KNOWLEDGE AND AWARENESS OF HEPATITIS B AMONG STUDENTS OF A PUBLIC SECTOR UNIVERSITY

Transcription

1 ORIGINAL ARTICLE KNOWLEDGE AND AWARENESS OF HEPATITIS B AMONG STUDENTS OF A PUBLIC SECTOR UNIVERSITY ASLAM GHOURI, SONIHA ASLAM, YASMEEN IQBAL, AKHTAR ADIL SHAH ABSTRACT OBJECTIVE: To determine the level of knowledge and awareness of hepatitis-b infection among udents of a public sector university. STUDY DESIGN: A cross-sectional observational udy. PLACE AND DURATION: The udy was conducted among udents of Center for Physical Education Health & Sports Science, University of Sindh, Jamshoro from July to 3 December 203. METHODOLOGY: Our tool of data collection was a self-adminiered queionnaire which assessed basic knowledge of hepatitis B, its modes of transmission, prevention, treatment, sequel and practices and attitudes towards patients with HBV infection. The queionnaire was diributed to the udents in the class and they were asked to fill it according to their knowledge without guessing. Data gathered was analyzed by SPSS V. 8. RESULTS: A total of 0 udents with mean age 2 years (SD ±.524) took part in this survey. Majority of our udents have heard about hepatitis (95%) and a large number of them knew that blood transfusion and re use of syringes (8%) are the main sources of transmission. Intereingly, a reasonable number of udents (32%) thought hepatitis B could spread through hug, cough and sneeze of a patient. About half of them were aware that a vaccine is available again HBV. Approximately 0% of the group believed that erilized syringes and screened blood for HBV should be used to prevent these infections. The mean scores were.%, 42% and 5.4% regarding basic knowledge, transmission and practices about hepatitis, respectively. CONCLUSION: Student's level of knowledge and awareness about hepatitis B was lacking. They had some misconceptions about disease transmission and treatment which has to be addressed. KEY WORDS: Knowledge, Awareness, Students, Hepatitis B, Blood Transfusion. INTRODUCTION Hepatitis B is the foremo public health problem around the world eating up the major portion of health resources. The increasing prevalence is a conant threat to our community as it is an important cause of liver cirrhosis and hepatocellular -3 carcinoma resulting in significant morbidity and mortality. Hepatitis B infection is prevalent worldwide, with a probable 2 billion people affected, of whom more than 350 million are chronic carriers. About die each year from HBV linked 4 liver ailment or hepatocellular carcinoma. The prevalence of HBV fluctuates greatly in different areas of world. Approximately three quarters of chronic carriers of hepatitis-b 5 live in Asia. The occurrence of HBV infection is 5-% in Southea Asia and % in North Europe and America. The incidence in India is 3-4%. Hepatitis B and C are both endemic in our country and the predictable frequency of hepatitis B antigen among healthy adults in a udy done locally was 2.4% (ranging from.4-.0%). The frequency is even greater in high-. Assiant Professor of Medicine Liaquat University of Medical and Health Sciences Jamshoro. 2. Assiant Professor of Health and Physical Education 3. Professor of Natural Sciences Center for Physical Education, Health and Sports Science, University of Sindh, Jamshoro Corresponding to: Aslam Ghouri, FCPS Assiant Professor of Medicine Liaquat University of Medical and Health Sciences Jamshoro. aslamghouri20@hotmail.com risk groups. Another udy recorded an eimate of 405 million carriers in Pakian with a carrier rate of 3-4% for HBV. Likewise a survey on hepatitis C infections observed that overall prevalence of HCV in Mansehra was.3% while among males it 8 was.8%, whereas, in females it was 9.4%.One more udy shows that the prevalence of hepatitis B and C in general population in Khyber Pakhtunkhwa (KPK), Pakian was 2.28% 9 and 3.9 respectively. The key factors responsible for global epidemic of hepatitis B include reuse of syringes, blood transfusion, tattooing, mother to child transmission and unsafe sexual practices. Therapeutic injections are quite common in our community and this pose a 5 consient threat of transmitting such infections.overuse of injections and unsafe injection practices causes an eimated 8- million cases of hepatitis B. As management is expensive and lots of the patients cannot afford this expensive treatment, it is essential that everyone, particularly those at risk should be vaccinated again hepatitis B virus and public should be educated regarding its preventive measures. General public particularly the health care personnel should be familiar with epidemiological factors of disease for inance communicability, Sequel, prevention and control. The introduction of training in universal safety measures and countrywide vaccination programs in decreasing the load of disease cannot be overemphasized. Rationale: Hepatitis infection is a main health problem in our ate and is responsible for high morbidity and mortality among those infected. Lack of knowledge and awareness about the disease is responsible for this ate of affairs. As not many udies are conducted in our country to assess the knowledge of general public concerning Hepatitis B, this udy was carried out 95

