A Cross-Sectional Study To Assess The Prevalence Of Hepatitis B Serological Markers Among Individuals With A History Of Jaundice
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Abstract
Background: Hepatitis B infection presents a significant global health challenge, with Pakistan experiencing particularly high prevalence rates. Moreover, jaundice is often regarded as a non-threatening metabolic condition by most individuals rather than an infectious concern. Given the strong association between hepatitis B and jaundice, this study sought to investigate the prevalence of hepatitis B serological markers specifically among individuals with a history of jaundice. The findings hold implications for targeted screening and intervention strategies aimed at addressing this pressing health concern.
Methods: A cross-sectional study was conducted among 100 participants, selected based on a history of jaundice within the last 6 months and aged over 18 years. Data collection included basic ethno-demographic information and screening for hepatitis B using immuno-chromatographic test (ICT) devices for HBsAg, anti-HBc, HBeAg, anti-HCV, and anti-HDV. HBV DNA was extracted for positive HBsAg cases and subjected to PCR amplification. Statistical analysis was performed using GraphPad Prism Version 9.0.
Results: Among the participants, 2% tested positive for HBsAg, 1% for HBV DNA, and 1% for HBeAg. Fortunately, none tested positive for Anti-HCV or Anti-HDV. Age-stratified analysis revealed a higher prevalence of hepatitis B markers among participants aged above 25 years. Male participants exhibited a higher prevalence of HBsAg compared to females (9.5% vs. 0%; p = 0.0056; χ2 = 7.677). District-wise prevalence varied, with Bagh district showing the highest rate of 10%, while some districts reported no cases. Job status analysis indicated higher prevalence among employees (28.6%) compared to students (0%). Tribal analysis revealed varying prevalence rates, with the Chaudhary tribe showing a positivity rate of 16.7%, and the Khan tribe exhibiting a positivity rate of 12.5% for hepatitis B markers.
Conclusion: The findings emphasize the significance of recommending hepatitis screening for individuals with a history of jaundice, particularly among older age groups and males. Understanding ethno-demographic variations in hepatitis B prevalence is essential for designing effective prevention and control strategies in AJK state, Pakistan.
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References
Lai CL, Chien RN, Leung NW, et al. A one-year trial of lamivudine for chronic hepatitis B. Asia Hepatitis Lamivudine Study Group. N Engl J Med 1998; 339:61-8.
Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546-55.
Biswas T, Biswas SK. Seroprevalence of Hepatitis B Infection among First-Time Blood Donors in Faridpur, Bangladesh. Int J Med Students. 2016;3(1):15-19.
Martin A, Islam MR, Mridha MA-A, Mowla MG, Hepatitis B & C viral markers status in icteric children at a tertiary care hospital. J Shaheed Suhrawardy Med Col. 2012;3(2):35-7.
Atkinson W, Wolfe S, Hamborsky J, Atkinson W, Wolfe C, Hamborsky J. Epidemiology and prevention of vaccine preventable diseases: Public Health Foundation; 2011.
Livramento Ad, Cordova CM, Spada C, Treitinger A. Seroprevalence of hepatitis B and C infection markers among children and adolescents in the southern Brazilian region. Rev Inst Med Trop. 2011;53(1):13-7.
Ali SA, Donahue RM, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis. 2009;13(1):9-19.
Jafri W, Jafri N, Yakoob J, Islam M, Tirmizi SFA, Jafar T, et al. Hepatitis B and C: prevalence and risk factors associated with seropositivity among children in Karachi, Pakistan. BMC Infect Dis. 2006;6(1):101-11.
Cui Y, Jia J. Update on epidemiology of hepatitis B and C in China. J Gastroenterol Hepatol. 2013;28(1):7-10.
Mansouri N, Movafagh A, Sayad A, Ghafouri-Fard S, Darvish H, Zare-Abdollahi D, et al. Hepatitis B virus infection in patients with blood disorders: a concise review in pediatric study. Iran J Ped Hematol Oncol. 2014;4(4):178-87.
Al-Fahdi, F., Al-Harthy, N., Al-Abri, S., Al-Abaidani, I., Al-Mashhadani, M., &Al- Hatmi, H. (2013). Prevalence and risk factors associated with hepatitis B in mass screening of jaundice patients: a cross-sectional study. Oman Medical Journal, 28(6), 434-438.
Al-Faleh, F. Z. (2013). Changing patterns of hepatitis viral infection in Saudi Arabia. Annals of Saudi Medicine, 33(4), 361-368.
Alshamrani, M., Albaqumi, M., & Alhazmi, M. (2015). Seroprevalence of hepatitis B virus among patients with chronic liver disease in Saudi Arabia. Journal of Infection and Public Health, 8(2), 170-176.
Ola, S. O., Odaibo, G. N., & Olaleye, O. D. (2009). Prevalence of hepatitis Bsurface antigen in patients with HIV/AIDS and HIV sero-negative individuals in Lagos, Nigeria. African Journal of Biomedical Research, 12(1), 9-16.
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 Aug 31;14(9):1936.
Abdul Rauf, Muqaddas Tahir, Humaira Abid, Fahad Alshahrani, Muhammad Zahid Latif, Mohammed Merae Alshahrani, Ahmed Abdullah Al Awadh, Nawal E Al-Hazmi, Abdulfattah Omar, Tasleem Akhtar, Syed Ayaz Kazmi, Zeeshan Anjum, Iqra Bibi, Zia-ur-Rehman, & Zahoor Iqbal. (2024). A HIGH PREVALENCE OF HBV AND HCV INFECTIONS AMONG PREGNANT WOMEN: A PROSPECTIVE CROSS SECTIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 31(1), 75–89. https://doi.org/10.53555/jptcp.v31i1.3814
Zumrah Bilal Butt, Sabeen Zahid, Aliza Hamadani. (2017). Prevalence of Hepatitis B Virus Infection among Jaundiced Children in Pakistan. P.J.M.H.S., Vol. 11, NO. 3, 902-904.
