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Akin Belli A, Omarufilo F, Birnbaum J, Emeasoba EU, Sigal SH. The challenges of integrating an immigrant population with chronic hepatitis B into long-term hepatology care: Lessons learned from a Bronx West African screening program. IJID REGIONS 2024; 12:100385. [PMID: 39070138 PMCID: PMC11278613 DOI: 10.1016/j.ijregi.2024.100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/30/2024]
Abstract
Objectives Hepatitis B virus (HBV) is endemic in West Africa. Because of immigration to the United States, screening and transition to long-term care is a significant public health concern. We describe the challenges of integrating individuals identified in a screening program into long-term care and the spectrum of disease severity. Methods Between 2019 and 2023, 749 individuals were screened. Beginning 2022, all were offered a free serologic evaluation. Details of the previous diagnosis, HBV care, the serologic evaluation, aspartate aminotransferase to platelet ratio index, and Fibrosis index-4 scores were recorded. The results of transient elastography (TE) were correlated with the serologic evaluation. Results A total of 75 (10%) individuals were hepatitis B surface antigen-positive, including 58 (77.3%) previously and 17 (22.7%) newly diagnosed. Despite attempts at linkage to care, only 14 (37.8%) of those diagnosed before the offer continued and/or entered long-term care. A total of 63 of 75 (84%) returned for the evaluation. Among 56 HBV treatment-naïve individuals, 66.1% had a serologic profile consistent with the carrier state. A total of 10 (18.2%) individuals met the criteria for HBV therapy, and 10 (21.7%) had ≥F2 fibrosis on TE. There was no correlation between aspartate aminotransferase to platelet ratio index and Fibrosis index-4 scores and TE. Eight (29.6%) of 27 patients with a profile of the HBV carrier state had ≥F2 fibrosis. Conclusion Integration of individuals with HBV from West Africa identified in a screening program into long-term care is challenging. Inclusion of a serologic evaluation in programs for immigrant communities should be considered. Up to 30% of individuals with a serologic profile consistent with the HBV carrier state may have ≥F2 fibrosis.
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Affiliation(s)
- Asli Akin Belli
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Fatima Omarufilo
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Jessie Birnbaum
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Emmanuel U. Emeasoba
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Samuel H. Sigal
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
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Larebo YM, Anshebo AA, Abdo RA, Behera SK, Gopalan N. Prevalence of hepatitis B virus infection among pregnant women in Africa: A systematic review and meta-analysis. PLoS One 2024; 19:e0305838. [PMID: 39012904 PMCID: PMC11251621 DOI: 10.1371/journal.pone.0305838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/05/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION Africa exhibits a considerably high prevalence of the hepatitis B virus among pregnant women. Furthermore, there is a discernible lack of a well-established surveillance system to adequately monitor and comprehend the epidemiology of the hepatitis B virus, particularly among pregnant women. The eradication efforts of the virus in Africa have been impeded by the significant disease burden in the region, and there is a lack of evidence regarding the pooled prevalence of the hepatitis B virus in Africa. Consequently, this systematic review and meta-analysis aims to determine the prevalence of hepatitis B virus infection among pregnant women in Africa. METHODS We conducted a systematic literature search using reputable databases such as PubMed, Advanced Google Scholar, Scopus, and the Cochrane Library. The search spanned from July 2013 to July 2023 and included all relevant articles published within this period. To identify potentially eligible articles, we conducted a comprehensive manual review of the reference lists of the identified studies. Our review encompassed articles from the African Journal Online. The analysis focused on observational studies published in peer-reviewed journals that reported the prevalence of hepatitis B surface antigen-positive testing among pregnant women. We utilized the Newcastle-Ottawa critical appraisal checklist to assess the methodological quality of each paper. Finally, a meta-analysis was conducted using a random-effects model. RESULTS Out of the 774 studies identified, 31 studies involving 33,967 pregnant women were selected for the meta-analysis. According to the random-effects model, the combined prevalence of hepatitis B virus among pregnant women was 6.77% [95% CI: 5.72, 7.83]. The I2 statistic was calculated to be 95.57% (p = 0.00), indicating significant heterogeneity among the studies. The high I2 value of 95.57% suggests a substantial degree of heterogeneity. A subgroup meta-analysis revealed that factors such as time-dependent bias, sample size dependence, or individual variation among study participants contributed to this heterogeneity (p-difference < 0.05). CONCLUSION According to the findings of this study, the pooled prevalence of hepatitis B infection among pregnant women in Africa was found to be intermediate-high. It is recommended that policymakers implement hepatitis B virus immunization programs targeting pregnant women and their new-born babies at higher risk of exposure.
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Affiliation(s)
- Yilma Markos Larebo
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
- Department of Epidemiology, School of Public Health, Wachemo University, Hossana, Ethiopia
| | - Abebe Alemu Anshebo
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
- Department of Midwifery, School of Nursing, Wachemo University, Hossana, Ethiopia
| | - Ritbano Ahmed Abdo
- Department of Midwifery, School of Nursing, Wachemo University, Hossana, Ethiopia
| | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
| | - Natarajan Gopalan
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
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Quintas AE, Cuboia N, Cordeiro L, Sarmento A, Azevedo L. Seroprevalence of human immunodeficiency virus in African blood donors: a systematic review and meta-analysis. EBioMedicine 2024; 105:105210. [PMID: 38941957 PMCID: PMC11260585 DOI: 10.1016/j.ebiom.2024.105210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/07/2024] [Accepted: 06/04/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND In developing countries, the safety of blood transfusions remains an important public health concern as it is associated with a higher risk of transfusion-transmissible infections (TTIs). In this study, we aimed to estimate the seroprevalence of HIV among blood donors in Africa and assess the temporal trends and regional differences within the continent through a systematic review and meta-analysis. METHODS Seven electronic databases (PubMed, Web of Science, Cochrane, Scopus, HINARI, Global Index Medicus and Clinical. TRIAL gov) were searched for relevant studies for our research. We included all primary studies that estimated the seroprevalence of HIV among blood donors in Africa with an age population from 16 to 65 years old, without language restrictions, from inception up to March 1st 2024. The pooled seroprevalence was estimated through the DerSimonian-Laird random effects model. The temporal trends and regional differences were assessed through subgroup and meta-regression analysis. FINDINGS We obtained 122 studies that met our inclusion criteria, comprising 7,814,996 blood donors tested for HIV. Sixty-six percent of the studies were from Western and Eastern Africa. The pooled seroprevalence of HIV among blood donors in Africa was 2.66% (95% CI: 2.17-3.20%; I2 = 99.80%, p < 0.01). The highest prevalence was observed in the Central African region, 3.28% (95% CI: 2.57%-4.06%), followed by the Eastern 3.21% (95% CI: 2.12%-4.52%), and the Western 2.66% (95% CI: 1.93%-3.49%) regions. Lower prevalences were observed in the Northern region, 0.57% (95% CI: 0.0%-2.10%), followed by the Southern African region with 0.45% (95% CI: 0.16%-0.86%). We observed a temporal decreased trend of HIV prevalence. INTERPRETATION The prevalence of HIV infection among African blood donors remains high and is not homogeneous across the continent. Efficient measures to strengthen HIV testing and prevent HIV transmission through blood transfusion are needed in Africa. Systematic review protocol registration: PROSPERO CRD42023395616. FUNDING This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020).
