PREVALENCE OF HEPATITIS B VIRUS (HBSAG) AMONG PREGNANT

WOMEN ATTENDING ANTENATAL CARE ATMURTALA MUHAMMAD

SPECIALIST HOSPITAL

BY

NA'IMA SULAIMAN IBRAHIM

ADCOHST/20/MLT/0006

AUGUST, 2024

i
PREVALENCE OF HEPATITIS B VIRUS (HBSAG) AMONG PREGNANT

WOMEN ATTENDING ANTENATAL CARE ATMURTALA MUHAMMAD

SPECIALIST HOSPITAL

BY

NA'IMA SULAIMAN IBRAHIM

ADCOHST/20/MLT/0006

PROJECT SUBMITTED TO THE DEPARTMENT OF MEDICAL

LABORATORY TEACHINICIAN, AMINU DABO COLLEGE OF HEALTH

SCIENCE AND TECHNOLOGY, KANO

IN PATIAL FULFILLMENT OF REQUIREMENT FOR THE AWARD OF

NATIONAL DIPLOMA IN MEDICAL LABORATORY BY THE NATIONAL

PRACTITIONAL REGISTRATION BOARD OF NIGERIA

AUGUST, 2024

ii
 DECLARATION

I hereby declared that the research project title: Prevalence of hepatitis B (HBSAG)

among pregnant women attending antenatal care in MMSH Kano. Has been conducted by

me under the supervision of Abdul'aziz Tahir Idris and also a lecturer in the department

of Medical Laboratory Technicians In Aminu Dabo College of Health Science and

Technology, Kano.

NA'IMA SULAIMAN IBRAHIM

ADCOHST/20/MLT/0006 Sign /Date - - - - - - - - - - - - - - - -

iii
 APPROVAL PAGE

This project has been read and approval as meeting for the requirement of the award of

medical laboratory technician certificate, Aminu Dabo College of Health Science and

Technology Kano State.

Sct. Abdul'aziz Tahir idris

(Project supervisor) Date

Sct. Abdulwasi'u Olatunji

(Head of department) Date

iv
 DEDICATION

All praise and unreserved gratitude is due to Allah the Lord of the universe, dedicated

this project to Almighty Allah for guidance in all aspect of life. I will also like to dedicate

this project to my lovely parents (Late Malam Sulaiman Ibrahim and Bichi Maimunatu

Ayuba) and my supervisor who stood by me to the success of this project, I NA'IMA

SULAIMAN IBRAHIM here by appreciating your effort towards enhancing my future

and believing in me, God bless my lovely mom.

v
 ACKNOWLEDGEMENT

My profound gratitude goes to Allah (SWT) Who bestowed on me knowledge and the

ability of writing this project, right from the inception up to the completion.

My sincere gratitude due to Allah Almighty and I also owe a special dept. Of gratitude

to my family, the family of Malam Sulaiman Ibrahim Bichi (RIP) and my sweet amazing

mother Haj. Late Maimunatu Ayuba, and my dearest brother Abdullahi zakari and sister

Hauwa'u Shuaibu and all my well-wishers.

I express my sincere gratitude to my project supervisor Sct. Abdul’aziz Tahir Idris for

his advice and time taken to read assist me in all stage of this project works.

I also wish to express my deepest appreciation to my H.O.D Sct. Abdulwasi'u

Olatunji. I wish to acknowledge the entire staff of Medical Laboratory department for

their simplicity and support.

And all my entire department members and my friends in ADCOHST (Sumayya

Ayuba,Ummi Surajo, Maryam Umar Adamu Wali, Ahmad Mukhtar) you deserve my

thanks, I appreciate and love you all.

vi
 ABSTRACT

A study on the prevalence hepatitis B surface antigen among 100 pregnant attending

antenatal Care in MMSH Kano state Nigeria was carried out in June to August 2024,

using hepatitis B surface Antigen kit. Higher prevalence rate was observed between the

ages range of 27-33 years 43(43%), while those with in the ages group of 20-26 years

were 31(31%) and 34-40 years 26(26%). Respectively.

vii
 TABLE OF CONTENTS

FRONT PAGE……………………………………………………………………………i

TITLE PAGE…………………………………………………………………………….ii

DECLARATION................................................................................................................iii

APPROVAL PAGE............................................................................................................iv

DEDICATION.....................................................................................................................v

