Seroprevalence and factors associated with hepatitis B infection among the hill tribe adult population in Thailand: a cross-sectional study

Molecular and serological investigation of hepatitis B virus in patients with acute undifferentiated febrile illness at Tha Song Yang hospital, Tak Province, Thailand

BACKGROUND

Hepatitis B virus (HBV) infection is associated with hepatitis, often progressing to liver cirrhosis or cancer, posing a significant public health challenge, particularly in Thailand. Previous research revealed that viral causes account for 18.5% of acute undifferentiated febrile illness (AUFI) in Asian countries. This study examined the prevalence of HBV and its seroprevalence among patients with AUFI at Tha Song Yang Hospital (Tak Province, Thailand).

METHODS

A cross-sectional study was conducted using residual serum samples collected between 2016 and 2017 from patients exhibiting symptoms of AUFI at Tha Song Yang Hospital. DNA was extracted and identified for HBV using real-time polymerase chain reaction (PCR). Positive samples were further characterized for the HBV genotype using semi-nested PCR targeting the pre-S gene. The serum samples were subjected to enzyme-linked immunosorbent assay to detect antibodies against hepatitis B core antigen (HBcAg) and hepatitis B surface antigen (HBsAg).

RESULTS

Among AUFI patients, the prevalence of HBV infection was 6.45% (18 of 279). Genotyping revealed the presence of genotype C with subgenotype C1 (88.89%) and genotype B with subgenotype B3 (11.11%). The seroprevalence of HBcAb and HBsAb was observed in 40.58% (112 of 276) and 48.98% (120 of 245) of the cases, respectively.

CONCLUSIONS

The detection of HBV infection among AUFI patients (6.45%) underscores the spread of HBV within neighboring countries, such as Thailand and Myanmar. Pending confirmation of test results, physicians should maintain vigilance regarding potential HBV infection in AUFI cases. The overall seroprevalence showed 40.58% positivity for HBcAb and 48.98% for HBsAb. Therefore, individuals residing near the Thai border who did not receive the HBV vaccine at birth were recommended to complete a catch-up vaccination series of three doses to mitigate the HBV infection rate and enhance HBV antibody levels.

Hepatitis B prevalence and associated factors in adults presenting for infection screening in northern Thailand

Background and aims

Hepatitis B is a leading cause of morbidity and mortality worldwide. In view of the World Health Organization 2030 targets, effective screening of chronic infection is crucial. We have assessed the prevalence and risk factors of hepatitis B surface antigen in adults presenting for screening.

Methods

Free-of-charge and anonymous services for simultaneous hepatitis B, hepatitis C, human immunodeficiency virus and syphilis screening and counseling were provided in four facilities in northern Thailand. Analyses were performed separately in clients born before integration into the 1992 hepatitis B vaccine Thailand's Expanded Program on Immunization and in clients born afterwards.

Results

Between October 2015 and August 2020, hepatitis B surface antigen prevalence was 7.2 % (185/2578) in clients born before 1992 (95 % confidence interval [CI] = 6.2%-8.2 %). In the multivariable analysis, characteristics independently associated with a higher risk of infection were being born male (adjusted odds ratio [aOR] = 1.49, 95 % CI = 1.10-2.01) and being part of a hill tribe (aOR = 1.65, 95 % CI = 1.01-2.70). Forty-two percent were unaware of their infection. In clients born in 1992 or afterwards, prevalence was 1.5 % (43/2933) (95 % CI = 1.1%-2.0 %) and characteristics independently associated with a higher risk were being born between 1992 and 1995 (aOR = 1.90, 95 % CI = 1.00-3.61), being born male (aOR = 2.60, 95 % CI = 1.34-5.07), being part of a hill tribe (aOR = 5.09, 95 % CI = 2.52-10.26) and having ever injected drugs (aOR = 4.33, 95 % CI = 1.23-15.24).

Conclusions

Risk factor-based screening would miss many chronic hepatitis cases. Screening all adults once in their lifetime may be beneficial until the second generation of immunized infants have reached adult age.

Epidemiology of and Factors Associated with Prehypertension Among Hill Tribe Adults Aged 30-59 Years in Thailand: A Cross-Sectional Study

The study aimed to estimate the prevalence of and to determine the factors associated with prehypertension among the hill tribe aged 30-59 years. A cross-sectional study was conducted to collect data using a validated questionnaire and 5 mL blood specimens among six main hill tribe people living in 30 villages. Logistic regression was used to assess the associations between variables at a significance level of α = 0.05. A total of 1,076 individuals were recruited into the study: 67.3% were females, and 22.6% were aged 30-39 years. The overall prevalence was 67.8%. Six variables were found to be associated with prehypertension: being female; had family members ≤ 4 people; being members of Lahu, Hmong, Yao, Karen, and Lisu; had family debt; had overweight; and had a high total cholesterol. The implementation focused on encouraging active physical activity to reduce prehypertension is serious concerned and introduced.

Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma

Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma (HCC). Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC, the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region. This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination, screening, and treatment in low-resource regions. Demographics including male gender, older age, ethnicity, and geographic location as well as low socioeconomic status are more heavily impacted by chronic hepatitis B and related HCC. Methods to mitigate this impact include increasing screening in high-risk groups according to national guidelines, increasing awareness and health literacy in vulnerable populations, and developing more robust vaccination programs in under-served regions.

Knowledge, attitude, and behaviors toward liver health and viral hepatitis-related liver diseases in Thailand

This study aimed to quantify and evaluate the knowledge and awareness toward liver health and diseases as well as explore the attitudes and knowledge toward screening, diagnosis, and treatment of liver disease among the Thai population.This is a cross-sectional, self-reported and web-based questionnaire study. Awareness, perceptions and attitudes toward liver-related health and diseases as well as screening, diagnosis and treatment of liver diseases were assessed among 500 Thai adults.Respondents were mostly ≥35 years (62.0%) and females (52.0%). While there was an overall awareness regarding viral hepatitis as the main etiology of liver failure/cancer, respondents expressed misperceptions that hint at social stigmatization or discrimination toward infected individuals. A significant proportion lacked knowledge of liver screening tests and relevant diagnostic tests for viral hepatitis-related liver diseases. Screening or treatment costs and perception of being healthy were among reasons for not seeking medical consultation when exposed to risk factors or diagnosed. Treatment practices of hepatitis included prescription medication (59.1%), functional foods (51.8%) and traditional treatment (28.2%). Multivariate analysis identified income, recent health screening status and being diagnosed with liver disease(s) as significant predictors of the knowledge, attitude, and behaviors of the Thai population toward liver diseases.This study highlighted a degree of misperception and lack of in-depth understanding toward hepatitis-related liver diseases including poor attitudes and knowledge toward screening, diagnosis, and treatment of liver diseases. Factors identified suggest an unmet need to encourage proactive health-seeking behaviors to reduce transmission risks of hepatitis-related liver diseases within the community.