A study of risk factors of hepatitis B infection among rural adult population of Patna, Bihar

Abstract

INTRODUCTIONGlobally 325 million people are HBsAg positive hence carriers of hepatitis B Virus (HBV).1 This is a public health challenge as majority of them have poor access to testing and treatment facilities. With a prevalence of 3 -4.2%, India is in the intermediate endemic zone but has around 40 million HBV carriers.2 Annually around 7,80,000 people die due to consequences of chronic HBV.2 Among those with infection, chances of becoming HBV carriers are 90% in infants, 30% in early childhood and upto 5% in adults.2 In persons with chronic HBV infection, risk of dying prematurely due to liver cirrhosis and hepatocellular carcinoma (HCC) is 15-25%; one in every 26 infants born run the life-time risk of developing chronic HBV infection.3 Chronic infection with HBV is responsible for 80% of cirrhosis , and about 60% of HCC in India. 4 HBV is resilient and can survive outside the body for at least 7 days at room temperature without losing its infectivity. This virus is 100 times more infectious than HIV. 3 The risk of infection with HBV after single needle-stick injury is 30%. 5 ABSTRACTBackground: Chronic infection with heptitis B virus (HBV) leading to cirrhosis, cancer, premature death and consequent economic burden is a global problem. Prevention is a public health challenge especially in unvaccinated and disadvantaged populations with unknown risk factors. Majority of Bihar's population is rural, whose risk factors have not been studied earlier. The objective was to study the risk factors of HBV infection in the rural adult population of Bihar with aim of identifying target group for prevention. Methods: Analytic case-control study in which health camps were organized in villages of Phulwarisharif block of Patna district to screen adults and identify cases and controls. Results: H/o jaundice 6 months or more (p=0.00, OR=3.58); contact with HBV (p=0.00, OR=4.17), family H/o HBV (p=0.00 OR=5.41); blood transfusion (p=0.00, OR=6), H/o hospitalization (p=0.001, OR=2.36), surgery (p=0.003, OR=2.17) and migration (p=0.018, OR=1.95) were significant risk factors. Lack of knowledge about HBV was significant (p<0.030). About 40% and 20% of both cases and controls were aware of parenteral and sexual transmission respectively; 4% cases vs. 13% controls knew about preventive vaccination. Logistic regression revealed that H/o jaundice, family H/o hepatitis B, blood transfusion, hospitalization and migration were independent risk factors for HBV transmission (OR=4.69, 6.55, 3.89. 2.49 and 2.76 respectively) Conclusions: Screening and awareness programs for rural adults necessary to identify and follow up those with H/o jaundice, HBV + contacts and migrant population. Infection control and biomedical waste management need strengthening.

Prevalence and knowledge of hepatitis B infection in pregnant women in a primary health center of Patna district, Bihar

“…[ 19 ] Additionally, in a case-control study conducted among a rural population in Phulwarisharif block of Patna, Bihar, to examine the risk factors for hepatitis B transmission in the rural area, 50% of the cases and 62% of the controls were aware of the hepatitis B disease, 40% in each group were aware of blood transfusion, and 20% about sexual route as a mode of spread. However, only 4% of the cases and 13% of the controls knew about the hepatitis B vaccination,[ 20 ] whereas in our study, 30% of the mothers knew about the sexual route and 16% about the blood transfusion. This is similar to a study conducted in three slums of Mumbai by Jha et al .…”

Risk Factors for Hepatitis B Virus Infection in North Ethiopia: A Case–Control Study

“…This finding is similar to the unmatched case–control study conducted in rural areas of Patina, India, which showed that those who were unaware of transmission through sexual contact were more likely to contract hepatitis B virus infection as compared to participants having awareness of transmission through sexual contact. 20 This could be because infection with the hepatitis B virus can also be transmitted through semen and blood. Therefore, awareness of this can be the prerequisite for preventing the contraction of the disease.…”

“…Most of the questions were taken from questionnaires from other studies to investigate risk factors of hepatitis B virus infection. 20 , 29 , 30 Data were collected through face-to-face interviews with patients by trained experienced health professionals using pre-tested and interviewer-structured questionnaires. They were interviewed by trained health workers at Ayder comprehensive specialized hospital about their socio-demography, healthcare service-related factors, behavioural factors and awareness of hepatitis B virus infection.…”

Husband's behavior and early marriage as risk factors for hepatitis B virus infection among pregnant women in Karangasem, Bali, Indonesia

“…The results of a study in India showed that higher sero-positive HBsAg cases were found in adults with a history of migration. 14 Other studies have shown that the risk of sero-positive HBsAg is higher in pregnant women with a history of having their husbands working abroad.…”

“…Studies in Africa showed that a history of first-time sexual intercourse within the age <19 years in women 9-11 and having multiple sexual partners 9,10,12,13 increase the risk of HBV infection in pregnant women. In addition to sexual behavior, a study in India reported that the risk of HBV infection was higher among residents with a history of migration to find work, 14 whereas in Ethiopia and Turkey was higher among pregnant women who had permanent tattoos. 15,16 Another study in Kabul, Turkey showed that HBV infection was associated with injecting drug use.…”