Ochwoto M, Kimotho JH, Oyugi J, Okoth F, Kioko H, Mining S, Budambula NL, Giles E, Andonov A, Songok E, Osiowy C. Hepatitis B infection is highly prevalent among patients presenting with jaundice in Kenya. BMC Infect Dis. 2016; 16: 101. http://doi.org/10.1186/s12879-016-1409-2
Tsatsralt-Od B, Takahashi M, Endo K, Buyankhuu O, Baatarkhuu O, Nishizawa T, Okamoto H. Infection with hepatitis A, B, C, and delta viruses among patients with acute hepatitis in Mongolia. J Med Virol. 2006; 78(5): 542-50.
Owusu M, Bonney JK, Annan AA, Mawuli G, Okyere K, Mutocheluh M, et al. (2018) Aetiology of viral hepatitis among jaundiced patients presenting to a tertiary hospital in Ghana. PLoS ONE 13(9): e0203699. https://doi.org/10.1371/journal.pone.0203699
Kolou M, Katawa G, Salou M, Gozo-Akakpo KS, Dossim S, Kwarteng A, Prince-David M. High Prevalence of Hepatitis B Virus Infection in the Age Range of 20-39 Years Old Individuals in Lome. Open Virol J. 2017 Jan 12; 11: 1-7.
Khan F, Shams S, Qureshi ID, Israr M, Khan H, Sarwar MT, Ilyas M. Hepatitis B virus infection among different sex and age groups in Pakistani Punjab. Virol J. 2011 May 13; 8: 225.
Toy, M., Önder, F.O., Wörmann, T. et al. Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC Infect Dis 11, 337 (2011). https://doi.org/10.1186/1471-2334-11-337
Anwar, F., Khan, M., Salman, M., Ahmad, S., Abdullah, Ullah, F., Khan, J., Haq, I., & Abbas, M. (2021). Seroprevalence of hepatitis B virus in human population of district Buner Khyber Pakhtunkhwa Pakistan. Clinical Epidemiology and Global Health, 10, 100688. https://doi.org/10.1016/j.cegh.2020.100688
Nejo Y, Faneye AO, Olusola B, Bakarey S, Olayinka A, Motayo B; PERVI Study Group. Hepatitis B virus infection among sexually active individuals in Nigeria: a cross-sectional study. Pan Afr Med J. 2018 Jun 20; 30: 155.
Syed Ayaz Kazmi, Rauf, A., Muhammad Zahid Latif, Sundus Khawaja, Tasleem Akhtar, Beenish Shahid, Iqra Batool, Nuzhat Shafi, Zeeshan Anjum, Humaira Abid, Mohsin Nazir Awan, Ejaz Ahmad Khan, & Faisal Farooq. (2024). EPIDEMIOLOGICAL INSIGHTS INTO THE PREVALENCE OF HEPATITIS B AND ASSOCIATED RISK FACTORS AMONG COLLEGE POPULATIONS. Journal of Population Therapeutics and Clinical Pharmacology, 31(1), 471–482. https://doi.org/10.53555/jptcp.v31i1.3877.
Khan, F., Akbar, H., Idrees, M. et al. The prevalence of HBV infection in the cohort of IDPs of war against terrorism in Malakand Division of Northern Pakistan. BMC Infect Dis 11, 176 (2011). https://doi.org/10.1186/1471-2334-11-176
Asghar, M. S., Rasheed, U., Hassan, M., Mohammed, A., Yaseen, R., & Fayaz, B. (2021). A CROSS-SECTIONAL SCREENING SURVEY ON THE SEROPREVALENCE OF HEPATITIS B AND HEPATITIS C AMONGST THE GENERAL POPULATION OF RURAL DISTRICTS OF SINDH, PAKISTAN. Arquivos De Gastroenterologia, 58(2), 150–156. https://doi.org/10.1590/s0004-2803.202100000-26
Mayanja Y, Rida W, Kimani J, Ssetala A, Mpendo J, Nanvubya A, Mutua G, Anzala O, Price MA. Hepatitis B status and associated factors among participants screened for simulated HIV vaccine efficacy trials in Kenya and Uganda. PLoS One. 2023 Jul 17;18(7):e0288604.
Tosun, S., Aygün, O., Özdemir, H.Ö. et al. The impact of economic and social factors on the prevalence of hepatitis B in Turkey. BMC Public Health 18, 649 (2018). https://doi.org/10.1186/s12889-018-5575-6
Dwibedi B, Sabat J, Ho LM, Singh SP, Sahu P, Arora R, Kar SK. Molecular epidemiology of hepatitis B virus in primitive tribes of Odisha, eastern India. Pathog Glob Health. 2014 Dec;108(8):362-8.
Ishida, T., Takao, S., Settheetham-Ishida, W., & Tiwawech, D. (2002). Prevalence of hepatitis B and C virus infection in rural ethnic populations of Northern Thailand. Journal of Clinical Virology, 24(1–2), 31–35. https://doi.org/10.1016/s1386-6532(01)00222-0
Kazmi, S.A., Rauf, A., Latif, M.Z. et al. A 28-year-old male patient with asymptomatic and multi-drug-resistant HBV infection: a case report. Egypt Liver Journal 14, 13 (2024). https://doi.org/10.1186/s43066-024-00319-6