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      Hepatitis B infection in the rural area of Dschang, Cameroon: seroprevalence and associated factors

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          Abstract

          Introduction

          viral hepatitis B remains a major public health problem around the world, especially in underdeveloped and developing countries. Cameroon shows a grate variability in prevalence of this infection in the country and even within different populations groups. The aim of this study was to determine the prevalence and factors associated with viral hepatitis B infection in the rural area of Dschang.

          Methods

          we conducted a cross-sectional community-based study, involving 551 participants of both genders recruited by a voluntary sampling technique. The biological diagnosis of HBsAg was done by the Immunochromatographic method (PKL® kit of PARAMEDICAL srl laboratories). Positive cases were confirmed by ELISA method (reagent Kit from DIALAB Laboratories).

          Results

          results show a Viral Hepatitis B prevalence of 5.08% (95% CI: 3.2-6.9). University students were the most infected (11/88) with a positivity rate of 12.50% (95%CI: 5.6-19.4). Only 29/551 participants (5.26%) had received at least one dose of vaccine against the disease and were less infected (3.44%) than the others (5.17%). Age (p=0.000), level of education (p=0.013), occupation (p = 0.002), belief in the traditional healing of hepatitis B (p=0.000) and knowledge about the disease and its contamination roads (p=0.049) were associated with viral hepatitis B.

          Conclusion

          there is a need of intensifying awareness, education, routine screening and vaccination of the population, especially in schools and university milieu to better counteract the infection with hepatitis B virus in our local Communities.

          Most cited references18

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          Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures.

          D Lavanchy (2004)
          Hepatitis B virus (HBV) infection is a serious global health problem, with 2 billion people infected worldwide, and 350 million suffering from chronic HBV infection. The 10th leading cause of death worldwide, HBV infections result in 500 000 to 1.2 million deaths per year caused by chronic hepatitis, cirrhosis, and hepatocellular carcinoma; the last accounts for 320 000 deaths per year. In Western countries, the disease is relatively rare and acquired primarily in adulthood, whereas in Asia and most of Africa, chronic HBV infection is common and usually acquired perinatally or in childhood. More efficacious treatments, mass immunization programs, and safe injection techniques are essential for eliminating HBV infection and reducing global HBV-related morbidity and mortality. Safe and effective vaccines against HBV infection have been available since 1982. The implementation of mass immunization programs, which have been recommended by the World Health Organization since 1991, have dramatically decreased the incidence of HBV infection among infants, children, and adolescents in many countries. However, not all countries have adopted these recommendations and there remains a large number of persons that were infected with HBV prior to the implementation of immunization programs. Antiviral treatment is the only way to reduce morbidity and mortality from chronic HBV infection. Conventional interferon alfa and lamivudine have been the primary treatments to date. Conventional interferon alfa produces a durable response in a moderate proportion of patients but has undesirable side-effects and must be administered subcutaneously three times per week. Lamivudine also produces a response in a modest proportion of patients and causes few side-effects. However, prolonged treatment is often necessary to prevent relapse on cessation of therapy, and continuous treatment can lead to the development of lamivudine resistance. Promising emerging new treatments include adefovir, entecavir and peginterferon alfa-2a (40 kDa).
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            Hepatitis B: Epidemiology and prevention in developing countries.

            Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.
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              Hepatitis B infection awareness, vaccine perceptions and uptake, and serological profile of a group of health care workers in Yaoundé, Cameroon

              Background Cameroon is one of the countries in Africa with the highest burden of Hepatitis B infection. Health care workers are known to be at risk of occupational exposure to blood and other infectious bodily fluids. The aim of this study was to assess the profile of serological markers of hepatitis B virus (HBV) infection, knowledge and perceptions regarding HBV infection among health care workers in a health area in Yaoundé. Methods A cross-sectional study was conducted in the Mvog-Ada Health Area of the Djoungolo Health District from March 1 to November 31, 2014. All consenting health care workers were included in the study. Serological markers of HBV (HBs Ag, Hbe Ag, anti-HBs Ab, anti-HBe Ab, anti-HBc Ab) were qualitatively tested using Biotech®(OneHBV-5 parameter rapid test website) in each participant and the anti-HBs antibodies were quantified by ELISA (Biorex) among those who were positive with the qualitative test. Chi square test or its equivalents were used to compare qualitative variables and a p-value less than or equal to 0.05 was considered significant. Result A total of 100 participants were retained for the study out of 163 in the health area giving a response rate of 61.34 %; the mean age was 30.5 (SD 6.8) years and 71 % of participants were women. Forty seven percent (47 %) of workers had good level of knowledge of HBV infection. The men were 3.20 times (95 % CI: 1.02–9.19, p = 0.04) more likely to have a good level of knowledge than women. Participants with a university study level were more (95 % CI: 3.17–25, p < 0.0001) likely to have a good level of knowledge than those with a high school study level. Ninety-six percent of participants thought that they were at a greater risk of becoming infected with HBV than the general population, 93 % felt that the vaccine should be compulsory and all (100 %) were willing to recommend it to others. However, only 19 % had received at least one dose of the vaccine. The proportion of HBs Ag was 11 %. The different serological profiles with regard to HBV infection were naive subjects (62 %), chronic carriers (11 %), vaccinated (19 %) and subjects naturally immunized (8 %). Three out of the 19 participants who received at least one dose of the vaccine, only 9 (47.4 %) of whom had titers ≥100 IU/l indicating a good response to vaccination. Among those who received three doses of the vaccine (n = 12, 63 %), 2 (16, 66 %) had poor response to vaccination (HBs Ab titers < 100 IU/l). Conclusion The prevalence of HBs Ag among health care workers in the Mvog-Ada Health Area is high (11 %). These workers are at high risk of HBV infection because of very low vaccine uptake and poor post-exposure practices. Their knowledge of HBV infection is non-optimal.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                28 August 2020
                2020
                : 36
                : 362
                Affiliations
                [1 ]Saint Vincent de Paul Hospital Dschang, Dschang, Cameroon,
                [2 ]University of Dschang, Dschang, Cameroon
                Author notes
                Corresponding author: Thomas Djifack Tadongfack, Saint Vincent de Paul Hospital Dschang, Dschang, Cameroon. talk2thomasson@ 123456yahoo.com
                Article
                PAMJ-36-362
                10.11604/pamj.2020.36.362.17787
                7666683
                61158c93-b1a2-4e6e-b91b-214d6ac53fee
                Copyright: Thomas Djifack Tadongfack et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 November 2018
                : 26 June 2020
                Categories
                Research

                Medicine
                viral hepatitis b,seroprevalence,associated factors,dschang,cameroon
                Medicine
                viral hepatitis b, seroprevalence, associated factors, dschang, cameroon

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