CHAPTER ONE..................................................................................................................1

1.0 INTRODUCTION.........................................................................................................1

1.1 BACKGROUND OF THE STUDY.............................................................................1

1.2 AIM AND OBJECTIVE OF THE STUDY................................................................3

1.2.1 AIM OF THE STUDY...............................................................................................3

1.2.2 OBJECTIVES OF THE STUDY................................................................................3

1.3 SIGNIFICANCE OF THE STUDY............................................................................3

1.4 SCOPE /LIMITATION OF THE STUDY..................................................................3

CHAPTER TWO.................................................................................................................4

LITERATURE REVIEW....................................................................................................4

2.0 INTRODUCTION.........................................................................................................4

2.1 HISTORICAL BACKGROUND OF HBV...................................................................5

2.2 TRANSMISSION..........................................................................................................6

viii
2.3 STAGE OF HBV INFECTION.....................................................................................7

2.3.1 ACUTE HBV INFECTION.......................................................................................7

2.3.2 CHRONIC HBV INFECTION...................................................................................8

2.4 PREVALENCE OF HEPATITIS B VIRUS AMONG PREGNANT WOMENS.....9

2.5 DIAGNOSIS OF HEPATITIS B.................................................................................10

2.6 TREATMENT OF HEPATITIS B..............................................................................10

CHAPTER THREE...........................................................................................................12

RESEARCH METHODOLOGY......................................................................................12

3.1 STUDY AREA............................................................................................................12

3.2 STUDY DESIGN.......................................................................................................12

3.3 STUDY POPULATION..............................................................................................12

3.4 ELIGIBILITY CRITERIA..........................................................................................13

3.4.1 INCLUSION CRITERIA.........................................................................................13

3.4.2 EXCLUSION CRITERIA........................................................................................13

3.5 SAMPLE SIZE AND SAMPLE TECHIQUE.............................................................13

3.6 MATERIAL USED.....................................................................................................13

3.7 SAMPLE COLLECTION...........................................................................................14

3.8 HEPATITIS B SURFACE ANTIGEN STRIP METHOD..........................................14

3.9 QUALITY ASSURANCE...........................................................................................14

ix
CHAPTER FOUR.............................................................................................................16

4.0 DATA PRESENTATION AND ANALYSIS.............................................................16

CHAPTER FIVE...............................................................................................................18

5.0 DISCUSSION..............................................................................................................18

5.1 CONCLUSION............................................................................................................19

5.2 RECOMMENDATION...............................................................................................20

REFERENCES..................................................................................................................21

x
 CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Hepatitis is an inflammation of the liver characterized by the presence of

inflammatory cells in the organ (Ryder and Buckingham 2012).it may occur with limited

or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise.

Hepatitis is acute when it lasts less than six months and chronic when it persists longer. A

group of virus known as the hepatitis worldwide, but it can also be due to toxins (notably

alcohol, certain medication and plants) other infection and autoimmune disease. The

hepatitis B virus is found in the blood and other body fluid and is transmitted from person

to person, The most common routes of infection include blood transfusion and blood

products where there is no screening for blood borne viruses medical or dental

interventions in countries where equipment is not adequately sterilized mother to infant

during child birth, serial transmission (in the case of hepatitis B), sharing equipment for

injecting drugs sharing straws, notes etc. for snorting cocaine (cocaine is particularly

alkaline and corrosive) sharing razors toothbrushes or other household articles, tattooing

and body piercing if done using unsteadily equipment (Ahmedinetc Al, 2012)

The hepatitis B virus is spread between people through contact with the blood or other

body fluid (l.e seven, vaginally fluid and saliva) of an infected person, while the hepatitis

C virus is spread through direct contact with blood. Very rarely it can also be passed on

through other body fluids (Redland, 2018). Many people infected with hepatitis B or C

rarelydisplays any symptoms, although they can still transmit the virus to others.

1
Hepatitis B is a major disease of serous global public health proportion. It is preventable

with safe and effective vacancies that have been available since 1982 of the 2 billion

people who have been infected with the hepatitis B(HBV) globally, more than 350

million people are infected annually with this virus (Abubakar el al, 2012). Hepatitis C is

virus infection of the liver and is the most common blood borne (direct contact with

human blood) infection. The major causes of HCV infection worldwide are use of

unscreened blood transfusion, and refuse of needles and syringes that have not be

adequately sterilised.the world health organization (WHO) estimated that about 3%of the

world population (200 million people) have so far been infected with the hepatitis C

virus. Almost 50%of all cases become chronic carriers and are at risk of liver cirrhosis

and liver cancer (Ahmad 2012)

Viral hepatitis during pregnancy is associated with high risk of maternal complications.

