Objective. To explore the underlying causes and take precautionary measures to control the spread of disease. Methodology. A Sample of around 50 Hepatitis patients visiting Services Hospital OPD were randomly selected and information gathered through filling of structured questionnaire to access gap in knowledge and practice regarding self care in hepatitis B, C among both Male and Female and socioeconomic factors contributing to hepatitis. prone lifestyle. Results. A Study was carried out among Hepatitis patients in Services Hospital OPD Lahore. Total 50 randomly selected patients 16 Male 26 Female were inducted in the study with age above equal or less than 50 Out of the 43 patients interviewed 762 were above the age of 40 years, 619 were females while 381 were males. The socioeconomic status was good. Income per Capita 3000 in 88 1 Percentage of exposure prior to diagnosis was 95 within 6 months and 90, 5 for more than 6 months. Conclusion. A Study revealed that the ratio of occurrence of Hepatits B, C awareness in that area is not satisfactory. People who were aware of this viral infection were not aware of its underlying factors and were constantly using those methods to spread the disease. Hence the null hypothesis was proved to be corrected. Key Words. Hepatitis B, Hepatitis C, Prevention, Causes Control.
Introduction. Hepatitis B and Hepatitis C have been one of the most endemic diseases of last two decades. By rough estimation around 8 people suffer from this disease out of 100 people. In Pakistan different researches have shown prevalence among different groups with varying degree of exposure to various risk factors. Hepatitis C has affected around 200 million people worldwide out of which around 10 million are in Pakistan. Hepatitis B also has major prevalence in Pakistan with around 9 million diseased individuals. Researches occurring between 2010 and 2015 interpreted that HCV sero prevalence among the Pakistani population is 6 8 while active HCV infection was found in approximately 6 of the population. These researches also showed that extremely high HCV prevalence in rural and underdeveloped peri urban areas up to 25. The prevalence of Hepatitis B. Surface Antigen HBs Ag and antibodies to hepatitis C, virus anti HCV in young healthy Pakistani adults in recent studies carried out in different cross sections of population has ranged 2 56 3 53 and 2 3 5 3. Literature for data on HBsAg and anti HCV, Ab prevalence and screening of the general population and five subgroups and used data for people who inject drugs. PWID and blood donors from two European organizations. Of 1759 and 468 papers found in the prevalence respectively HBsAg and anti HCV Ab prevalence in the general population ranged from 0 1 5 6 and 0 4 5 2 respectively by country. For PWID men who have sex with men and migrants the prevalence of HBsAg and anti HCV Ab was higher than the prevalence in the general population in all but 3 countries. The prevalence of HCV in the general population in Africa ranges between 0 1 and 17 5 depending on the country.
The countries with the highest prevalence include Egypt 17 5 Cameroon, 13 8 and Burundi 11 3. The countries with the lowest prevalence include Zambia, Kenya, Malawi and South Africa all with a prevalence 1. High risk populations include Intravenous drug users HIV infected patients on hemodialysis patients with history of blood transfusions or organ transplantation health care workers after needle stick injuries children born to HCV infected mothers. Also sexually active adults with multiple partners have higher prevalence rates. Available data on HCV reveal high prevalence in patients with hepatocellular carcinoma or chronic liver disease Burundi 55 Rwanda 45 7 and sexually transmitted diseases, Ethiopia 38 2. Countries with low HCV prevalence in high risk groups include Zimbabwe 1 3 and Kenya 1 7. To assess the prevalence of HBV and HCV among blood donors PWID and migrants alternative sources for data were used. These sources were the latest Council of Europe report on national blood donor data, data from the European Monitoring Centre for Drugs and Drug Addiction. EMCDDA database and an ECDC systematic review entitled Epidemiological assessment of hepatitis B. and C among migrants in the EU EEA. For HBV estimates that were considered representative for the general population in the risk of bias assessment were available for 13 countries where the prevalence ranged from 0 1. in Ireland to 4 4 in Romania For HCV prevalence estimates that were considered representative for the general population were available for 13 countries with the reported prevalence ranging from 0 1. Belgium Ireland and the Netherlands to 5, 9 Italy. Objectives 1. To understand the Prevalence of hepatitis B and C in Pakistan. Objectives 2. To investigate socioeconomic factors that are responsible for hepatitis B, C. Objectives 3. To know behavior and practices of patients regarding transmission of hepatitis B and C.
