Hepatitis B among University Population: Prevalence, Associated Risk Factors, Knowledge Assessment, and Treatment Management
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population and Blood Sampling
2.2. Laboratory Testing
2.3. HBV DNA Extraction and Amplification
- Forward: 50-CATCCTGCTGCTATGCCTCATCT-30
- Reverse: 50-CGAACCACTGAACAAATGGCACT-30
- Forward: 50-GGTATGTTGCCCGTTTGTCCTCT-30
- Reverse: 50-GGCACTAGTAAACTGAGCCA-30
2.4. Liver Function Tests (LFTs) and International Normalized Ratio (INR)
2.5. Detection of HBeAg
2.6. Risk Factors and Knowledge Assessment
2.7. Statistical Analysis
2.8. Treatment Management for Hepatitis B
3. Results
3.1. Overall Prevalence of Hepatitis B
3.2. Age-Wise Prevalence of Hepatitis B
3.3. Prevalence of Hepatitis B Regarding Social Status of the Participants
3.4. Viral Load of the PCR-Positive Individuals
3.5. Liver Function Tests (LFTs) of the HBV-Positive Individuals
3.6. Prothrombin Time Test (PT-Test) or International Normalized Ratio (INR) (n = 39)
3.7. Risk Factor Assessment Associated with Hepatitis B Spread among Studied Population
3.8. Knowledge Assessment of the Participants before and after Awareness
3.9. Prevalence of Hepatitis B among Different Tribes
3.10. Previous Medical History of the Participants
3.11. Treatment Management for the Acute and Chronic HBV-Postive Participants
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Sex | Total Participants | HBsAg Positive | HBsAg Negative | HBV Positive | HBV Negative | HBeAg Positive | HBeAg Negative |
---|---|---|---|---|---|---|---|
Male | 3210 | 86 | 3124 | 32 | 54 | 1 | 31 |
Female | 3805 | 64 | 3786 | 7 | 57 | 1 | 6 |
Age Groups | No. of Individuals | Standard Deviation | Median Age | Mode of Age | Mean Age with 95% (Z* = 1.96) Confidence Interval (CI) | HBsAg-Positive Individuals |
---|---|---|---|---|---|---|
16–30 | 6270 | 3.3 | 21 | 21 | 21.5 ± 0.08 | 138 (2.2%) |
31–45 | 504 | 13.9 | 36 | 35 | 36.8 ± 1.2 | 0 |
46–60 | 228 | 27.9 | 50 | 50 | 51.4 ± 3.6 | 12 (5.3%) |
Above 60 | 13 | 40.1 | 63 | 63 | 63.6 ± 21.8 | 0 |
Total Population | 7015 | 7.2 | 22 | 21 | 23.7 ± 0.17 | 150 (2.13) |
Population Distribution | No. of Individuals | Prevalence of HBsAg | Percentage |
---|---|---|---|
Employees | 493 | 47 | 9.5% |
Students | 6522 | 103 | 1.6% |
Total | 7015 | 150 | 2.13% |
Viral Load | No. of Individuals | Percentage |
---|---|---|
<10,000 IU/mL | 0 | 0% |
10,000–20,000 IU/mL | 9 | 23.1% |
>20,000 IU/mL | 30 | 76.9% |
Test | Normal Range | No. of Individuals within Normal Range | % | No. of Individuals above Normal Range | % |
---|---|---|---|---|---|
Bilirubin | 0.2–1.0 mg/dL | 18 | 46.2 | 21 | 53.8 |
ALT | Male 0–43 U/L | ||||
Female 0–36 U/L | |||||
ALP | Adult 80–306 U/L | ||||
Child up to 645 U/L |
Prothrombin Time | INR = (PT Patient/PT Normal)ISI | Indications | No. of Individuals (n = 17) | % |
---|---|---|---|---|
Below 11 s | <0.8 | Hyperprothrombinemia | 0 | 0 |
11 to 13.5 s | 0.8 to 1.1 | Normal | 36 | 92.3 |
Above 13.5 s | >1.1 | Hypoprothrombinemia | 03 | 7.7 |
Factors | Responses | Overall Responses | Frequencies Diseased | Frequencies Non-Diseased | p-Value (0.05) | Statistical Significance |
---|---|---|---|---|---|---|
Jaundice/hepatitis history | Yes | 100 (1.4%) | 02 | 98 | 0.9 | No |
No | 7005 (98.6%) | 148 | 6767 | |||
Vaccination against hepatitis | Yes | 21 (0.3%) | 0 | 21 | 0.49 | No |
No | 6994 (99.7%) | 150 | 6844 | |||
History of blood transfusion | Yes | 1170 (16.7%) | 30 | 1140 | 0.27 | No |
No | 5845 (83.3%) | 120 | 5725 | |||