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Affiliation(s)
- Angelina Edna Quintas
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal; CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE) Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Nelson Cuboia
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal; CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE) Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Lemuel Cordeiro
- Department of Education Office, Clínica Girassol, Luanda, Angola.
| | - António Sarmento
- CHUSJ, Infectious Diseases Service at the University Hospital Center of São João, Portugal.
| | - Luís Azevedo
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal; CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE) Faculty of Medicine, University of Porto, Porto, Portugal.
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Tochukwu EJ, Onyinye EN, Obinna OE. Assessing the awareness and acceptability of hepatitis B immunoglobulin among pregnant women in Enugu metropolis, Southeast, Nigeria: A cross-sectional study. SAGE Open Med 2024; 12:20503121241257083. [PMID: 38826829 PMCID: PMC11143833 DOI: 10.1177/20503121241257083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/07/2024] [Indexed: 06/04/2024] Open
Abstract
Objectives Assessed the level of awareness of hepatitis B virus infection and hepatitis B immunoglobulin, and determined the proportion of pregnant women that will accept hepatitis B immunoglobulin if needed for their babies and the factors that were associated with the choices made by pregnant women in the Enugu metropolis. Methods A cross-sectional study of 379 pregnant women in health facilities in the Enugu metropolis was undertaken between March and November 2019. A structured pre-tested interviewer-administered questionnaire was used for data collection. Data collected were analysed using SPSS version 23. Results The overall knowledge of the respondents on hepatitis B virus infection was poor as only 26.6% had good knowledge. Only 25.6% of the respondents had heard of hepatitis B immunoglobulin but the majority of the respondents (93.1%) were both willing to accept to give the vaccine to their babies and recommend the vaccine to their relatives. The educational level and occupation of the respondents were significantly associated with overall knowledge of hepatitis B. Only the religion of the respondents correctly predicted the overall knowledge of the respondents on hepatitis B. Conclusion Despite the poor knowledge of hepatitis B and hepatitis B immunoglobulin among the study participants, the acceptability of hepatitis B immunoglobulin was high.
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Affiliation(s)
- Enebe Joseph Tochukwu
- Department of Obstetrics and Gynaecology, Enugu State University of Science and Technology, College of Medicine/Teaching Hospital, Enugu, Nigeria
| | - Enebe Nympha Onyinye
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Onwujekwe Emmanuel Obinna
- Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Nigeria
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Orabueze IN, Ike AC, Aniche OM, Nwafia IN, Ebede SO. Hepatitis B virus infection among illegal drug users in Enugu State, Nigeria: prevalence, immune status, and related risk factors. BMC Public Health 2024; 24:1203. [PMID: 38724938 PMCID: PMC11080182 DOI: 10.1186/s12889-024-18675-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Hepatitis B virus infection poses a global health challenge, particularly in low- and middle-income African countries. Illicit drug use exacerbates the problem, with drug users having a higher HBV infection risk and maintaining a quiet transmission pool. This study aimed to determine HBV infection prevalence, immune status, and risk factors among illegal drug users in Enugu State, Nigeria. MATERIALS AND METHODS A cross-sectional study was conducted in Enugu State, using privileged access interviewer methods to enroll drug users. Pre-tested structured questionnaires were administered after informed consent was obtained. Blood samples were tested for HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb using immunochromatographic rapid test kits. Statistical analysis was performed using SPSS version 25. RESULTS One hundred drug users were recruited into the study. Overall, 7% of the drug users had HBV infection. 61% were found to be susceptible to HBV infection, 15% showed serological evidence of immunity from HBV vaccination and 1% developed natural immunity from HBV exposure. Significant risk factors for HBV infection were age less than 20 years, young age (≤ 20 years) at drug initiation, being single, injecting drugs more than or equal to 20 times per month and injecting with used syringes. CONCLUSION This study shows high intermediate endemicity of HBV infection among drug users, low vaccination uptake, and high susceptibility to HBV infection. This calls for the urgent inclusion of drug users in national HBV vaccination campaigns and the adoption of the World Health Organization's recommendations on the prevention of viral hepatitis among people who inject drugs.
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Affiliation(s)
- Ibuchukwu N Orabueze
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria
| | - Anthony C Ike
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Oluchi M Aniche
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
- Department of Community Medicine, Faculty of Basic Clinical Sciences, University of Nigeria Enugu Campus, Enugu, Enugu State, Nigeria
| | - Ifeyinwa N Nwafia
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria.
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria.
| | - Samuel O Ebede
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria
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Tolulope Nejo Y, Oluwasemowo OO, Ibidunni Ajao E, Odunayo Ajala M, Felicia Adedire O, Kingsley Adegbite I, Favour Esan B, Olajumoke Morakinyo O, Samuel Ibitoye A, Beauty Alade A. Serological profile of hepatitis B virus infection among traditional birth attendants and the attending pregnant women in Ibadan, Nigeria. J Immunoassay Immunochem 2024; 45:247-260. [PMID: 38755959 DOI: 10.1080/15321819.2024.2355549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Although a sizable number of pregnant women patronize Traditional Birth Attendants (TBAs) for deliveries in Nigeria, efforts to prevent or reduce the risk of HBV transmission are not targeted at the TBAs and the pregnant women patronizing them. This may be linked to the dearth of information on the serological profiles of HBV among this cohort. We, therefore, show the serological profiles of HBV among the cohort. One hundred and seventy pregnant women and 91 TBAs participated in this study between May and July 2019. Serological markers of HBV infection were assayed using ELISA. A prevalence of, 8.0% (95% CI: 5.0% - 11.5%) for HBsAg, 0.8% (95% CI: 0.0% - 1.9%) for HBeAg, 2.7% (95% CI: 0.8% - 5.0%) for HBcIgM, 26.1% (95% CI: 20.7% - 31.4%) for anti-HBs, 21.5% (95% CI: 16.5% - 25.4%) for anti-HBe and 67.0% (95% CI: 60.9% - 72.8%) for anti-HBc was found indicating a high percentage of carriers. Although 32 (12.3%) of the entire participants claimed to be fully vaccinated, serological evidence was only detected in 4 (12.5%). The high percentage of carriers and low evidence of vaccination necessitate intensified efforts to ensure that adequate interventions are made available and accessible to the TBAs and the pregnant women patronizing them (including newborn babies).