2 to determine the level of knowledge and awareness about hepatitis B among the udents of a public sector university. This udy will identify the gaps in knowledge and misconceptions and help in planning effective health education campaign. METHODOLOGY A cross sectional observational udy was conducted among the udents of Center for Physical Education Health & Sports Science, University of Sindh Jamshoro, from July to 3 December 203. One hundred udents were randomly selected by convenient sampling; the subjects were fully informed about the design and purpose of the udy. Out of those selected, (%) were admitted to bachelor's degree course and 24 (24%) were maer's degree udents. A written informed consent was obtained from each participant. The participants were given a ructured queionnaire. The queionnaire was designed to get information about demographic and it contained five other sections to assess basic knowledge about hepatitis B, its modes of transmission, prevention, sequel and practices and attitudes towards patients with HBV infection. Respondents were asked whether they have ever heard about a disease called hepatitis B. They were further queried about routes of transmission like sexual intercourse, child birth, blood transfusion, sharing toothbrushes and razors and reuse RESULTS A total of 0 udents participated in the udy with mean age of 2 years (±.524 SD) and age range of 8-35 years. The male to female ratio was 2.5: (2 males and 28 females). Graph No. shows the sex ratio of the respondents. Majority of the udents (95% n=95) had heard about hepatitis but only two-thirds agreed that hepatitis B is a contiguous disease and it affects the liver. A large number of them (4% n=4) were aware that a blood te is the only way to know for sure if you have hepatitis. Table - I shows the atements regarding the basic knowledge about hepatitis B. Regarding mode of transmission, bulk of the respondents (8% n=8) knew that blood transfusion and reuse of syringes were important sources of transmitting these infections. But a large volume (2% n=2) didn't consider sexual contact as a source of transmission. Sharing room with a hepatitis B infected person was acceptable to only (30% n=30) respondents and a reasonable number of udents (32% n=32) thought hepatitis B could spread through cough and sneeze of a patient. Visit to a barber (% n=) and dental and surgical procedures (48% n=48) were ated to be the major source of infection. Table-II shows the atements regarding transmission of hepatitis B. Half of the udents think that HBV infection is a preventable disease and a vaccine is available again it. Wearing gloves (32% n=32) and safe disposal of hospital wae (8% n=8) were recognized by the udents to be the methods to protect again these infections. Table - III shows the atements regarding prevention again hepatitis B. Regarding complications of hepatitis B, our respondents were less informed but more than half knew it can cause death. Table - IV shows the atements regarding complications of hepatitis B. our respondents were less informed but more than half knew it can cause death. Table No. IV shows the atements regarding complications of hepatitis B. Majority of the group (8% n=8) believed that screening blood for HBV renders blood safe for transfusion and erilized syringes should be used (2% n=2). A large number of udents (0% n=0) agreed that a person with H/O hepatitis shouldn't donate blood. Table no.v shows the atements regarding attitude and practices again hepatitis B. On an average,.% (n=) and 33.9% (n=40) had correct and incorrect knowledge about Hepatitis B infection, respectively. A total of 42.% (n=43) exhibited adequate level of awareness while 5.3% (n=5) exhibited incorrect level of awareness about transmission of Hepatitis B infection. The mo popular source of information was television (5% n=5) followed by family and friends (22% n=22) and print media (3% n=3). In our survey we assessed five aspects of hepatitis B like basic knowledge, its modes of transmission, prevention, sequel and attitude and practices. The mean scores of the udents were.% (n=), 42.% (n=43), 42% (n=42), 40% (n=40) and 5.4% (n=5) respectively. Students had more information about basic knowledge than mode of transmission, treatment and prevention of hepatitis B. Moreover they demonrated good attitude and practices again hepatitis. A trend was observed in our udy with increasing frequency of correct responses associated with increasing educational level. FIGURE - : SEX RATIO OF THE SUBJECTS 9