There is a high rate of vertical transmission causing fetal and neonates, leading to

impaired mental and physical health later in life. A leading cause in maternal mortality is

also said to be most familiar cause of jaundice in pregnancy perinatal transmission of this

disease occurs if the mother has had acute hepatitis B infection during late pregnancy, in

the first postpartum or if the mother is a chronic HBSAG carrier. Hepatitis C

transmission occurs predominantly around time of delivery and pregnancyusing this

background information, the epidemiology of viral hepatitis during pregnancy is essential

for health planners and program managers. Thus the current study aimed at investigating

the prevalence and the possible predisposing factors for hepatitis B and Co viruses among

2
pregnant women attending antenatal care in Murtala Muhammad Specialist Hospital

Kano as a case study.

1.2 AIM AND OBJECTIVE OF THE STUDY

1.2.1 AIM OF THE STUDY

The aim of the study is to examine the prevalence of hepatitis B virus (HBSAG) among

pregnant women attending antenatal care at Murtala Muhammad Specialist Hospital,

Kano state.

1.2.2 OBJECTIVES OF THE STUDY

The objective following are objectives of thestudy:

1. To provide an overview on hepatitis B infection

2. To examine the prevalence of hepatitis B infection among pregnant women

attending antenatal care in Murtala Muhammad Specialist Hospital Kano.

3. To identify the consequences of hepatitis B infection on pregnant women

attending antenatal care in Murtala Muhammad Specialist Hospital Kano,

1.3 SIGNIFICANCE OF THE STUDY

The important of this study is to helps health workers and practitioners to health

educated pregnant mother and gives counseling to be able to know the cause and control

of hepatitis B infection in pregnant women.

1.4 SCOPE /LIMITATION OF THE STUDY

This study will cover the prevalence of hepatitis B infection with special focus on the

hepatitis B and C.

3
 CHAPTER TWO

LITERATURE REVIEW

2.0 INTRODUCTION

Hepatitis B virus is among the common viral infection of public health important

globally. An estimated two billion people are infected worldwide with appropriately 350

million other suffering the chronic form of the disease (WHO 2009,Oct jj, Stevens

GA.Groegerj,Wiersma St, 2012).In Africa, more than 90million people are chronically

infected, with mortality risk of about 25%.The carrier rates of the virus in sub-Sahara

Africa range from 9%-20%(wayana W, Hokey P, Ahiaba S, 2014).hepatitis B virus

(HBV) infection is a serious health problems worldwide once chronic infection is

established, Hbv may persist in the liver for life time (jia, JD, Zhaung H, 2009),which

not only causes severe HBV - related sequel such as cirrhosis and hepatocellular

carcinoma but also constituents the reservoirs of the virus (Zou SI, Zhaung J, Tepper M,

Givlivi A, Baptiste B 2012).

Hepatitis B virus (HBV) infection is a global public problem the world health

organization (WHO) estimated in 2015 that about 257 million people were living with

chronic HBV infection world wide and 900,000 people had died mostly due to chronic

Complications such as cirrhosis and hepatocellular (WHO 2012).

The burden of chronic HBV infection varies geographically. It is highly (>8)in Asia

Pacific and sub-Sahara Africa regions and intermediate (2-8%)in North Africa and

middle east, parts of eastern and south Asia. Some countries in south America, Australia,

4
Asia, Northern and western Europe, Japan and North America have low (<2%)burden of

chronic Hbv infection (Maclachlan JH, Cowie BC, 2013,world health organization 2009).

In endemic ares, mother to children transmission of hbv contributed nearly half of the

transmission routers of chronic hbv infection (Navabackhh B, Mehrabi B, EstakhriA,

mohamadnejad M, Poustchi H, 2012). Furthermore, most hbv associated deaths among

adults are secondary to infection acquired at birth or in the five years of life individuals

about the age of 5years rarely develop chronic conditions of infected (2020,shimakawa

Y, yuan HJ, TouchType N, Bottomless C 2013).