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Affiliation(s)
- Yewande Tolulope Nejo
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Esther Ibidunni Ajao
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
| | - Miracle Odunayo Ajala
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
| | | | - Ibrahim Kingsley Adegbite
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
| | - Boluwaji Favour Esan
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
| | | | - Ayodele Samuel Ibitoye
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
| | - Anuoluwapo Beauty Alade
- Microbiology Programme, College of Agriculture, Engineering and Science, Bowen University, Iwo, Nigeria
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Olaoye T, Osie-Efietie B, Ogunsanmi OO, Mustapha AM, Asekun-Olarinmoye I, Atulomah NO. Evaluation of a school-based health education program on hepatitis B virus infection prevention practice in rural South-Western, Nigeria. BMC Public Health 2024; 24:591. [PMID: 38395844 PMCID: PMC10893707 DOI: 10.1186/s12889-024-18092-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection prevention is most effective early in childhood with vaccination programme. However, where this is missed, primary prevention modes of intervention become an alternative recommendation to be considered before the occurrence of risk exposure to the virus. This study sought to evaluate outcomes of a theory-based HBV infection prevention educational intervention among students from four selected secondary schools in Ogun state, Nigeria. METHODOLOGY A quasi-experimental design enrolling 256 consenting secondary school students from four schools in Ogun state randomized into three intervention schools consisting teacher-instructed (E1), peer-directed (E2) and combination of the two (E3) respectively with a control group ( C) was implemented. The theory-based educational intervention was for six weeks with follow-up period of 8 weeks. A 66-item validated instrument was used to collect data at three reference points and response items for variables in the study were transformed into weighted-aggregate scores of mean and standard deviation of HBV infection prevention practice of participants. Statistical analysis of ANOVA, paired-sample t-test and Cohen's D Effect Size (ES) was used to quantify the changes produced by the intervention on the outcome variable at 5% level of significance. RESULTS At baseline, there was no significant difference (p > 0.05) in the mean HBV infection prevention practice scores between the four groups E1 (17.21 ± 3.03), E2 (15.57 ± 1.90), E3 (17.90 ± 3.10), and C (15.20 ± 2.44). However, at 14th week follow up, there was observed significant differences in mean scores of HBV infection prevention practices between all four groups E1 (23.09 ± 2.4), E2 (22.6 ± 3.6), E3 (23.82 ± 2.3), and C (15.25 ± 2.4). Paired-sample t-test conducted demonstrated significant differences between baseline and 14th week follow up for E1 (17.21 ± 3.07 and 23.18 ± 2.9; p = 0.001), E2(15.57 ± 1.90 and 23.53 ± 3.12; p = 0.001), E3(17.90 ± 3.10 and 25.1 ± 2.6; p < 0.001), but not for C (15.20 ± 2.44 and 15.25 ± 2.4; p = 0.92), with most significant impact (ES(95%CI) on HBV infection prevention practices observed for E2(3.106 95%CI: [2.66 to 3.55; p = 0.001]). Importantly, the participants in E2 showed more improvement in prevention practices than their counterparts from E1, E3, and control. Therefore, the intervention demonstrated proof-of-concept in facilitating behavior modification expected. Peer education can be utilized as a strategy to promote Hepatitis B infection prevention practices among adolescents.
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Affiliation(s)
- Titilayo Olaoye
- Department of Public Health, Babcock University, Ilishan Remo-Ogun State, Ilishan, Nigeria
| | | | - Ololade O Ogunsanmi
- Department of Public Health, Babcock University, Ilishan Remo-Ogun State, Ilishan, Nigeria
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Alege JB, Oyore JP, Nanyonga RC, Musoke P, Orago ASS. Barriers and facilitators of integrated hepatitis B, C, and HIV screening among pregnant mothers and their newborns attending maternal and newborn clinics in Koboko District, Uganda: A qualitative inquiry of providers' perspective. RESEARCH SQUARE 2023:rs.3.rs-3739602. [PMID: 38196577 PMCID: PMC10775386 DOI: 10.21203/rs.3.rs-3739602/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background HIV and HBV remain significant public health challenges characterized by high prevalence, morbidity, and mortality, especially among women of reproductive age in Uganda. However, both HIV and HBV patients are managed in separate clinics with separate staff even though they all receive ART. Patients with HBV do not receive routine counselling and education, and there are limited resources for laboratory investigation coupled with a high loss to follow-up. This study set out to "assess barriers and facilitators of integrated viral hepatitis B C and HIV care model to optimize screening uptake among mothers and newborns at health facilities in Koboko District, west Nile sub-region, Uganda". Methods A cross-sectional grounded theory qualitative approach was employed in an institutional setting (HC IIIs). Data was audio recorded using a recording device during the key informant interviews and was transcribed after all interviews were conducted. Data was then analyzed using framework analysis. Results The following facilitated integration: High prevalence, and therefore burden of hepatitis B infection in West Nile region, team spirit by the health workers, reduced long waiting time, availability of medical products such as HBV and HCV test kits, integration of HBV and HIV into HMIS2 form and availability of support from implementing partners such as Infectious Dease Institute which offered mentorship and training on integration and support supervision. Conclusion Barriers to integration included; knowledge gap among health care workers, lack of transport for patients, language barriers during health education, inadequate human resources for health, stock-out of testing kits for HBV and HCV, lack of HMIS 2 column to capture HCV data, lack of funds to facilitate follow up of patients after referral for further investigation upon suspected cases of HBV and HCV. The study participants recommended; Promoting the integration of HBV, HCV, and HIV into routine health services; ensuring a constant supply of HBV, and HCV test kits to avoid stock-out; Engaging VHTs/Community health volunteers to support follow-up of patients and conducting health care workers performance reviews; addressing the issue of inadequate human resource; and finally dealing with misconceptions at community level about HBV and HCV diseases which hinder access to services.
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Ade-Ojo IP, Babatola AO, Ojo TO, Ogundare EO, Agbesanwa T, Adeniyi AT, Alao O, Olatunya OS, Fadare JO. Knowledge and Willingness to Utilize Hepatitis B Preventive Measures among Pregnant Women in Ado-Ekiti, Southwest, Nigeria. Interdiscip Perspect Infect Dis 2023; 2023:9168038. [PMID: 38025795 PMCID: PMC10667044 DOI: 10.1155/2023/9168038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 10/16/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Mother-to-child transmission remains an important mode of transmission of hepatitis B infection particularly in endemic areas. The knowledge and practices of pregnant women about mother-to-child transmission (MTCT) of hepatitis B virus (HBV) may influence the uptake of strategies to reduce mother-to-child transmission of infection. Objectives This study assessed the knowledge and willingness to uptake hepatitis B virus infection preventive services among pregnant women in Ado-Ekiti, Nigeria. Methods This was a cross-sectional study that involved 373 pregnant women at the Ekiti State University Teaching Hospital (EKSUTH) and Maternal Child Specialist Clinics, Ado-Ekiti, Nigeria. A structured questionnaire was used to assess their knowledge, practices, and perceptions about MTCT of hepatitis B infection. Results Only 52.5% (196) of the respondents had good knowledge, although the majority 290 (77.7%) had heard of hepatitis B infection prior to the survey. Only 147 (39.4%) of the respondents had ever had hepatitis B screening. More persons with professional jobs had good knowledge about hepatitis B infection compared with other occupations (p < 0.001). However, more respondents aged 30-34 years had poor knowledge about hepatitis B infection compared with other age groups (p = 0.045). Respondents with good knowledge about hepatitis B infection were willing to uptake hepatitis B infection prevention services (p < 0.001). Conclusion This study showed that respondents with professional jobs had good knowledge about hepatitis B infection and those who had good knowledge about the infection were willing to utilize hepatitis B preventive measures. Awareness of MTCT of HBV did not translate into good practice as only few respondents had screened for hepatitis B. There is a need to intensify education about modes of transmission of hepatitis B infection with an emphasis on promoting good preventive practices.
