemiology

Hepatitis B virus (HBV) infection is a global public health problem. The World Health Organization estimated that, in 2015, there were 257 million HBV carriers in the world and roughly 887,000 died that year from HBV-related liver disease (WHO 2020).

In the WHO Eastern Mediterranean Region, the WHO South-East Asia Region and the WHO European Region, an estimated 3.3%, 2.0% and 1.6% of the general population is infected, respectively. And in the WHO Region of the Americas, 0.7% of the population is infected.

1.3 RATIONAL

Considering the socioeconomic consequences of hepatitis b in Cameroon as a whole and southwest region in particular couple with the fact that chemotherapy have not been able to eradicate the disease, knowledge on the disease, prevalence and mode of transmission remains essential in completely eradicating this disease.

Thus, this project is set out to determine the prevalence of the disease in the Buea municipality by assessing the factors that might influence the transmission of hepatitis B.

1.4 Hypothesis

The prevalence of hepatitis B infection is high in the Buea municipality.

1.5 Objectives

1.5.1 General objective

The general objective of this study is to determine the prevalence of hepatitis B infection in Buea.

1.5.2 Specific objective

1. To assess the risk factors associated with the disease.
2. To determine the prevalence of hepatitis B infection using the hepatitis rapid diagnostic test strip
3. To analyze and compare the result from previous results.