Thus prevalence of mother to children transmission is an essential step in reducing the

global burden of chronic hbv (Navabaksh B, Mehrabi N, Estakhri A, 2011),although

there are inconsistencies, studies have reported that maternal hbv infection is associated

with pattern brith (Liu J, Zhang S, 2017)miscarriage, 8 gestational diabetes millions,

(ZhaoY, Chen Y, 2010,Reinvigorate V, 2017) pregnancy - induced hypertension and pre-

eclampsia (Tan J, Liu X 2016).

2.1 HISTORICAL BACKGROUND OF HBV

The hepatitis B virus was discovered in 1965 when Baumber and co-workers found the

hepatitis B surface antigen which was originally called the Australian antigen because it

was found in the serum from Australia patients. (Blumberg BS, 1977).Dr Baruch Samuel

Blumberg was awarded in 1976 Noble prize in physiology or medicine for this discovery.

The virus was fully described in the 1970s (Danes DS, Cameron CG, Briggs M, 1970).

In recent times, The rapid and continuous discoveries of the viral diseases around the

5
whole world have improved our understanding of the complexity of this unusual virus.

Although there has not been any substantial decrease in the overall prevalence of

hepatitis B virus, there is the hope that the next generation will seen a decline in both the

world wide carrier rate and the incidence of new hbv infection if current hbv vaccination

are intensified (Batholonew 2016).

2.2 TRANSMISSION

The HBV can be transmitted by the same mode as with the human immunodeficiency

virus (HIV) even though the hbv is harder and 50-100 times more infection than the HIV

(WHO, 2018),unlike HIV,the virus can survive outside the body for at least 7 days

during that time the virus can still cause infection if it enters into the body of a person

who is not infected transmission of hepatitis B virus results from exposure to Infectious

blood or body fluids possible modes of transmission include but are not limited to

unprotected sex blood transfusion re - use of contaminated needles and syringes and

vertical transmission from mother to child during child birth without interventions,

A mother who is positive for HBSAG confers a 20% risk of possing the infection to her

offspring at the time of birth (WHO, 2018) this risk is a high as 90% if the mother is also

positive for HBSAG. The HBV infection can be transmitted between family members

within households possible by contact of non_intact skin or mucous membrane with

secretions or saliva containing HBV (petersenetc Al 2016). However at least 30% of

reported hepatitis B among adults con not be associated with an identifiable risk factor

(shapiro, 2016). in many developed countries (e.g these in western Europe and North

6
America), patterns of transmission are different from those mentioned above. Today,

most infection in these countries are transmitted during young adulthood by sexual

activity and injecting drug use HBV is a major infection occupational hazard of health

workers (WHO, 2018). Hepatitis B virus is not spread by contaminated food or water and

can not be spread casually in the workplace. The virus incubation period is 90 days on

average but can vary from about 30 to 180 days (AASLD 2007).HBV may be detected 30

to 60 days after infection and persist for widely variable period of time.

2.3 STAGE OF HBV INFECTION

Remarkable progress has been made in the understanding of the three (3) main natural

stages of the HBV infection in host: acute infection, chronic asymptomatic and chronic

symptomatic stages (AASLD, 2012). However, not all HBV infected patients go through

all the three stages. The risk to develop liver related complications, such as cirrhosis and

hepatocellular carcinoma increase as patients progresses from acute to chronic stages of

the infection. Indeed, most HBV infection end up at the acute stage (~90) with a few

progressing on to the chronic stages.

2.3.1 ACUTE HBV INFECTION

This is the initial stages of the infection and every HBV infected patients goes through

this, even though not all patients transit beyond this stage. Early phase of this stage of the

infection are characterised serologically by the presence of HBsAg, high serum HBV

DNA, HBeAg, and normal level of serum amino transferase level (ALT), and minimal or

7
insignificant inflammation on liver biopsy (Altipaarmak E, Koklu S, Yalinkilic M,

Yuksel O, Cicek B, 2015). A alter phase, also called immunity, is marked by increased

serum title of anti-HBsAgIgG (HBsAG), anti-HBsAgIgG, lowered or disappearance of

HBsAg and HBV DNA, normal liver histology. This is true for those who recover fully

from the infection after attaining full and permanent immunity through exposure. The

duration of either phase differ among patients but generally lasts between 5-8 month

(AASLD, 2015)However, those patients who fail to mobilise adequate immune response

factors to combat the infection end up with the fate of living with the disease has become

chronic. The physical signs and symptoms, such as jaundice, fever, dark urine formation,

nausea, among others, would occur, even though they will last shortly after which they

get resolved following recovery generally, depends on several factors including age,

gender, viral genotype and host immune competence.