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Affiliation(s)
- Idowu Pius Ade-Ojo
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
- Department of Obstetrics and Gynaecology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Adefunke Olarinre Babatola
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
- Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Temitope Olumuyiwa Ojo
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Ezra Olatunde Ogundare
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
- Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Tosin Agbesanwa
- Department of Family Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Adewuyi Temidayo Adeniyi
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
- Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Omolola Alao
- Department of Obstetrics and Gynaecology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Oladele Simeon Olatunya
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
- Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Joseph Olusesan Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
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Chikwendu A, Unikutelle HL, Olumide AT. Hepatitis B and C virus prevalence among patients and healthcare workers' prevention practices towards the viruses in a secondary healthcare facility in Northern Nigeria. Pan Afr Med J 2023; 46:82. [PMID: 38314232 PMCID: PMC10837276 DOI: 10.11604/pamj.2023.46.82.40530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/31/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction hepatitis B Virus (HBV) and hepatitis c virus (HCV) affect millions of people globally. Healthcare workers (HCWs) are at increased risk of infection due to occupation exposures where the viruses are spread mainly through needle stick injuries and exposure to infected blood and body fluid. The objective of this study was to assess the prevalence of viral hepatitis among patients and the practices of HCWs. Methods this study involved a 5-years retrospective review of laboratory results of patients for HBV and HCV in addition to a questionnaire-based assessment of the preventive practices of 103 HCWs on HBV and HCV. Data was analyzed using SPSS. Results the prevalence of HBV among the patients was 12.6% and 15.2% for HCV while the prevalence among the HCWs was 6.6% for HBV and 6.5% for HCV. About 60% of the HCWs had good overall preventive practices for viral hepatitis. Among the HCWs, 29.28% dropped needles in sharp containers after use, 53.5% recapped needles, 21.4% reused needles, 36.9% did not practice regular hand washing, and 53.4% completed the doses for HBV vaccine. Conclusion there is high prevalence of HBV and HCV among the patients and the HCWs. This increases the occupational risk of infection with the viruses among HCWs. We recommend that more enlightenments and trainings be done for the HCWs to enable them take appropriate measures to protect themselves. Also, HCWs should provide HBV and HCV screening to patients accessing care and those found positive should be linked to care and treatment.
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Affiliation(s)
- Amaike Chikwendu
- Department of Community Medicine, Babcock University, Ilishan-Remo, Ogun State, Nigeria
- Department of Community Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | | | - Afolaranmi Tolulope Olumide
- Department of Community Medicine, University of Jos and Jos University Teaching Hospital, Plateau State, Nigeria
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11
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Sobajo OA, Oguzie JU, Adegboyega B, Eromon P, Happi C, Komolafe I, Folarin O. Detection of Immune Escape and Basal Core Promoter/Precore Gene Mutations in Hepatitis B Virus Isolated from Asymptomatic Hospital Attendees in Two Southwestern States in Nigeria. Viruses 2023; 15:2188. [PMID: 38005866 PMCID: PMC10674980 DOI: 10.3390/v15112188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/22/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Several mutations in the surface (S), basal core promoter (BCP), and precore (PC) genes of the hepatitis B virus have been linked to inaccurate diagnosis and the development of immune escape mutants (IEMs) of the infection, which can lead to chronic infection. Understanding the prevalence and spread of these mutations is critical in the global effort to eliminate HBV. Blood samples were collected from 410 people in Osun and Ekiti states, southwest Nigeria, between 2019 and 2021. Participants were drawn from a group of asymptomatic people who were either blood donors, outpatients, or antenatal patients with no record of HBV infection at the medical outpatients' unit of the hospital. DNA was extracted from plasma using a Qiagen DNEasy kit, followed by nested PCR targeting HBV S and BCP/PC genes. The Sanger sequencing method was used to sequence the positive PCR amplicons, which were further analyzed for IEMs, BCP, and PC mutations. HBV-DNA was detected in 12.4% (51/410) of individuals. After DNA amplification and purification, 47.1% (24) of the S gene and 76.5% (39) of the BCP/PC gene amplicons were successfully sequenced. Phylogenetic analysis showed that all the HBV sequences obtained in this study were classified as HBV genotype E. Mutational analysis of the major hydrophilic region (MHR) and a-determinant domain of S gene sequences revealed the presence of three immune escape mutations: two samples harbored a T116N substitution, six samples had heterogenous D144A/N/S/H substitution, and one sample had a G145E substitution, respectively. The BCP/PC region analysis revealed a preponderance of major BCP mutants, with the prevalence of BCP double substitutions ranging from 38.5% (A1762T) to 43.6% (G1764A). Previously reported classical PC mutant variants were observed in high proportion, including G1896A (33.3%) and G1899A (12.8%) mutations. This study confirms the strong presence of HBV genotype E in Nigeria, the ongoing circulation of HBV IEMs, and a high prevalence of BCP/PC mutants in the cohorts. This has implications for diagnosis and vaccine efficacy for efficient management and control of HBV in the country.
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Affiliation(s)
- Oguntope Adeorike Sobajo
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede 232102, Osun State, Nigeria or (O.A.S.); (J.U.O.); (C.H.); (I.K.)
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede 232102, Osun State, Nigeria; (B.A.); (P.E.)
- Department of Biological Science, College of Sciences, Afe Babalola University, Ado-Ekiti 360101, Ekiti State, Nigeria
| | - Judith Uche Oguzie
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede 232102, Osun State, Nigeria or (O.A.S.); (J.U.O.); (C.H.); (I.K.)
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede 232102, Osun State, Nigeria; (B.A.); (P.E.)
| | - Benjamin Adegboyega
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede 232102, Osun State, Nigeria; (B.A.); (P.E.)
| | - Philomena Eromon
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede 232102, Osun State, Nigeria; (B.A.); (P.E.)
| | - Christian Happi
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede 232102, Osun State, Nigeria or (O.A.S.); (J.U.O.); (C.H.); (I.K.)
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede 232102, Osun State, Nigeria; (B.A.); (P.E.)
| | - Isaac Komolafe
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede 232102, Osun State, Nigeria or (O.A.S.); (J.U.O.); (C.H.); (I.K.)
| | - Onikepe Folarin
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede 232102, Osun State, Nigeria or (O.A.S.); (J.U.O.); (C.H.); (I.K.)
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University, Ede 232102, Osun State, Nigeria; (B.A.); (P.E.)
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12
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Ayamolowo LB, Olorunfemi O, Irinoye OO, Afolabi AO. Perceived risk factors and preventive practices of Hepatitis B viral infection among pregnant women in Nigerian hospitals: A cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 37:100896. [PMID: 37549467 DOI: 10.1016/j.srhc.2023.100896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/10/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE The study assessed the perceived risk factors and prevention practices of HBV infection among pregnant women in Nigerian hospitals. STUDY DESIGN A descriptive cross-sectional study was conducted among 343 pregnant women attending antenatal clinics at two purposefully selected primary health care centers in Ile-Ife. Women were included in the study using systematic sampling. A structured researcher-administered questionnaire was used for data collection. Descriptive and inferential (Chi-square test and Logistic regression) statistical analysis were carried out. RESULTS More than half (53%) of the respondents had a low perceived risk for hepatitis. Majority (73.5%) had been screened for HBV during the index pregnancy but only 30% received complete doses of HBV vaccine. Respondents who underwent HBV screening during pregnancy (OR = 2.06, 95% CI = 0.94 - 4.5), who had completed Hepatitis B vaccination had reduced odds ratios for perceiving risk factors for Hepatitis B Viral Infection (OR = 0.224, 95% CI = 0.94 - 4.5). CONCLUSION Pregnant women had a low-risk perception of HBV infection. The low level of risk perception can serve as a basis for developing preventive interventions aimed at educating and empowering expectant mothers in order to prevent HBV infection and its transmission to their children.
