Perception And Attitude Of Pregnant Women Towards Hepatitis B Infection In Selected Clinics In Chanchiga LGA Niger State

ABSTRACT

The purpose of this study was to investigate the perception and attitude of pregnant women in the Chanchiga L.G.A on Hepatitis B and also ascertained the relationship between pregnant women’ perception and their practices on the prevention of hepatitis B. The study employed a descriptive cross-sectional survey design. Multistage sampling procedure was used to sample 300 pregnant women in towns in the Chanchiga L.G.A. Researcher generated questionnaire was the main instrument for the study. Frequency and percentages and Chi Square test of independence were used to analyze the data. The results revealed high knowledge, with positive attitude, and good practices, among pregnant women in Chanchiga L.G.A. There was correlation between pregnant women’ perception on hepatitis B and their practices. The study found that there is high knowledge, positive attitude and good practices among the pregnant women in the Chanchiga L.G.A and these are likely to influence positively the children that they raise, enable children dispense good attitude and will also help to reduce prevalence of Hepatitis B in the Chanchiga L.G.A. It was recommended that there is the need to improve upon the knowledge level of the pregnant women who exhibited low knowledge about Hepatitis B. The study also recommended that screening in the Towns must be made compulsory with education attached, and free compulsory vaccination program must be introduced among the pregnant women to help reduce prevalence of the disease.

 

CHAPTER ONE

INTRODUCTION

Background to the Study

Globally, two billion people have been infected with HBV at some point in time in their life time and 360 to 400 million people, which represents more than 5% of the world’s population, are chronic carriers with an estimated 600,000 deaths each year due to consequences of HBV. It is estimated to be the tenth cause of deaths worldwide (WHO, 2008). The incidence of acute hepatitis B varies greatly from country to country as a result of insufficient reliable data and comparisons between countries is often difficult due to different reporting systems with limited quality (Grob, 1995).

The WHO has therefore demarcated the world according to chronic hepatitis B prevalence into three major blocks which include high, intermediate and low prevalence (WHO, 2008). High prevalence areas have a prevalence of chronic hepatitis B infection that is equal to or greater than 8% made up of countries from North America, South America, Sub-Saharan Africa and most Asian countries. Intermediate prevalence areas have a prevalence rate which ranges between 2% and 7% and include countries from South America, North Africa, Western Europe, Eastern Europe and the Indian subcontinent. Low prevalence areas are estimated to have a prevalence of chronic infection less than (2%) which includes most of the North American countries, Australia and most of Western Europe including the United Kingdom.

New WHO data reveal that an estimated 325 million people worldwide are living with chronic hepatitis B virus (HBV) infection despite the fact that since 1982 there is a vaccine against HBV that gives 90-100% protection against the infection (WHO, 2017). The WHO Global hepatitis report, 2017 indicates that the large majority of these people lack access to life-saving testing and treatment. As a result, millions of people are at risk of a slow progression to chronic liver disease, cancer, and death (WHO). The consequence of this is that approximately 600 000 HBV related deaths every year around the world, where the cause is primary liver cirrhosis or liver cancer (Dunford et al., 2012; WHO, 2012).

The virus is transmitted differently between geographic regions and countries depending on how endemic the HBV is there. It is more common that the virus is transmitted through horizontal routes such as injecting drug use, high-risk sexual behaviour and receiving blood products in regions where the endemicity is low. When in regions with high endemicity, for example in Vietnam, HBV is primarily spread by vertical transmission early in childhood or perinatally, from mother to child at birth (Dunford et al., 2012). Even though all humans can be infected with HBV, Asians have the highest proportion (two thirds) of HBV-infected persons (The Hepatitis B Foundation, 2013).  HBV is endemic in Vietnam as in many other countries in Southeast Asia (Dunford et al., 2012) and it is the leading cause of chronic liver disease (Nguyen et al., 2008). Approximately 90% of the infants, who are infected during their first year, develop chronic liver infections later in life. About 25% of the adults who developed these infections die from infection related conditions, such as liver cirrhosis or liver cancer (CDC, 2013). According to Bui et al. (2002), in the article by Nguyen, Dore and McLaws (2008), 8-25% of the Vietnamese population are carriers of chronic hepatitis B. That is approximately 8.4 million Vietnamese individuals. It was estimated in the year of 2005 that this resulted in 23,300 HBV-related mortalities per year in Vietnam (Dunford et al., 2012).