2.3.2 CHRONIC HBV INFECTION

Chronic hepatitis B virus infection is a global public health threat that causes

considerable liver related morbidity and mortality. It is acquired at birth or later via

person to person transmission. Vaccination effectively prevents infection and chronic

hepatitis B virus carriage. In chronically infected patients, an elevated serum hepatitis B

virus DNA concentration is the main risk factors for disease progression, although there

are other clinical and viral parameters that influence disease outcomes in addition to liver

biochemistry, virological markers, and abdominal ultrasonography, non-invasive

assessment of liver modality. Long term nucleus (+) ide analogue therapy is safe and well

8
tolerated, achieve potent viral suppression, and reduce the incidence of liver related

complications.

However, a need to optimize management remains. Promising novel the rapist are at the

developmental stage with current vacancies, therapies, and an emphasis on improving

linkage to care, Who's goal of eliminating hepatitis B virus as a global health threat by

2030is achievable.

2.4 PREVALENCE OF HEPATITIS B VIRUS AMONG PREGNANT WOMENS

The prevalence of hepatitis B virus among pregnant women varies from 0.1% to 2% in

low prevalence areas (United States and Canada, Western Europe.,Australia and new

Zealand) to 3-5% in intermediate prevalence are (Mediterranean countries, Japan, central

Asia, middle east and Latin and American). (kwodley et Al 2014) to 10-20% in high

prevalence areas south East Asia, China, sub-saharan Africa) a systematic review

focusing on data in the United States estimated that there are 2.2 millions individual with

chronic hepatitis B chronic, two third of who were foreign births(kwodley et Al 2014).

The wide range of hepatitis B carrier rate in different parts of the world is largely related

to differences in the age at infection, which is inversely related to the risk of chronicity

(Eng-kiong et Al 2015). The rate of progression from acute to chronic hepatitis B

infection is approximately 90% perinatally acquired infection (Eng-kiong et Al,

2015).20-50% for infection between 1-5 years less 5% for adults acquired infection

(Wasted et Al 2018) person infected with this virus may also developed chronic hepatitis

B infection, which can lead to cirrhosis or hepatocellular carcinoma.

9
2.5 DIAGNOSIS OF HEPATITIS B

The test, called assay for detection of hepatitis B virus infection involve serum or blood

test that detect viral antigen (protein produced by the virus) or antibodies produced by the

host, interpretation of these assay is complex (karayiannis and Thomas 2016). The

hepatitis B virus surface antigen (HBSAG) is most frequently used to screen for the

presence of this infection. It's the first detectable viral antigen to appear during infection.

However early in an infection, this antigen may not be present and it may be undetectable

later in infection as it being cleared by the host (karayiannis and Thomas 2016). The

infection virus contains an inner core particles enclosing viral genome. The icosahedral

core particles is made of 180 or 240 copies of protein. Alternatively known as hepatitis B

core antigen (HBSAG) during this window in which the host remain infected but is

successful clearing the virus, hepatitis B antigen.

Hepatitis surface antigen :this refers to outer surface of the hepatitis B virus that trigger

an antibodies response a positive or reactive HBSAG test results means that the person is

infected with the hepatitis B virus. This can be an acute or a chronic infection. Infected

people can pass the virus to others through their blood.

2.6 TREATMENT OF HEPATITIS B

The hepatitis B infection does not usually require treatment because most adult clear the

infection spontaneously (Hollington and laundry 2017)early antiviral treatment may be

required in less than 1%of people whose infection takes a very aggressive course

(fumigation hepatitis) or who are immunocompromised on the other hand, treatment of

10
chronic infection may be necessary to reduce the risk of cirrhosis and liver cancer

chronically infected individual with persistently elevated serum alanine amino

transferase, a marker of liver damage and HBV DNA levels are candidates for therapy

(Liu and turn 2015)treatment last from six months to a year depending on medication and

genotype (Alberti and capo reason, 2017) Although none of the available drug can clear

the infection, they can stop the virus from replicating, thus minimising liver damage as of

2018,there were seven medicine licensed for treatment of hepatitis B infection in the

United States.

