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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 6  |  Issue : 3  |  Page : 454-457

Seroprevalence of hepatitis B viral infection in the okpoko community


1 Department of Microbiology, Abia State University, Uturu, Abia
2 Department of Food Science and Technology, Abia State University, Uturu, Abia
3 Department of Medical Laboratory Sciences, Nnamdi Azikiwe University, Awka, Anambra, Nigeria

Date of Submission06-Apr-2022
Date of Decision16-May-2022
Date of Acceptance17-Jun-2022
Date of Web Publication17-Sep-2022

Correspondence Address:
Ndubuisi Obiora Nwachukwu
Department of Microbiology, Abia State University, P. M. B 2000, Uturu, Abia
Abia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_85_22

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  Abstract 


Background: Hepatitis B virus infection (HBV) is a potentially life-threatening liver infection. Little is known about seroprevalence at the community level. A cross-sectional, community-based study was conducted at Okopko, an urban slum in Ogbaru Local Government Area of Anambra State, Nigeria, using a multistage sampling technique. Stages were the constituency level, ward, and household levels. A total of 867 participants were enrolled. Methods: Testing for the markers of HBV was performed using Diagnostic Kit (USA). The test panel detects hepatitis B surface antigen (HBsAg), hepatitis e antigen (HBeAg), antibody to e antigen (HBeAb), core antibody (HBcAb), and surface antibody (HBsAb) using colloidal gold and membrane chromatographic technology. Results: The seroprevalence of HBsAg was 6.6%. Seroprevalence was higher in males (7.4%) than in females (5.5%) (P > 0.05). The peak seroprevalence occurred in the age group of 40–49 years for both males (13.6%) and females (8.1%) (P < 0.05). Exactly 4.7% were positive for HBeAg and 5.8% for HBsAg + HBeAg + HBcAb. Only 1% was positive for HBsAb. Conclusion: Okpoko community has a high intermediate prevalence rate of HBV infection. The HBV vaccination level is very low in the community.

Keywords: Hepatitis B, viral infection, seroprevalence, Nigeria


How to cite this article:
Nwachukwu NO, Okoronkwo CU, Duru PN. Seroprevalence of hepatitis B viral infection in the okpoko community. Biomed Biotechnol Res J 2022;6:454-7

How to cite this URL:
Nwachukwu NO, Okoronkwo CU, Duru PN. Seroprevalence of hepatitis B viral infection in the okpoko community. Biomed Biotechnol Res J [serial online] 2022 [cited 2022 Oct 5];6:454-7. Available from: https://www.bmbtrj.org/text.asp?2022/6/3/454/356158




  Introduction Top


Hepatitis B virus (HBV) is one of the causes of viral infections of the liver.[1] Individuals who are chronically infected can transmit the virus to others.[2] Other means of transmission include infected mother to child during birth, through sex with an infected partner, and multi-sex partners. Health workers are also at risk of contracting the virus.[3],[4]

Worldwide, over two billion people are infected with HBV and about 350 million people are chronic HBV carriers.[5] More than 1 million people die each year from cases related to viral hepatitis.[6] In sub-Saharan Africa, almost 8% of this global burden exists.[7] Hepatitis B viral infection is highly endemic in Nigeria[8],[9] and had previously been reported in different parts of the country.[10],[11],[12]

At the community level in Nigeria, not much is known about HBV infection. However, early detection and treatment is a key to breaking transmission at the community level. The World Health Organization is poised to eliminate HBV as a public health challenge by the year 2030.[13] We, therefore, determined the seroprevalence of HBV in the Okpoko community of Anambra State, Nigeria.


  Methods Top


Study area/participants/design

A community-based study was carried out at Okpoko, an urban slum in Ogbaru Local Government Area of Anambra State, Nigeria, between February 2018 and February 2019. Okpoko has an estimated population of 670,000. The population density is estimated at 49.78 persons per hectare[13] and is inhabited by poor- and middle-class families.

Design

A multistage sampling was performed at the constituency level, ward (smaller administrative units), and household levels. Multilevel sampling was to generate a representative sample, thus, distributing the overall sample size proportionately to the size of the population. Study participants were drawn from Okpoko 1 constituency, made up of six wards. A total of 867 people participated. Sociodemographic characters of the participants were collated using a structured questionnaire.

Testing for HBV Markers

Venous blood (5 ml) was collected from each participant and used for the investigations.

Diagnostics Kit (USA), which utilizes colloidal gold and membrane chromatography technology, was used for the detection of HBV markers in whole blood. The test panel included the qualitative detection of hepatitis B surface antigen (HBsAg), hepatitis e antigen (HBeAg) in whole blood with dual-antigen sandwich method, and measures HBsAb with dual-antigen sandwich method, and measures HBeAb and HBcAb with neutralization competitive inhibition method. Results were interpreted as positive or negative based on kit manufacturers.