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Affiliation(s)
- Love B Ayamolowo
- Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Olawumi Olorunfemi
- Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Omolola O Irinoye
- Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria
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13
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Ajuwon BI, Richardson A, Roper K, Lidbury BA. Clinical Validity of a Machine Learning Decision Support System for Early Detection of Hepatitis B Virus: A Binational External Validation Study. Viruses 2023; 15:1735. [PMID: 37632077 PMCID: PMC10458613 DOI: 10.3390/v15081735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
HepB LiveTest is a machine learning decision support system developed for the early detection of hepatitis B virus (HBV). However, there is a lack of evidence on its generalisability. In this study, we aimed to externally assess the clinical validity and portability of HepB LiveTest in predicting HBV infection among independent patient cohorts from Nigeria and Australia. The performance of HepB LiveTest was evaluated by constructing receiver operating characteristic curves and estimating the area under the curve. Delong's method was used to estimate the 95% confidence interval (CI) of the area under the receiver-operating characteristic curve (AUROC). Compared to the Australian cohort, patients in the derivation cohort of HepB LiveTest and the hospital-based Nigerian cohort were younger (mean age, 45.5 years vs. 38.8 years vs. 40.8 years, respectively; p < 0.001) and had a higher incidence of HBV infection (1.9% vs. 69.4% vs. 57.3%). In the hospital-based Nigerian cohort, HepB LiveTest performed optimally with an AUROC of 0.94 (95% CI, 0.91-0.97). The model provided tailored predictions that ensured most cases of HBV infection did not go undetected. However, its discriminatory measure dropped to 0.60 (95% CI, 0.56-0.64) in the Australian cohort. These findings indicate that HepB LiveTest exhibits adequate cross-site transportability and clinical validity in the hospital-based Nigerian patient cohort but shows limited performance in the Australian cohort. Whilst HepB LiveTest holds promise for reducing HBV prevalence in underserved populations, caution is warranted when implementing the model in older populations, particularly in regions with low incidence of HBV infection.
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Affiliation(s)
- Busayo I. Ajuwon
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Acton, Canberra, ACT 2601, Australia; (K.R.); (B.A.L.)
- Department of Biosciences and Biotechnology, Faculty of Pure and Applied Sciences, Kwara State University, Malete 241103, Nigeria
| | - Alice Richardson
- Statistical Support Network, The Australian National University, Acton, Canberra, ACT 2601, Australia;
| | - Katrina Roper
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Acton, Canberra, ACT 2601, Australia; (K.R.); (B.A.L.)
| | - Brett A. Lidbury
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Acton, Canberra, ACT 2601, Australia; (K.R.); (B.A.L.)
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14
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Freeland C, Kanu F, Mohammed Y, Nwokoro UU, Sandhu H, Ikwe H, Uba B, Asekun A, Akataobi C, Adewole A, Fadahunsi R, Wisdom M, Akudo OL, Ugbenyo G, Simple E, Waziri N, Vasumu JJ, Bahuli AU, Bashir SS, Isa A, Ugwu GO, Obi EI, Binta H, Bassey BO, Shuaib F, Bolu O, Tohme RA. Barriers and facilitators to hepatitis B birth dose vaccination: Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001332. [PMID: 37289735 DOI: 10.1371/journal.pgph.0001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/04/2023] [Indexed: 06/10/2023]
Abstract
Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowledge, limited availability of HepB-BD to vaccination days only, misconceptions about HepB-BD vaccination, challenges in health facility staffing capacity, costs associated with vaccine transportation, and concerns related to vaccine wastage. Facilitators of timely HepB-BD vaccination included: vaccine availability, storage, and hospital births occurring during immunization days. Overarching themes identified as barriers among pregnant women were lack of hepatitis B knowledge, limited understanding of HepB-BD importance, and limited access to vaccines for births occurring outside of a health facility. Facilitators were high vaccine acceptance and willingness for their infants to receive HepB-BD if recommended by providers. Findings indicate the need for enhanced HepB-BD vaccination training for HCWs, educating pregnant women on HBV and the importance of timely HepB-BD, updating policies to enable HepB-BD administration within 24 hours of birth, expanding HepB-BD availability in public and private hospital maternity wards for all facility births, and outreach activities to reach home births.
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Affiliation(s)
- Catherine Freeland
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Florence Kanu
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Yahaya Mohammed
- Department of Medical Microbiology and Parasitology, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- African Field Epidemiology Network, Abuja, Nigeria
| | - Ugochukwu Uzoechina Nwokoro
- African Field Epidemiology Network, Abuja, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Hardeep Sandhu
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hadley Ikwe
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Centers for Disease Control and Prevention Nigeria, Abuja, Nigeria
| | - Belinda Uba
- African Field Epidemiology Network, Abuja, Nigeria
- National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria
| | - Adeyelu Asekun
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Centers for Disease Control and Prevention Nigeria, Abuja, Nigeria
| | - Charles Akataobi
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Adefisoye Adewole
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Rhoda Fadahunsi
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Margeret Wisdom
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Okeke Lilian Akudo
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Gideon Ugbenyo
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Edwin Simple
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Ndadilnasiya Waziri
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - James Jacob Vasumu
- Adamawa State Primary Health Care Development Agency, Yola, Adamawa State, Nigeria
| | - Abubakar Umar Bahuli
- Adamawa State Primary Health Care Development Agency, Yola, Adamawa State, Nigeria
| | | | - Abdullahi Isa
- Adamawa State Primary Health Care Development Agency, Yola, Adamawa State, Nigeria
| | - George Onyemachi Ugwu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nsukka, Nsukka, Nigeria
- Enugu State Primary Health Care Development Agency, Enugu, Nigeria
| | | | - Haj Binta
- National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria
- Department of Community Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria/ University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Omotayo Bolu
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Centers for Disease Control and Prevention Nigeria, Abuja, Nigeria
| | - Rania A Tohme
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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15
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Davwar PM, Okeke E, Duguru M, Nyam D, Bell K, Odeghe EA, Oyeleke G, Lesi OA, Singh R, Kim KY, Imade G, Akanmu AS, Sagay AS, Ogunsola FT, Peters MG, Roberts LR, Hou L, Murphy RL, Hawkins CA. Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV. PLoS One 2023; 18:e0282539. [PMID: 36877687 PMCID: PMC9987777 DOI: 10.1371/journal.pone.0282539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/17/2023] [Indexed: 03/07/2023] Open
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) is an increasing cause of mortality in Nigeria among persons with HIV (PLH), as access to antiretroviral therapy (ART) improves. In this study we describe clinical, radiological, and laboratory characteristics in Nigerian adults with HCC, with and without HIV, and examine how HIV impacts survival. METHODS This prospective observational study was conducted between August 2018 and November 2021 at two Nigerian hospitals [Jos University Teaching Hospital (JUTH) and Lagos University Teaching Hospital (LUTH)]. Subjects ≥18 years with HCC diagnosed according to American Association for the Study of Liver Diseases (AASLD) criteria were included. Baseline characteristics were compared, and Kaplan-Meier curves were generated to estimate survival. RESULTS 213 subjects [177 (83%) without HIV and 36 (17%) with HIV (PLH)] were enrolled. Median age was 52 years (IQR 42,60) and most subjects were male (71%). 83% PLH were on antiretroviral therapy (ART). Hepatitis B surface antigen (HBsAg) positivity was similar between the two groups [91/177 (51%) without HIV vs. 18/36 (50%) with HIV; p = 0.86]. 46/213 (22%) subjects had active hepatitis C (anti-HCV+/HCV RNA>10 IU/mL). Cirrhosis was more common in PLH but there were no other significant differences in clinical and tumor characteristics between the groups. Overall, 99% subjects were symptomatic and 78% in late-stage HCC. Median overall survival was significantly shorter in PLH vs. without HIV (0.98 months vs 3.02 months, HR = 1.55, 95%CI 1.02, 2.37, p = 0.04). This association was not significant after adjusting for known risk factors including gender, current alcohol use, alpha-fetoprotein (AFP), albumin, and total bilirubin (HR = 1.38, 95%CI 0.84, 2.29, p = 0.21). CONCLUSION HCC presented late with an extremely poor overall prognosis, highlighting the urgent need for more intensive surveillance in Nigeria to diagnose HCC at earlier stages. Early diagnosis and management of viral hepatitis, and access to HCC therapies, could prevent early mortality among persons with HCC, especially among PLH.