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4 DISCUSSION In a udy carried out among adults in a periurban community of Karachi, it was found that 8percent of the patients who attended the clinic received injections and in 94 percent of those patients, syringes were reused. More than half were teed for HBV and HCV and it was found that 44 percent of those patients had anti HCV and 9 percent were HBsAg positive.knowledge and awareness about hepatitis B is crucial to reduce the burden of this deadly disease in our community. Safe and clinically indicated injections are needed to prevent these infections in Pakian. During our survey, we found relatively good fundamental knowledge of hepatitis among the udents. Bulk of whom had heard about hepatitis but only half knew that hepatitis B is a th contiguous disease and it affects the liver. About 3/4 confessed that a blood te is the only way to know for sure if you have hepatitis. In a local udy done on medical udents, it was shown that mo of the male udents (9.8 percent) knew about hepatitis B infection. In a udy carried out among Asian Canadians, it was eablish that 8 percent were aware about HBV but over 0 percent were not aware of that HBV could 2 cause HCC or cirrhosis. One more udy involving dental udents in India, examined that 3 percent udents knew that Hepatitis B is an infectious illness caused by HBV and 88 percent of them considered that Hepatitis B surface antigen (HBs Ag) was mo commonly used te for the screening of Hepatitis B infection. A Dutch Turkish community udy observed less level of awareness and knowledge concerning hepatitis B, as the majority of respondents (3percent) never consider about the 3 disease. Almo similar results were reported in other, 2, 3,,4 udies. Regarding the modes of transmission of hepatitis B, the overall awareness of the udents was average. Majority of our respondents knew that transmission of HBV results from exposure to blood and blood products, reuse of syringes and razor of barber. But mo of them were less informed about other routes of transmission such as sex, mother to child, tattoo and surgical/dental procedures. In addition, when we inquired about routes of transmission that are not relevant to HBV, a reasonable number of udents thought cough, hand shake, sharing of utensils, sharing of room and eating food prepared by an infected person as a source of transmission. In a udy done on females attending gynecology clinics, the awareness about routes of transmission was not satisfactory. Less than half thought it can be transmitted by kissing, touching, sharing 5 rooms and utensils with hepatitis patient. In a udy done at a local university, more than 90 percent of the respondents thought blood and blood products, syringes, razor and sex are rd the leading source of infection. More than 2/3 of them knew sharing room and utensils with a patient of hepatitis B don't transmit the disease. In a udy performed on dental udents, majority knew that transmission of HBV results from exposure to contaminated blood (88%), needle ick injury (95%) and unsafe sex (92%) and 95% of them thought it can't be transmitted through hand shake. A udy conducted in Malaysia also highlights misconception about disease transmission among hepatitis patients. Majority (93.2%) believed that HBV can be communicated by sharing of eating 5,, and drinking utensils. Other udies show similar results. In our udy, knowledge about HBV vaccine was not satisfactory. Only half of the respondents knew that a vaccine is available for prevention of HBV but they didn't know about its lifelong protection. Our results are less when compared with other,, udies. This may be because of increasing knowledge and awareness among medical and dental udents about the,5,4 disease. But other udies show similar results. In present udy, about half of the responders knew that treatment is available for HBV in the form of injections. Another local udy reported the same results (50.8%). A udy done on medical udents' shows that 85% of them appreciated the availability of treatment. A udy done in Nawabshah on patients determined a significant lack of knowledge regarding treatment of disease. Awareness about complications and consequences of hepatitis th B was poor in our udy population. Only /4 of the responders thought it can result in liver cirrhosis and hepatocellular carcinoma but half of them knew it may cause death. In a udy done on dental udents, 8% udents knew hepatitis B can result in cirrhosis and carcinoma. In a local udy, almo half of the udents knew about complications. Regarding practices and attitude towards hepatitis patient, present udy reported fair amount of knowledge about good practices and attitude. More than half of our responders knew the role of screening blood for HBV before transfusion in prevention of the disease and majority would prefer using 98