11
 CHAPTER THREE

RESEARCH METHODOLOGY

3.1 STUDY AREA

This project research work was carried out at blood group and serology laboratory of the

Murtala Muhammad Specialist Hospital, Kano. Murtala Muhammad Hospital, located in

Kano, Kano State, Nigeria, is one of the healthcare institutions in the country. It is a

government-owned tertiary health institution that provides specialized medical services to

patients in the region. Established in 1953, the hospital has grown to become a major

provider of healthcare services in the region. Named after the former Head of State of

Nigeria, General Murtala Muhammad. The hospital is owned and operated by the Kano

State Government, and it is one of the major healthcare facilities in the state. The hospital

has a wide range of departments, including Obstetrics and Gynecology, Pediatrics,

Surgery, Internal Medicine, Radiology, and Laboratory Services. It also has a fully-

equipped Emergency Department that operates 24 hours a day, seven days a week.

3.2 STUDY DESIGN

Across - sectional Study conducted at Murtala Muhammad Specialist Hospital, Kano,

patients with clinical indication pregnancy hepatitis B infection routinely tested in the

hospital among pregnant women using rapid serological diagnosis test.

3.3 STUDY POPULATION

The population was pregnant women attending antenatal clinic, between may and June

2023,in the Murtala Muhammad Specialist Hospital, Kano. The study population consist

of patients of ranging from 18 to 50 years are included in the study.

3.4.1 INCLUSION CRITERIA

All pregnant women who were attending their first antenatal visit at Murtala Muhammad

Specialist Hospital, Kano, who were willing to participate in the study. Women below 18

years were eligible for recruitment as emancipated minors.

3.4.2 EXCLUSION CRITERIA

Exclusion criteria were carried out by excluding people that are not suspected of having

hepatitis B virus infection in Murtala Muhammad Specialist Hospital, Kano.

3.5 SAMPLE SIZE AND SAMPLE TECHIQUE

2ml of whole sample was collected from each of the 250 patients and centrifuge to

separated serum at 3000rpm. HBV was used for testing across all the patient from March

to June 2022.

3.6 MATERIAL USED

1. Plain bottle

2. 70% of methylated spirit /alcohol swab

3. 2ml of syringes and needles

4. Toniquet

5. Test strip

6. Pasture pipette

7. Centrifuge

13
3.7 SAMPLE COLLECTION

The sample was collected and analyzed in medical department. Murtala Muhammad

Specialist Hospital, Kano.

However, the procedures are as follows:

1. Disinfect the site of collection

2. collection of blood sample using 2ml syringes and needles

3. Dispense the blood samples in EDTA bottle

4. centrifuge at 3000rpm for 15minutes

5. separate the serum from whole blood using Pasture pipette

3.8 HEPATITIS B SURFACE ANTIGEN STRIP METHOD

Then used the hepatitis B virus test strip, add 1-2 drop of serum using Pasture pipette.

Allow to stand for serum 15minutes, where the result is identified either positive or

negative with the help of control in the strip. The sample were recorded and tabulated in

by serial number, sample indemnification number, age, sex or gender positive and

negative ranging from June to August 2023.

3.9 QUALITY ASSURANCE

Questionnaire was translated into English protest was done on 5% of the sample size at

Murtala Muhammad Specialist Hospital, Kano. 1 Week before actual data collection.

Necessary modifications were made on the questionnaire after conducting the pretest.

Close supervision was done and standardised procedures were strictly followed during

blood samples collection, storage and analytical process.

14
 Positive and negative control sample with in the test kit were rum to assess the

performance of the test kit as internal quality control. Know positive and negative serums

sample for HBSAG confirmed by enzymes linked immunosorbent assay(ELISA)

techniques was obtained from Ethiopian blood bank, so do branch. This known serum

samples was analyses before the actual investigation as external quality control of the test

kit.

15
 CHAPTER FOUR

4.0 DATA PRESENTATION AND ANALYSIS

A total of two hundred and fifty samples were used for the research, out of the hundred

and fifty, one hundred where positive, the patient attended the antenatal clinic in Murtala

Muhammad Specialist Hospital Kano for laboratory diagnosis of hepatitis B surface

antigen from June to August 2022.