Dental treatment | Yes | 2630 (37.5%) | 76 | 2554 | 0.0008 | Yes |
No | 4385 (62.5%) | 74 | 4311 | |||
Surgery (minor/major) | Yes | 3309 (47.2%) | 78 | 3231 | 0.2 | No |
No | 3706 (52.8%) | 72 | 3634 | |||
History of injections | Yes | 7015 (100%) | 150 | 6865 | 0 | No |
No | 0 (0%) | 0 | 0 | |||
Sharing of comb, nail cutter, etc. | Yes | 7015 (100%) | 150 | 6865 | 0 | No |
No | 0 (0%) | 0 | 0 | |||
Visit to beauty parlor/barber shop | Yes | 7015 (100%) | 150 | 6865 | 0 | No |
No | 0 (0%) | 0 | 0 | |||
Hospitalization history | Yes | 3309 (47.2%) | 85 | 3224 | 0.018 | Yes |
No | 3706 (52.8%) | 65 | 3641 | |||
Other diseases, i.e., diabetes/T.B or any other | Yes | 656 (9.4%) | 01 | 655 | 0.0002 | Yes |
No | 6359 (90.6%) | 149 | 6210 | |||
Organ transplantation | Yes | 02 (0.03%) | 0 | 02 | 0.8 | No |
No | 7013 (99.97%) | 150 | 6863 | |||
Use of contaminated mourning blades | Yes | 27 (0.38%) | 27 | 0 | <0.0001 | Yes |
No | 6988 (99.62%) | 123 | 6865 | |||
Tattooing/piercing on any part of the body | Yes | 4381 (62.5%) | 123 | 4258 | <0.0001 | Yes |
No | 2634 (37.5%) | 27 | 2585 |
Questions | Before Awareness | After Awareness | Chi- Square (p = 0.05, CI = 95% and df = 1) | Fisher’s Exact Test (p = 0.05 and CI = 95%) | Statistical Significance | ||
---|---|---|---|---|---|---|---|
Yes | No | Yes | No | ||||
Have you ever heard of a disease termed as hepatitis? | 2570 (36.6%) | 4445 (63.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Have you ever heard of a disease termed as hepatitis B? | 2570 (36.6%) | 4445 (63.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Is hepatitis B a viral disease? | 2570 (36.6%) | 4445 (63.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B affect liver function? | 1940 (27.6%) | 5075 (72.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B cause liver Cancer? | 1207 (17.2%) | 5808 (82.8%) | 6200 (88.4%) | 815 (11.6%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B affect any age group? | 641 (9.1%) | 6374 (90.9%) | 6033 (86%) | 982 (14%) | 0.0001 | 0.0001 | Yes |
The early symptoms of hepatitis B are the same as cold and flu (fever, running nose, cough) | 5069 (72.3%) | 1946 (27.7%) | 187 (2.6%) | 6828 (97.4%) | 0.0001 | 0.0001 | Yes |
Jaundice is one of the common symptoms of hepatitis B? | 1946 (27.7%) | 5069 (72.3%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Are nausea, vomiting, and loss of appetite common symptom of hepatitis B? | 1533 (21.8%) | 5482 (78.2%) | 6828 (97.4%) | 187 (2.6%) | 0.0001 | 0.0001 | Yes |
Are there no symptoms of hepatitis B in some of the patients? | 281 (4.0%) | 6734 (9.6%) | 5083 (72.5%) | 1932 (27.5%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be transmitted by un-sterilized syringes, needles, and surgical instruments? | 2570 (36.6%) | 4445 (63.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be transmitted by contaminated blood and blood products? | 2570 (36.6%) | 4445 (63.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be transmitted by using blades of the barber/ear and nose piercing? | 2570 (36.6%) | 4445 (63.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be transmitted by sharing of jewelry? | 0 (100%) | 7015 (100%) | 5055 (72%) | 1960 (28%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be transmitted from mother to child? | 2003 (28.6%) | 5012 (71.4%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be transmitted by contaminated water/food prepared by person suffering with these infections? | 4445 (63.4%) | 2570 (36.6%) | 0 (0%) | 7015 (100%) | 0.0001 | 0.0001 | Yes |