5 erilized syringes when required. A reasonable number of udents thought patients undergoing surgical or dental procedures should be inveigated for HBV and the bulk of the responders would ask barber to use new blades for shaving and hair cut. Reuse of the blades for shaving armpits or beard is quite common especially in the small towns and villages which pose a considerable risk for transmitting these infections. Sharing personal things is a known risk factor for hepatitis but a sizeable number of our udents were either sharing or not sure about the role of personal belongings in disease transmission. In a local udy, majority of the participants had developed good practices of using erilized syringes (8percent) and screened blood for transfusion (5 percent) but to ask barbers to use new blades for shave was not found as frequent practice (50 percent). In a udy conducted in India, majority (95%) believed that patients undergoing surgical dental procedures to be inveigated for HBV. In our udy, safe disposal of hospital wae was appreciated as an important method again spread of infection but only one third of responders knew the role of wearing gloves again spread of infection. In a udy done in a local university at Karachi, majority of the responders knew the role of wearing gloves (8%) and safe disposal of sharp wae (98%) to protect again these infections. Television was the key source of information among our udy population followed by internet and family and friends. In a udy done on medical udents, books (85%), media (85%) and teachers (84%) were mentioned as main source of information. In a udy done at Isra hospital, teachers, books and media were regarded as source of information. In our udy it was found that increasing frequency of correct responses was associated with increasing educational level. In a udy conducted by Habra, et al (2005) on medical udents of Delhi, senior udents had the highe level of information compared with other groups. Similar results were reported in a 2 5 udy done in Iran and Malaysia. CONCLUSION The knowledge and awareness about hepatitis B was lacking among university udents. They had more knowledge about precautions than transmission and consequences of the disease. RECOMMENDATIONS Health education programs were found necessary for all udents to improve awareness of these diseases. Efforts need to be made to ensure greater awareness by arranging public awareness programs and seminars emphasizing on routes of transmission and prevention procedures to avoid the occurrence of these infections. Students are the be targeted group for health education who can educate their family and friends easily. REFERENCES. Razi A, Rehman R, Naz S, Ghafoor F, Khan M A. Knowledge attitude and practices of university udents regarding hepatitis B and C. ARPN J Agricul and Bio Sci. 20; 5(4): Ghahramani F, Mohammad beigi A, Mohammad salehi N. A Survey of the Students' Knowledge about Hepatitis in Shiraz University of Medical Sciences. Hepatitis monthly. 200; (2): Taylor V M, Choe JH, Yasui Y, Li L, Burke N, Jackson JC. Hepatitis B awareness, teing, and knowledge among Vietnamese American men and women. J. Commun. Health. 2005; 30(): Bibl F, Alaei M, Negro F. The new EASL guidelines for the management of chronic hepatitis B infection. Swiss Med Wkly 20; 40(-2): Haider G, Haider A. Awareness of women regarding hepatitis B. J. Ayub Med. Coll. Abbottabad 2008; 20(4):4-4.. Saini R, Saini S, Sugandha RS. Knowledge and awareness of Hepatitis B infection among the udents of Rural Dental College, Maharashtra, India. Ann Nigerian Med 20; 4: Nisar N, Baloach R, Munir A. A. Does clinical experience affect knowledge regarding Hepatitis-B among male medical udents at a private university J Pak Med Assoc. 2009; 59(2): Jamil M S, Ali H, Shaheen R, Basit A. Prevalence, knowledge and awareness of hepatitis C among residents of three union councils in Mansehra. J. Ayub Med. Coll. Abbottabad 20;22(3) 9. Farooqi J. I., Farooqi R J, Khan N, Mussarat. Frequency of hepatitis B and C in selected groups of population in NWFP, Pakian. JPMI 200; 2(03): Anjum Q, Siddiqui H, Ahmed Y, Rizvi SR, Usman Y. Knowledge of Students regarding Hepatitis and HIV/AIDS of a Private Medical University in Karachi. J Pak Med Assoc 2005; 55 (): Khan AJ, Luby SP, Fikree F, Karim A, Obaid S, Dellawala S, Mirza S, Malik T, Fisher-Hoch S, McCormick JB. Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakian. Bull World Health Organ.2000; 8(8): Cheung J, Lee TK, Teh CZ, Wang CY, Kwan WC, Yoshida EM. Cross-sectional udy of hepatitis B awareness among Chinese and Southea Asian Canadians in the Vancouver- Richmond community Can J Garoenterol.2005 A; 9(4): Van der Veen YJ, Voeten HA, dezwart O, Richardus J.H. Awareness, knowledge and self-reported te rates regarding Hepatitis B in Turkish-Dutch: a survey. BMC Public Health 20, :52 4. Al-Jabri AA, Al-Adawi S, Al-Abri J.H., Al-Dhahry SH. 99

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