Hypothesis.Null hypothesis. The behavior and socioeconomic factors have no association with occurrence of disease. Alternative. The behavior and socioeconomic factors have association with occurrence of disease Methodology. Material and methods Setting Services Hospital Lahore Design Descriptive cross sectional studies. Duration 6 months. Universe All diagnosed patients of Hepatitis B, C visiting OPD Variables Predictor Variables: Age, Sex, Income, Level of education, Life style, Poor lifestyle, Inaccessibility to health care facilities, shared needles, born to case carrier, tattoo, acupuncture, piercing. Outcome Variables Hepatitis B, C. Operational Definition diagnosed cases by doctors visiting OPD for treatment. Study subjects Inclusion. All hepatitis B, C patients visiting OPD Exclusion co morbidity. Sample size 42 hepatitis patients presenting in OPD. Sample technique Convenient sampling, Non probability Tools of measurements. Questionnaire open and close ended structure questionnaire. Analysis Frequency percentages means and standard deviation were calculated for Continues numerical data. Proportions were found for categorical data. Chi square test was applied for testing the significance of association Results Table No 1. Variables Frequency Percent Gender Male 16 38 1 Female 26 61 9 Age 40 10 23 8 40 32 76 2. Education of respondent Literate 32 76 2 Illiterate. 10 23 8 Education of spouse Illiterate 35 83 3. Under Matric 7 16 7. Total family member 5 10 23 8 5 32 76 2. Income per capita per month 3000 5 11 9 3000 37 88 1. Hepatitis B, C diagnosed when 10 years 39 92 9 10 years 3 7 1. Going to quakes Yes 9 21 4 No 33 78 6. Blood transfusion Yes. 8 19 0 No 34 81 0 Ear Piercing Yes, 16 38 1 No 26 61 9 Tattooing Yes, 8 19 0 No 34 81 0 Extramarital relations No, 42 100 Homosexual multiple sex partners No, 42 100 Table No 2, Variables Frequency Percent Drug use Yes, 3 7 1 No 39 92 9 Shared needles Yes, 2 4 8 No, 40 95 2 Dental extraction Yes, 15 35 7 No 27 64 3 Organ tissue transplantation Yes, 7 16 7 No 35 83 3 Dialysis Yes, 2 4 8 No 40 95 2 Occupational exposure Yes, 4 9 5 No 38 90 5 Treatment taken from whom Doctor 41 97 6, Hakeem 1 2 4 Partner had hepatitis B vaccination Yes, 4 9 5 No 38 90 5 Vaccinate against Hepatitis B Yes, 5 11 9 No 37 88 1 counseling session for prevention of spreading of hepatitis Yes, 6 14 3 No 36 85 7 Ever had Kushta Steroids Yes, 1 2 4 No 41 97 6 History of taking anti tuberculosis Yes, 4 9 5 No 38 90 5 Ever had long term intake of steroids Yes, 2 4 8 No 40 95 2 Results A cross sectional study was done including cases of hepatitis B, C infections on the basis of consent from patients presenting in the outdoor clinic. The patients were interviewed using a pre formed questionnaire. The data was compiled and was analyzed by the calculation of frequency presentation means and standard deviation of the variable.
Proper times were found for categorical data. Chi square chart was applied to test the significance of association. Out of the 50 patients interviewed 76 2 were above the age of 40 years 61 9 were females while 38 1 were males the data collected shows females preponderance. The socioeconomic status was analyzed and the income per capita was 3000 in 88 1 and 3000 in 11 9 76 2 were literate. Total family member was 5 in 76 2 the duration of illness after provisional diagnosis was 10 in 7 1 while it was 1o years in 92 9 of the patients. Blood transfusion was the cause of infection in 19 1 of the patients. Ear piercing cause hepatitis 38 1 patients and tattooing caused hepatitis in 19 patients. 100 of the patients were not having extramarital sex partners. According to the data collected the underlying factors of the hepatitis like needle sharing caused hepatitis in 4, 8 of the patients dental extraction. in 37 7 organ tissue transplantation in 16 7 dialysis in 4 8 drug intake in 7 1 and occupational exposure in 9 5 of the patients. Reasons for the development of hepatitis were lack of hepatitis B vaccination in 88, lack of the fitness in 90 5, lack of counseling session for invention of spread of hepatitis in 85 7, 97 6 of the patients sought to be treated by doctor. Most of the P value were significant Discussion. The data was collected on the basis of a simple questionnaire According to the analysis data in this study there was 92 1. HBV positivity among the 50 individuals included HCV positivity was 7 9. The main focus however was the underlying factors causing hepatitis B, C presenting to the Services Hospital OPD. The factors listed in the questionnaire were the null hypothesis was developed on the notion that behavior and socioeconomic status had no relation with the development of complications in HBC. HCV positive individual results achieving insignificant results during the analysis of the collected data. We speculate that these insignificant values may be due to a small sample size a total 50 patients were interviewed.
Conclusion. According to the data collected and analyzed the results were conclusive of the fact that behaviors and socioeconomic statuses have no relationship with the development of complications in hepatitis B and C. Hence the null hypothesis was proved to be correct. Recommendation. Although there is no significant relationship between behavior and socioeconomic factors but still we have to create awareness among the masses not to indulge indecent behavior because it enhance the transmission hepatitis B, C. References 1 Devi KS Singh NB Mara J Singh TB Singh YM. Seroprevalence of Hepatitis B virus and Hepatitis C virus among hepatic disorders and injecting users in Manipur. A preliminary report Indian Journal of Medical Microbiology 2004 22 2 136 137 2. Erdem K Tas T Tekelioglu UY Bugra O Akkaya A Demirhan A et al The hepatitis B hepatitis C and human immunodeficiency virus seroprevalence of cardiac surgery patients SDÜ Tip Fak Derg 2013 14 17 20 3. Krasteva A Panov VI Garova M Velikova R Kisselova A Krastev Z Hepatitis B and C in Dentistry Journal of IMAB Annual Proceeding 2008 14 book 2 38 40. Scientific Papers 4 Abdul Mujeeb S Jamal Q Khanani R Iqbal N Kaher S Prevalence of hepatitis B surface antigen and HCV antibodies in hepatocellular carcinoma cases in Karachi Pakistan Trop Doct 1997 27 45 6 5. Luby SP Qamruddin K Shah AA Omair A Pasha O Khan AJ McCormick JB Hoodbhouy F Fisher Hock S The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad Punjab Epidemiol Infect 1997 119 349 56 10 1017. S0950 6 Zuckerman JN Zuckerman AJ Current topics in hepatitis B Journal of infections 2000 41 2 130 136 10 1053 jinf 2000 0720.