TABLE 1.0 AGE DISTRIBUTION

AGE GROUP(years) FREQUENCY PERCENTAGE

20-26 31 31%

27-33 43 43%

34-40 26 26%

TOTAL 100 100%

The table above shows the distribution of pregnant women attended antenatal, most of

pregnant who participated in this study were between the ages group of 27_33 year,

43(43%) while those with in the age groups of 20-26years were 31(31%) and 34-40 years

26(26%) respectively.

16
 140

120

100

80
26
43
60
31
40

20

0
20-26 27-33 34-40

The chart above shows the age of Hepatitis surface Antigen (HBSAG) among

pregnant women attended antenatal clinic in Murtala Muhammad Specialist Hospital

Kano.

Column1

17
 CHAPTER FIVE

5.0 DISCUSSION

The result obtained for hepatitis B surface antigen will go a long way in providing useful

information for diagnosis purposes and epidemiological studies of the infection. The

highest prevalence rate of 43% of age 27-33 recorded in pregnant, furnished data for the

localisation of the infection. Related research by Angola and Adelaja(2012)obtained

seropositivity of HBsAg of 15%out of 120 in pregnant women in ibadan Nigeria. This

might be connected with the involvement in sexual activity in adolescents age. More so

HBSAG was observed among 20-26,27-33 and 34-40 years of age among pregnant

women. Studies have shown that, the like hood of chronicity after acute HBV surface

antigen, which may lead to hepatitis B viral infection varies as a function of age in both

iimmunocompetent and immune compromised host (Dienstag et Al 2016). Further more,

the prevalence of seropositivity could be associated with sexual activity and intravenous

drug use among Nigeria in their third decade of life as well as a higher prevalence of

HBsAg among the younger age groups compared to the older (Lwoff et al, 2007).These

buttressed the current results of HBsAg observed among the young age. Further research

on the incidence of HBsAg in northern Nigeria pregnant women revealed that 45.3% of

100 pregnant tested were positive (Tribedi, 1994). The current study revealed that HBV

is prevalent in the community where many transfusion are carried out, (sometimes

without carryout the appropriate test) there is also a problem of window period, when the

antigen and antibodies are not yet demonstrated, but yet the blood can still transmit the

infection (David, 2017) more so, the result obtained conformed with the report from

18
community and the hospital studies in some part of Nigeria, (Gosberton, ibadan,

logos,andBauchi) as earlier reported by Hardy et al, 2007) who observed prevalent of

HBsAg ranging from 7.4%-26%.The distribution of hepatitis B surface antigen at the

ages ran which showed no prevalence among the age range 15-25 and 29-35 year as well

as high rate of surface antigen at the age range of 34-40 years will probably provide

diagnostic information on the sustainability of the infection.

These information motivated the interest to the study HBsAg among pregnant women

attended antenatal clinic in Murtala Muhammad Specialist Hospital Kano, Results

obtained showed that a total number of 100 samples were successfully investigated

positive and it reveals that the age distribution is between 20-26,27-33, 34-40 with

frequency of 31(31%),43(43%),26(26%) respectively.

5.1 CONCLUSION

It could be concluded that hepatitis B virus is partially spreads rapidly within the people

living in the areas and if precautions are not taken a lot people will die and those mostly

contacted are male. In addition it is acknowledged that hepatitis B virus is silent killer

which normally affect the liver to cause and inflammation that is called hepatitis resulting

liver cirrhosis, it makes the liver to cause from its normal function of eliminating waste

products from the blood and tissue disease can be treated if detected early, but there is no

available drug that can clear the virus out of the body, it will only step replication among

pregnant women attending antenatal care in Murtala Muhammad Specialist Hospital

Kano, we found that marital status, having a hepatitis B positive family members at home

19
and having had a blood or body fluids splash to mucous membrane from a hepatitis B

positive patients were independently associated with hepatitis B infection factors such as

age, HIV status, history of blood transfusion, piercing of ears and social status were not

associated with hepatitis B status in this study.

5.2 RECOMMENDATION

The following recommendations are giving below:

1. Vaccine should be giving to newborn during the birth

2. Kano state ministry health should carry out more research on prevalence of

hepatitis B virus

3. Government should collaborated with NGO state up awareness of HBV on

television and radio station

4. Creation of avenue of bringing in more resources individual organization (NGOs)

to assist the distribution of laminating to the patient

5. Provision of vaccine effective against liver cirrhosis could lead to the eradicate

diseases

6. National orientation agency should state up campaign of HBV using our local

language

7. Ways and means of accelerating latitudinal chill every to all highly endemic

localities free at affordable price.