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Affiliation(s)
| | | | | | | | - Kristen Bell
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
| | | | | | | | - Revika Singh
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
| | - Kwang-Youn Kim
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
| | | | | | | | | | - Marion G. Peters
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
| | - Lewis R. Roberts
- Mayo Clinic College of Medicine and Science, Rochester, Minnesota, United States of America
| | - Lifang Hou
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
| | - Robert L. Murphy
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
| | - Claudia A. Hawkins
- Feinberg School of Medicine - Northwestern University, Chicago, Illinois, United States of America
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16
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Osasona OG, Oguntoye T, Eromon P, Abdulkareem L, Arowosaye AO, Ariyo OE, George UE, Yusuf M, Adewumi OM, Happi C, Folarin OA. Atypical serologic profiles of hepatitis B virus infection across clinical cohorts of patients in Southwestern Nigeria. J Immunoassay Immunochem 2023; 44:176-191. [PMID: 36681932 DOI: 10.1080/15321819.2023.2168556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Hepatitis B virus (HBV) infection follows a natural course of events predicted by a dynamic interaction between viral antigen and the host immune system, which forms the basis for HBV serological diagnosis. These interactions may deviate from the typical serologic patterns. This study investigates the types of atypical HBV serologic profiles (AHBSP) across clinical cohorts of patients with HBV infection in southwestern Nigeria. This is a cross-sectional, hospital-based, multi-centered study. Patients' sera were analyzed for HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc IgM, and anti-HBc IgG by ELISA from 279 study participants attending selected gastroenterology clinics between August 2019 and December 2020. The prevalence of atypical HBV serologic profiles was 27% (n = 76). The mean age of patients was 35.7 ± 11.2 years. The gender distribution involved 183 females (65.6%) and 96 males (34.4%). Across clinical cohorts of patients with atypical serologic profiles, HBeAg Negative, anti-HBe positive with detectable HBV DNA had the highest prevalence of 21% followed by isolated anti-HBc antibody positive, HBsAg negative and detectable HBV DNA, 5%. The atypical serologic profiles, HBeAg positive, HBsAg negative with detectable HBV DNA and concurrent anti-HBs with HBsAg, had the lowest prevalence, 0.4%, respectively. This study identified the considerable presence of atypical HBV serologic profiles across clinical cohorts of HBV infection in southwestern Nigeria.
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Affiliation(s)
| | - Tosin Oguntoye
- Department of Medicine, Federal Teaching Hospital Ido- Ekiti, Federal Teaching Hospital Ido-Ekiti, Ido Ekiti, Nigeria
| | - Philomena Eromon
- African Center of Excellence for Genomics of Infectious diseases Redeemer's University, Redeemer's University Ede, Ede, Nigeria
| | - Lukman Abdulkareem
- Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Nigeria
| | | | - Olumuyiwa Elijah Ariyo
- Department of Medicine, Federal Teaching Hospital Ido- Ekiti, Federal Teaching Hospital Ido-Ekiti, Ido Ekiti, Nigeria
| | - Uwem Etop George
- Department of Biological Sciences, Redeemer's University, Osun, Nigeria
| | - Musa Yusuf
- Department of Medicine, Federal Teaching Hospital Ido- Ekiti, Federal Teaching Hospital Ido-Ekiti, Ido Ekiti, Nigeria
| | | | - Christian Happi
- African Centre of Excellence for Genomics of Infectious Diseases, Department of Biological Sciences, Redeemers University, Ede, Nigeria
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17
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Sobajo OA, George UE, Osasona OG, Eromon P, Aborisade OY, Ajayi OD, Folarin OA, Komolafe IOO. Seroprevalence, co-infection and risk of transmission of Hepatitis B and D virus among hospital attendees in two South-western states in Nigeria. J Immunoassay Immunochem 2023; 44:133-146. [PMID: 36369932 DOI: 10.1080/15321819.2022.2141578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Infection with both Hepatitis B (HBV) and D (HDV) virus causes more severe liver damage than HBV alone. Superinfections among chronic HBV infected cohorts often lead to HDV persistence with rapid progression to cirrhosis, necessitating continuous surveillance to determine their prevalence and relative contribution to liver pathology. A cross-sectional study among hospital outpatients in Ekiti and Osunstates was conducted using random sampling technique. Blood samples were collected from 410 participants and tested for HBV serological markers. All samples positive for HBsAg samples were tested for Hepatitis D virus antigen (HDAg), serum anti-HDV IgM, and serum anti-HDV IgG using enzyme-linked immunosorbent assay kits. The prevalence of HBV infection among the 410 samples was 12.4% (CI 9.5-15.9). Past HBV exposure was detected in 120 (29.2%), while 147(35.8%) were susceptible to HBV infection. Among the HBsAg positive individuals, 9.8% were hepatitis D antigen (HDAg) positive, while 3.9% and 1.9% were positive for IgG anti-HDV and IgM anti-HDV, respectively. Risk factors associated with HBV infections in this study were multiple sexual partners and sharing of sharp objects. Our investigation has verified the endemicity of HBV in Nigeria and revealed that HBV- HDV co-infection is highly prevalent in south-west Nigeria.
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Affiliation(s)
- Oguntope A Sobajo
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Nigeria.,African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria.,Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Uwem E George
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Nigeria.,African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria
| | - Oluwadamilola G Osasona
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Nigeria.,African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria
| | - Philomena Eromon
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria
| | - Olamide Y Aborisade
- Haematology and Blood Transfusion Service Department, UNIOSUN Teaching Hospital, Osogbo, Nigeria
| | - Oluwafemi D Ajayi
- Department of Medical Laboratory Science, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Onikepe A Folarin
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Nigeria.,African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria
| | - Isaac O O Komolafe
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, Ede, Nigeria
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18
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The development of a machine learning algorithm for early detection of viral hepatitis B infection in Nigerian patients. Sci Rep 2023; 13:3244. [PMID: 36829040 PMCID: PMC9958122 DOI: 10.1038/s41598-023-30440-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 02/23/2023] [Indexed: 02/26/2023] Open
Abstract
Access to Hepatitis B Virus (HBV) testing for people in low-resource settings has long been challenging due to the gold standard, enzyme immunoassay, being prohibitively expensive, and requiring specialised skills and facilities that are not readily available, particularly in remote and isolated laboratories. Routine pathology data in tandem with cutting-edge machine learning shows promising diagnostic potential. In this study, recursive partitioning ("trees") and Support Vector Machines (SVMs) were applied to interrogate patient dataset (n = 916) that comprised results for Hepatitis B Surface Antigen (HBsAg) and routine clinical chemistry and haematology blood tests. These algorithms were used to develop a predictive diagnostic model of HBV infection. Our SVM-based diagnostic model of infection (accuracy = 85.4%, sensitivity = 91%, specificity = 72.6%, precision = 88.2%, F1-score = 0.89, Area Under the Receiver Operating Curve, AUC = 0.90) proved to be highly accurate for discriminating HBsAg positive from negative patients, and thus rivals with immunoassay. Therefore, we propose a predictive model based on routine blood tests as a novel diagnostic for early detection of HBV infection. Early prediction of HBV infection via routine pathology markers and pattern recognition algorithms will offer decision-support to clinicians and enhance early diagnosis, which is critical for optimal clinical management and improved patient outcomes.