Is hepatitis B curable/treatable? | 1117 (15.9%) | 5898 (84.1%) | 6001 (85.5%) | 1014 (14.5) | 0.0001 | 0.0001 | Yes |
Can hepatitis B be self-cured by body? | 3568 (50.8%) | 3447 (49.2%) | 1101 (15.7%) | 5909 (84.3%) | 0.0001 | 0.0001 | Yes |
Is vaccination available for hepatitis B? | 5270 (75.2%) | 1745 (24.8%) | 7015 (100%) | 0 (0%) | 0.0001 | 0.0001 | Yes |
Is a specific diet required for the treatment of hepatitis B? | 4405 (52.8%) | 2610 (37.2%) | 6067 (86.5%) | 948 (13.5%) | 0.0001 | 0.0001 | Yes |
Caste | No. of Individuals per Tribe | No. of HBsAg-Positive Individuals |
---|---|---|
Abbasi | 421 | 10 (2.4%) |
Awan | 788 | 18 (2.3%) |
Balti | 105 | -- |
Chaudhary | 568 | 4 (0.7%) |
Khawaja | 936 | 22 (2.4%) |
Mughal | 688 | 06 (0.9%) |
Pakhtoon | 233 | -- |
Peerzada | 32 | -- |
Qureshi | 245 | 4 (1.6%) |
Rajpoot | 1635 | 21 (1.3%) |
Sheikh | 183 | 1 (0.5%) |
Sudhan | 310 | 3 (0.9%) |
Syed | 871 | 61 (7.0%) |
Total Tribes= 13 | Total No. Individuals = 7015 | Total HBsAg Positive = 150 (2.13%) |
Medical History | No. of Individuals | Male Individuals | Female Individuals |
---|---|---|---|
HBV Vaccination | 21 (0.3%) | 14 (66.6%) | 7 (33.4%) |
Hepatitis A | 58 (0.8%) | 50 (86.2%) | 8 (13.8%) |
Jaundice | 100 (1.4%) | 79 (79%) | 21 (21%) |
Hypocalcemia | 170 (2.4%) | 165 (97%) | 5 (03%) |
Tuberculosis | 656 (9.4%) | 231 (35.2%) | 425 (64.8%) |
Dental Surgery | 2630 (37.5%) | 1894 (72%) | 736 (28%) |
Transplantation | 2 (0.03%) | 1 (50%) | 1 (50%) |
Gastric Ulcer | 41 (0.6%) | 5 (12.2%) | 36 (87.8%) |
Gall Bladder Surgery | 9 (0.2%) | 3 (33.4%) | 6 (66.6%) |
Typhoid | 438 (6.2%) | 322 (73.5%) | 116 (26.5%) |
Chicken Pox | 45 (0.6%) | 31 (68.9%) | 14 (31.1%) |
Vision Abnormalities | 85 (1.2%) | 39 (45.8%) | 46 (54.2%) |
Renal Stones | 13 (0.2%) | 12 (92.3%) | 1 (7.7%) |
Appendicitis | 162 (2.3%) | 122 (75.3%) | 40 (24.7%) |
Any Allergy | 261 (3.7%) | 143 (54.8%) | 118 (45.2%) |
Cardiac Problems | 5 (0.07%) | 5 (100%) | -- |
Pneumonia | 7 (0.09%) | 2 (28.6%) | 5 (71.4%) |
Measles | 3 (0.04%) | 1 (33.4%) | 2 (66.6%) |
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Kazmi, S.A.; Rauf, A.; Alshahrani, M.M.; Awadh, A.A.A.; Iqbal, Z.; Soltane, R.; Tag-Eldin, E.; Ahmad, A.; Ansari, Z.; Zia-ur-Rehman. Hepatitis B among University Population: Prevalence, Associated Risk Factors, Knowledge Assessment, and Treatment Management. Viruses 2022, 14, 1936. https://doi.org/10.3390/v14091936
Kazmi SA, Rauf A, Alshahrani MM, Awadh AAA, Iqbal Z, Soltane R, Tag-Eldin E, Ahmad A, Ansari Z, Zia-ur-Rehman. Hepatitis B among University Population: Prevalence, Associated Risk Factors, Knowledge Assessment, and Treatment Management. Viruses. 2022; 14(9):1936. https://doi.org/10.3390/v14091936
Chicago/Turabian StyleKazmi, Syed Ayaz, Abdul Rauf, Mohammed Merae Alshahrani, Ahmed Abdullah Al Awadh, Zahoor Iqbal, Raya Soltane, ElSayed Tag-Eldin, Altaf Ahmad, Zulqarnain Ansari, and Zia-ur-Rehman. 2022. "Hepatitis B among University Population: Prevalence, Associated Risk Factors, Knowledge Assessment, and Treatment Management" Viruses 14, no. 9: 1936. https://doi.org/10.3390/v14091936
APA StyleKazmi, S. A., Rauf, A., Alshahrani, M. M., Awadh, A. A. A., Iqbal, Z., Soltane, R., Tag-Eldin, E., Ahmad, A., Ansari, Z., & Zia-ur-Rehman. (2022). Hepatitis B among University Population: Prevalence, Associated Risk Factors, Knowledge Assessment, and Treatment Management. Viruses, 14(9), 1936. https://doi.org/10.3390/v14091936