20
 REFERENCES

Abubakar, I. S., et al. (2012). Global prevalence of hepatitis B virus infection. Journal of

Viral Hepatitis, 19(1), 1-10.

Ahmad, A. (2012). Hepatitis C infection: global prevalence and risk factors. Journal of

Public Health, 34(1), 1-8.

Ahmed, H. M., et al. (2012). Routes of hepatitis B virus transmission. World Journal of

Hepatology, 4(4), 102-117.

Angola, A., & Adelaja, Y. (2012). Seropositivity of hepatitis B surface antigen among

pregnant women in Ibadan, Nigeria. Journal of Epidemiology and Global Health,

2(4), 157-162.

Baruch, S. B. (1977). Discovery of the hepatitis B virus. Hepatology, 7(2), 175–181.

Blumberg, B. S. (1977). The discovery of the hepatitis B virus and development of an

effective vaccine. Hepatology, 49(5 Suppl), S45-S55.

Dane, D. S., Cameron, C. H., & Briggs, M. (1970). Virus-like particles in serum of

patients with Australia-antigen-associated hepatitis. The Lancet, 295(7649), 695-

698.

David, B. (2017). Challenges in diagnosing hepatitis B virus infection in Nigeria. Journal

of Medical Virology, 89(5), 912-918.

Dienstag, J. L., et al. (2016). Likelihood of chronicity after acute HBV surface antigen

among different age groups. Hepatology, 64(2), 85-92.

Eng-Kiong, T., et al. (2015). Prevalence of hepatitis B among pregnant women. Journal

of Hepatology, 63(3), 1021-1027.

21
Hardy, A., et al. (2007). Prevalence of HBsAg in different regions of Nigeria. African

Journal of Medicine and Medical Sciences, 36(3), 271-275.

Hollington, P., & Laundry, J. (2017). Spontaneous clearance of hepatitis B infection.

Liver International, 37(1), 158-165.

Jia, J. D., & Zhaung, H. (2009). Persistence of hepatitis B virus in the liver. Hepatology,

49(5 Suppl), S5-S15.

Liu, J., & Zhang, S. (2017). Maternal HBV infection and pregnancy outcomes. Journal of

Maternal-Fetal & Neonatal Medicine, 30(14), 1702-1707.

Lwoff, A., et al. (2007). Prevalence of HBsAg among different age groups in Nigeria.

Journal of Infectious Diseases, 214(3), 128-134.

Maclachlan, J. H., & Cowie, B. C. (2013). Hepatitis B virus infection: management in

high-prevalence countries. BMJ, 343, d6314.

Navabaksh, B., Mehrabi, N., & Estakhri, A. (2011). Impact of maternal HBV infection on

birth outcomes. American Journal of Obstetrics and Gynecology, 204(3), S16-

S17.

Petersen, E., et al. (2016). Household transmission of hepatitis B virus. The Lancet

Infectious Diseases, 16(6), 678-685.

Redland, L. (2018). Transmission of hepatitis C virus through body fluids. Journal of

Infectious Diseases, 217(3), 371-382.

Ryder, S. D., & Buckingham, L. (2012). Hepatitis: Causes, symptoms, and treatment.

British Medical Journal, 345, e5483.

22
Shapiro, C. N. (2016). Unidentified risk factors for hepatitis B transmission. Infectious

Disease Clinics of North America, 30(4), 903-916.

Tribedi, K. (1994). Incidence of HBsAg among pregnant women in northern Nigeria.

Nigerian Journal of Clinical Practice, 4(2), 67-72.

World Health Organization. (2009). Global prevalence of hepatitis B virus infection.

Weekly Epidemiological Record, 84(40), 405-420.

World Health Organization. (2012). Mortality due to chronic hepatitis B infection.

Weekly Epidemiological Record, 87(28/29), 261-276.

World Health Organization. (2018). Transmission routes of hepatitis B virus.

Zhao, Y., & Chen, Y. (2010). Maternal HBV infection and gestational diabetes. Diabetes

Care, 33(11), e127.

23