The research work was carried out at General Hospital
Ezzamgbo in Ohaukwu L.G.A, Ebonyi State, Nigeria. The subjects included
448 patients who visited the hospital with various cases and were recommended
for laboratory test. A total of 448 serum samples were screened for the
presence of hepatitis B surface antigen (HBsAg). The age of the patients studied
varied from 1 to 71 years and above of both male and female. Their occupations
were civil servants, traders, motorists, students, and farmers.
About 5 mls of venous blood samples were aseptically
collected using disposable sterile syringes with needle through venipuncture
from the patients enlisted for the study, put into ethyl diaminetetracetic
acids (EDTA) bottles, allowed to stand for one hour (1hr) to clot at room
temperature and then centrifuged using a centrifuge.
The patients were interviewed to
obtain information on their socio-demographic data such as age, sex,
occupation, history of blood/blood product transfusion, scarification, marital
status, educational qualification, patients living accommodation, previous history
of surgery, injection by unqualified medical personnel etc.
The study employed parallel testing
method. The method involved the use of two rapid Enzyme Linked Immuno-Sorbent
Assay (ELISA) test kits simultaneously. The two rapid testing kits used in this
study were the Hepatitis B surface antigen ELISA kits produced by Acon Biotech Diagnostic
Systems, USA (Acon Hepatitis B ultra fast diagnostic kits) and Antek Diagnostic
Incorporated, United Kingdom. The entire test was performed according to the
manufacturer’s instruction to determine seropositivity.
The results were read thus: if distinct
red lines appeared in the control region (C) and test region (T) of the test
kits after 15 minutes, the samples was positive. Conversely, if only one red
line appeared in the control region (C), the sample was negative.
The
results were interpreted as positive if both test kits were positive and
negative if both test kits were negative. Thus:
Positive
on both kits ……………positive result
Negative
on both kits…………….negative result
If
one of the test kits was positive or negative, a third test kit (tie breaker)
was used to determine if the result was positive or negative. The third kit
used as tie breaker was HBsAg fast diagnostic kit produced by Welcome
Laboratory, UK.
The results were analyzed using Chi-square and ANOVA tests to explore
proportional relationship at 95% Confidence interval.
3. RESULTS
The age-related distribution of Hepatitis B surface
antigen showed the highest prevalence in the age groups 21-30 (12.2%) and 11-20
(11.3%) and the least prevalence in the age group ≥ 71 (3.2%) (Fig 1). The
relative prevalences in respect of other age categories are 31-40 (9.5%), 41-50
(7.1%), 51-60 (6.3%) and 61-70 (5.7%), (P<0.05). The sex-related
distribution showed higher prevalence in females (10.0%) than in males (7.4%)
(Fig 2). Fig 3 shows the distribution of HBsAg by occupation. Motorists
(11.1%), Traders (9.0%), and Students (8.5%) had higher prevalences than Civil
servants (6.2%) and Farmers (5.3%). The distribution of HBsAg according to
reported risk factors showed the highest prevalence in patients with previous
transfusion with blood/blood products (18.2%) and the least in persons with
tribal marks/circumcision (4.4%) (Fig 4). Persons with the lower socio-economic
class had higher distribution of HBsAg (11.9%) than those in upper
socio-economic class (3.1%) and middle socio-economic class (3.7%) (Fig 5),
(P<0.05). The distribution of HBsAg according to marital status showed the highest prevalence in
married patients (9.0%) than in singles (6.4%), (Fig 6). Fig 7 shows the distribution of HBsAg by level of education.
Patients with primary education (12.1%) and patients with secondary education
(9.3%) had higher prevalences than those with tertiary (4.4%) and no
educational qualification (5.9%), (P<0.05).