Interpretation of HBV test results

HBV status was defined as follows: HBsAg positive – it indicates that the individual has a current infection, HBeAg positive – the presence of HBV nucleocapsid gene (HBeAg) indicates active viral replication in individuals with high levels of viremia who are likely to transmit the virus, HBeAb positive – the presence of antibodies to HBV nucleocapsid gene (HBeAb) indicates that the individual is recovering from as a result of the immune system response to HBeAg and has a reduced level of infectivity, HBsAb positive is considered evidence of being immune to HBV due to vaccination, and HBcAb is considered evidence of previous exposure.[14]

Ethical approval and patient consent

Approval for the study was obtained from the Health and Ethics Committee of Ogbaru Local Government Area. Approval date/No: Approval was conveyed on May 8, 2018. Approval No.: OGB/HEC/018/0118.

The study was conducted in accordance with the ethical principles mentioned in the Declaration of Helsinski (2013).

Patient consent

Participants voluntarily consented to participate.

Data generated were analyzed using descriptive statistics and categorical variables expressed in percentages. Differences in proportions were compared using Chi-square. Level of significance was set at P < 0.05.


  Results Top


A total of 867 participants, 485 (55.9%) males and 382 (44.1%) females participated in the study. Exactly 29.3% of the participants were in the age group of 40–49 years old and were 65.2% [Table 1].
Table 1: Demographic characteristics of participants in the Okpoko community

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The seroprevalence of HBsAg in the community was 6.6%. Males (7.4%) were more infected than females (5.5%) (P > 0.05). The highest prevalence of HBsAg was observed in the 40–49 years old. A similar observation was seen in the females, with a peak of 8.1% in the 40–49 years old. A statistical difference existed between age and being HBsAg positive [Table 2].
Table 2: Seroprevalence of HBsAg among participants in the Okpoko community

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Forty-one (4.7%) participants were HBeAg positive. Similarly, HBcAb seroprevalence was 6.0%. The proportion of the studied population who were positive for HBsAg + HBeAg + HBcAb was 5.8%. Only 1% of the participants had evidence of protective antibodies (HBsAb) in their serum [Table 3].
Table 3: Hepatitis B virus biomarkers among participants in the Okpoko community

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  Discussion Top


Hepatitis B viral infection is a public health problem; with high rates of morbidity and mortality globally.[15] In the Okpoko community, the overall HBsAg seroprevalence was 6.6%. This is similar with 6.0% reported by Moses et al.[16] among healthy urban Nigerians and lower than 12.2% in a National Survey.[5] This result is also in consonant with 6.89% previously reported in China.[17] It shows that HBV infection is endemic in Okpoko.

Males had higher HBsAg seroprevalence than females. This agrees with earlier results.[17] It is, however, contrary to findings where higher prevalence was seen in females.[18],[19] The gender difference is also probably due to the natural protective influence of estrogen against inflammation in women; higher exposure to carcinogens such as tobacco and alcohol in men.[20]

We observed that peak seroprevalence occurred in the age group 40–49 years old. This is in line with previous studies [21],[22],[23] where seroprevalence increased with age for both sexes. Older people in the community are likely to transmit the infection through their lifestyle including sexual promiscuity and marital status.[24] Interventions targeted at this age group will further reduce the burden and break community transmission.

The results of HBV biomarkers revealed that 4.7% of the Okpoko community were HBeAg positive. These indicate active infection and infectivity.[25] The seroprevalence of HBsAg + HBeAg + HBcAb was 5.8%. This represents the acute phase of HBV infection.[26] HBV transmission, therefore, could be ongoing in the community.

Only 1% of the population had evidence of protective antibodies in their sera (HBsAb) as a result of vaccination. The HBV vaccination rate is low. The knowledge and attitude of the populace to immunization generally may have contributed to this low rate.[27],[28]

Previous exposure to HBV is a risk factor for contracting the infection.[29] This is supported by our findings as 6.0% of the Okpoko community were previously exposed to the virus.


  Conclusion Top


Okpoko community has a high intermediate prevalence rate (5–7.99%) of HBV infection. Vaccination against HBV is very low.

Limitation of study

We did not carry out HBV DNA studies to ascertain highly infectious carriers. Our findings should be interpreted in the light of the fact only Okpoko 1 constituency was studied. This could compromise the overall HBV prevalence, though Okpoko has the highest population in Ogbaro Local Government Area.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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World Health Organization. Global Hepatitis Report. Geneva, Switzerland: World Health Organization; 2017.  Back to cited text no. 4
    
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Olayinka AT, Oyemakinde A, Balogun MS, Ajudua A, Nguku P, Aderinola M, et al. Seroprevalence of hepatitis B infection in Nigeria: A National Survey. Am J Trop Med Hyg 2016;95:902-7.  Back to cited text no. 5
    
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Moses PA, Silas DG, Simon P, Obadiah G. Hepatitis B viral infection in apparently healthy urban Nigerians: Data from pre-vaccination test. J Infect Dev Countr 2010;4:397-400.  Back to cited text no. 16
    
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Wang H, Men P, Xiao Y, Gao P, Lv M, Yuan Q, et al. Hepatitis B infection in the general population of China: A systematic review and meta-analysis. BMC Infect Dis 2019;19:811.  Back to cited text no. 17
    
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Samsunder N, Ngcapu S, Lewis L, Baxter C, Cawood C, Khanyile D, et al. Seroprevalence of hepatitis B virus: Findings from a population-based household survey in KwaZulu-Natal, South Africa. Int J Infect Dis 2019;85:150-7.  Back to cited text no. 26
    
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    Tables

  [Table 1], [Table 2], [Table 3]



 

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