Despite the long history of the disease in the country, there seems to be not much attention given to it by policy makers, health institutions, the general public and decision makers. Apart from the formation of the Nigeria Hepatitis B Foundation (NHBF) which started its operation in September, 2007, there have not been any bold and pragmatic measures put in place to curb the disease in the country. In the light of the lukewarm attitude shown towards Hepatitis B and due to acts of selective prevention of infectious diseases by health professionals including HB, the disease is said to be spreading fast with an estimated number of four million people as carriers (Nigeria Health Service [NHS], 2009).

National HIV prevalence is relatively low with 2.4% as an estimated rate as compared to an estimated prevalence rate of 12.8% for hepatitis B (Ofori-Asenso et al., 2016). Much attention is given to its prevention and treatment through health education programs and provision of anti-retroviral drugs to the neglect of equally deadly diseases like hepatitis B by Nigeria Health Service and other health related organizations. Meanwhile, few studies conducted in the country about HB revealed its continuous increase. In a hospital-based study conducted among blood donors, pregnant women and children among the general population revealed that HB is endemic in the country with prevalence rates ranging from 6.4% to 10% among blood donors, 6.4% pregnant women and 16% children among the general population respectively (Sarkodie, 2015; Abongwa & Kenneth, 2016). There is no programme for mass screening and vaccination of children born before vaccine introduction, no screening for mothers, adolescents and the general public (Diederike et al., 2003).  This work therefore sought to assess the perception and attitude of pregnant women towards HBV in order to proffer better prevention strategies.

Statement of the Problem

It is an undeniable fact that although hepatitis B screening and vaccination is carried out in some few health facilities in Nigeria, it is not a national policy and is not incorporated into national health policies like the free counseling and testing for HIV or the mass immunization of children against measles (NHS, 2012). Also, media publicity on the disease is not substantial as compared to other infectious diseases.

However, Mothers are considered to be endowed with knowledge and seen as role models in any society or community (Nguyen et al., 2008). Thus when mothers are equipped with information on Hepatitis B, they would help in the campaign against Hepatitis B infection. Data gathered from the Government hospital and clinics within the Chanchiga L.G.A revealed that most pregnant women tested positive to hepatitis B in health screening conducted. There is therefore the need to assess the perception and attitude of these pregnant women as far as hepatitis B is concerned.

Purpose of the Study

The purpose of the study was to investigate: the perception and attitude of pregnant women in the Chanchiga L.G.A on hepatitis B and its prevention and the relationship between pregnant women’ knowledge and their practices on the prevention of hepatitis B.

Research Questions

This research sought to answer the following questions.

What are the attitudes of pregnant women in Chanchiga L.G.A towards Hepatitis B and its Prevention?

What practices do pregnant women in Chanchiga L.G.A engage in order to prevent themselves from contracting hepatitis B?

What is the relationship between pregnant women’ perception and their practices on the prevention of hepatitis B?

 

Significance of the Study

This study would help improve the welfare of the citizens of the country and Pregnant women in particular. To use the research as an alarm blower in order to create awareness on hepatitis B prevention as a national health priority which will result in Non-Governmental Organizations (NGOs) and government’s commitment to increase funding for HB prevention awareness, research and other related activities.

Definition of Terms

Knowledge – Knowledge refers to the fact or condition of being aware of something or subject.

Attitudes – Attitude refers to the opinions and feelings that one has about something or subject.  

Practices – Practice is carrying on professional working practice with integration to theory.  

Hepatitis B virus (HBV) – HBV is a DNA virus that is transmitted by percutaneous injuries or per mucosal exposure to infectious blood products or other body fluids.

Pregnant women – Pregnant women pursuing Diploma in basic education programme at College of Education.

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