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Makokha GN, Zhang P, Hayes CN, Songok E, Chayama K. The burden of Hepatitis B virus infection in Kenya: A systematic review and meta-analysis. Front Public Health 2023; 11:986020. [PMID: 36778557 PMCID: PMC9909240 DOI: 10.3389/fpubh.2023.986020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Background Chronic Hepatitis B virus (HBV) infection causes liver cirrhosis and cancer and is a major public health concern in Kenya. However, so far no systematic review and meta-analysis has been conducted to estimate the burden of disease in the country. A better understanding of HBV infection prevalence will help the government implement efficient strategies at eliminating the disease. This systematic review and meta-analysis was therefore conducted to summarize and update the available information on the burden of HBV in Kenya. Method We systematically searched PubMed, Science Direct, Web of Science, Scopus, African Journals OnLine, and Google Scholar databases to retrieve primary studies conducted between January 1990 and June 2021 that assessed the prevalence of HBV infection in Kenya based on measurement of the Hepatitis B Surface Antigen (HBsAg). Meta-analysis was performed using the random effects model where HBsAg prevalence was estimated at a 95% confidence interval (CI) after simple pooling analysis. Potential sources of heterogeneity were also investigated. Results Fifty studies were included in the meta-analysis with a sample size of 108448. The overall pooled prevalence estimate of HBV in Kenya was 7.8% (95% CI: 5.8-10.1). Subgroup analysis revealed the highest prevalence among patients presenting with jaundice at 41.7% (95% CI: 13.5-73.3) whereas blood donors had the lowest prevalence at 4.1% (95% CI: 2.4-6.3). Prevalence in Human Immunodeficiency Virus (HIV)-infected individuals was 8.2% (95% CI: 5.8-11.0). An estimate of the total variation between studies revealed substantial heterogeneity (I2 = 99%) which could be explained by the study type, the risk status of individuals, and the region of study. Conclusion We present the first systematic review and meta-analysis of the prevalence of HBV in Kenya. Our results show that the burden of HBV in Kenya is still enormous. This calls for an urgent need to implement public health intervention measures and strategic policies that will bring the disease under control and lead to final elimination. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=264859, identifier: CRD42021264859.
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Affiliation(s)
- Grace Naswa Makokha
- Laboratory of Medical Innovation, Department of Collaborative Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan,*Correspondence: Grace Naswa Makokha ✉
| | - Peiyi Zhang
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - C. Nelson Hayes
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Elijah Songok
- Graduate School of Health Sciences, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Kazuaki Chayama
- Laboratory of Medical Innovation, Department of Collaborative Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Vincent JP, Nyamasege C, Wang S, Madec Y, Shimakawa Y. Prevalence of hepatitis B, C, and D virus infection in Haiti: A systematic review and meta-analysis. Front Public Health 2023; 10:1099571. [PMID: 36711383 PMCID: PMC9874305 DOI: 10.3389/fpubh.2022.1099571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Background Viral hepatitis causes an important global health burden. In 2016, the World Health Assembly adopted an objective to globally eliminate this as a public health threat by 2030. However, significant gaps exist between countries in their progress. Haiti is the last country that has introduced infant hepatitis B vaccines into the routine immunization program in the Region of the Americas, and its schedule still does not incorporate birth dose vaccines. As the first step to raise awareness of viral hepatitis in this country, we conducted a systematic review and meta-analysis to estimate the prevalence of hepatitis B (HBV), C (HCV), and D (HDV) viruses in Haiti. Methods We searched PubMed, EMBASE, Web of Science and Scopus for studies reporting the prevalence of HBV, HCV and HDV among Haitian, with no language restriction, published until November 30th, 2021. Prevalence was pooled via a random-effects meta-analysis using a generalized linear mixed model with the logit link. Results Of 453 articles retrieved, 25 studies were included: 16 reported the prevalence of hepatitis B surface antigen (HBsAg), three for anti-HCV antibody, and six for both HBsAg and anti-HCV. No study was found for HDV prevalence. The pooled prevalence of HBsAg was 0.7% [95% confidence interval (CI): 0.3-1.4, I 2 = 77.7%] among children, 3.5% (95% CI: 2.8-4.4, I 2 = 93.2%) in the general adult population and 7.4% (95% CI: 4.0-13.3, I 2 = 83.9%) in high-risk adult population. The pooled prevalence of anti-HCV antibody was 0.9% (95% CI: 0.6-1.4, I 2 = 93.5%) among the general population and 1.4% (95% CI: 0.4-4.2, I 2 = 0.0%) in high-risk adult population. No study reported the prevalence of anti-HCV antibody exclusively in children. Interpretation The prevalence of blood-borne hepatitis, particularly that of HBV, is substantial in Haiti. The introduction of birth dose hepatitis B vaccines and improving access to testing and treatment services should be urgently considered to meet the elimination goal. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298081, identifier: PROSPERO (CRD42022298081).
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Affiliation(s)
- Jeanne Perpétue Vincent
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France,*Correspondence: Jeanne Perpétue Vincent ✉
| | - Carolyn Nyamasege
- Department of Health and Human Services, Institute for Health Policy and Practice, University of New Hampshire, Concord, NH, United States
| | - Su Wang
- Viral Hepatitis Program, Cooperman Barnabas Medical Center, Livingston, NJ, United States
| | - Yoann Madec
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France,Yusuke Shimakawa ✉
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Ogbenna AA, Akinsete AM, Kalejaiye OO, Matthew OK, Sharma D, Andrews J, Kassim AA. Reduction in seroprevalence of viral transfusion-transmitted infections in southwest Nigeria in children with sickle cell disease using an enhanced screening strategy. Br J Haematol 2022; 198:745-752. [PMID: 35719004 DOI: 10.1111/bjh.18313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/17/2022] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Abstract
Blood transfusion is an integral component in the management of children and adults with sickle cell disease (SCD). Concerns about blood safety due to the high risk of bloodborne infections in sub-Saharan Africa limits the application of this cost-effective strategy in the management of individuals with SCD. In a single-centre, retrospective, longitudinal study in southwest Nigeria, we hypothesised that the use of stringent blood donor selection, along with very sensitive enzyme-linked immunosorbent assay (ELISA) screening methods would reduce transfusion-transmitted infections (TTIs). Among 45 002 eligible blood donors at the Lagos University Teaching Hospital in Nigeria, over a 5-year review period (2015-2019), the seroprevalence rate of viral TTIs was 9.83%. The seroprevalence rates for human immunodeficiency, hepatitis B, and hepatitis C viruses were 1.37%, 6.2%, and 2.25% respectively. Among 172 children with SCD, 71% (122/172) on regular blood transfusion and 29% (50/172) who had never been transfused or had less than two transfusions per lifetime, none acquired any TTIs using our enhanced screening approach during the study period. Thus, safe blood transfusion practices can be provided for children with SCD in sub-Saharan Africa with the use of stringent donor selection protocols and fourth-generation ELISA kits for TTI screening.
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Affiliation(s)
- Ann A Ogbenna
- Department of Hematology and Blood Transfusion, College of Medicine/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adeseye M Akinsete
- Division of Pediatric Hematology and Oncology, College of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olufunto O Kalejaiye
- Department of Medicine, College of Medicine/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oyewole Kunmi Matthew
- Department of Hematology and Blood Transfusion, College of Medicine/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Deva Sharma
- Division of Transfusion Medicine and Pediatrics, Division of Hematology/Oncology, Departments of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer Andrews
- Division of Transfusion Medicine and Pediatrics, Division of Hematology/Oncology, Departments of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adetola A Kassim
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Duodu PA, Darkwah E, Agbadi P, Duah HO, Nutor JJ. Prevalence and geo-clinicodemographic factors associated with hepatitis B vaccination among healthcare workers in five developing countries. BMC Infect Dis 2022; 22:599. [PMID: 35799107 PMCID: PMC9264656 DOI: 10.1186/s12879-022-07556-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is a four-fold risk for hepatitis B infection among healthcare workers compared to the general population. Due to limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, there is a real risk that only few healthcare workers with viral hepatitis may get screened or diagnosed and treated. Studies on hepatitis B vaccination among healthcare workers in developing countries are sparse and this bodes ill for intervention and support. The aim of the study was to estimate the prevalence and explored the associated factors that predicted the uptake of the required, full dosage of hepatitis B vaccination among healthcare workers (HCWs) in five developing countries using nationally representative data. Methods We used recent datasets from the Demographic and Health Surveys Program’s Service Provision Assessment Survey. Descriptive summary statistics and logistic regressions were used to produce the results. Statistical significance was pegged at p < 0.05. Results The proportion of HCWs who received the required doses of hepatitis B vaccine in Afghanistan, Haiti, Malawi, Nepal, and Senegal were 69.1%, 11.3%, 15.4%, 46.5%, and 17.6%, respectively. Gender, occupational qualification, and years of education were significant correlates of receiving the required doses of hepatitis B among HCWs. Conclusions Given the increased risk of hepatitis B infection among healthcare workers, policymakers in developing countries should intensify education campaigns among HCWs and, perhaps, must take it a step further by making hepatitis B vaccination compulsory and a key requirement for employment, especially among those workers who regularly encounter bodily fluids of patients.
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Affiliation(s)
- Precious Adade Duodu
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Ernest Darkwah
- Department of Psychology, University of Ghana, P.O. Box LG 84, Legon, Ghana
| | - Pascal Agbadi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong, SAR, China
| | | | - Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, USA.
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Manko M, Mohammed MF, Ahmed MS, Bello AK, Egbegbedia PO, Abdullahi U, Jamoh YB, Mustapha SK. Demographic Profile and Etiology of Hepatocellular Carcinoma in Zaria, Northern Nigeria. Niger Med J 2022; 63:282-287. [PMID: 38863473 PMCID: PMC11163258 DOI: 10.60787/nmj-63-4-74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Background HCC is a common cancer worldwide and one of the leading causes of cancer death. This aim of this study is to determine the age and gender characteristics of the HCC patients in our center and to determine the contribution of viral hepatitis (B and C) and alcohol to the etiology of HCC among our patients. Methodology This is a retrospective study of HCC patients seen at the gastroenterology unit of ABUTH between April 2015 and September 2018. Data on age, gender, HBsAg, and HCV antibody status and alcohol consumption were recorded from the case files of all eligible patients. Results A total of 87 patients were included in the study. They consisted of 68 males (78.2%) and 19 females (21.8%) with male to female ratio of 4:1. The mean age of the study subjects was 46.7 years (SD ± 12.5), with a range of 22 and maximum age of 80 years. Majority of the patients were within the age group 40-49 (32.2%). HBsAg was present in 48 patients (55.2%), HCV antibody was positive in 14 patients (16.1%) and 3 patients (3.4%) were positive for both HBsAg and HCV antibody. Four (4.6%) had significant alcohol ingestion and in 18 patients (20.7%), the etiology was undetermined. Conclusion In our study, HCC was found predominantly among male patients in the age group 40-49 years. Viral hepatitis particularly HBV is the most important etiological factor for HCC among our patients.
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Affiliation(s)
- Muhammad Manko
- Department of Medicine, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | | | - Maryam Shehu Ahmed
- Department of Medicine, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Ahmad Kumo Bello
- Department of Medicine, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | | | - Umar Abdullahi
- Department of Medicine, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Yusuf Bello Jamoh
- Department of Medicine, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Shettima Kagu Mustapha
- Department of Medicine, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Jemilohun AC, Akande KO, Ngubor TD, Oku O, Ogunmola MI, Adesuyi YO. Endoscopic Findings in Patients With Upper Gastrointestinal Bleeding in Ogun State, Nigeria. Cureus 2022; 14:e23637. [PMID: 35510020 PMCID: PMC9057311 DOI: 10.7759/cureus.23637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction Although the global incidence of upper gastrointestinal bleeding (UGIB) appears to have reduced substantially in the past few decades, acute UGIB still carries significant morbidity and mortality worldwide. There are currently no published data on UGIB in Ogun State, Nigeria. This study examined the endoscopic findings in patients with UGIB in Ogun State. Methodology The study was a retrospective cross-sectional survey of patients with UGIB who had upper gastrointestinal endoscopy at three endoscopy centers in Ogun State, Southwest Nigeria, from January 2015 to December 2021. Patients’ data, which included age, gender, and endoscopic findings, were extracted from the endoscopy registers into a spreadsheet and analyzed statistically. Summary statistics included means ± standard deviation for continuous variables and frequencies and percentages for categorical variables. Categorical variables were compared for differences by chi-square test or Fisher’s exact test as appropriate. The statistical significance cutoff was p-value <0.05. Results A total of 171 had endoscopy for UGIB during the period under review but 168 had complete data. Out of the 168, 113 (67.3%) were males, giving a male-to-female ratio of 2:1. The mean age of the patients was 52.4 ± 18.1 years, with an age range of 7-85 years. The modal age group was ≥60 years (75; 39.9%). The most common endoscopic finding was peptic ulcer disease (77; 45.8%), followed by esophagogastric varices (27; 16.1%), erosive mucosal disease (25; 14.9 %), portal hypertensive gastropathy (15; 8.9%), suspected malignancies (11; 6.6%), hemorrhagic gastritis (7; 4.2%), gastric antral vascular ectasia (2; 1.2%), and Mallory-Weiss tear (1; 0.6%), respectively. Forty-four patients (26.2%) had no lesion that could explain UGIB. Conclusion Peptic ulcer disease was the most common cause of UGIB among our patient population, and the elderly male patients were the most affected.
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Elegbede O, Alabi A, Alao T, Sanni T. Knowledge and associated factors for the uptake of hepatitis B vaccine among nonmedical undergraduate students in a private university in Ekiti State, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_48_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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