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Seroprevalence and Associated Risk Factors of Hepatitis B Virus Infection Among Children in Enugu Metropolis
Maryann Chinenye Ezeilo1, Godwill Azeh Engwa2, Romanus Ifeanyi Iroha3
1Department of Microbiology, Godfrey Okoye University, Enugu, Nigeria.
Insights
Hepatitis B virus (HBV) infection affects 11.5% of children under six in Enugu, Nigeria. Vaccination is protective, but immunochromatographic test (ICT) strips show low sensitivity for diagnosing HBV.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hepatology
Background:
- Children under six in Nigeria are highly vulnerable to chronic Hepatitis B virus (HBV) infection.
- Routine screening is crucial for HBV control in children, but the performance of immunochromatographic test (ICT) strips is a concern.
- Identifying transmission risk factors in this age group is vital for implementing effective preventive strategies.
Purpose of the Study:
- To assess the diagnostic performance of the commonly used ICT strip for Hepatitis B virus (HBV) in children.
- To determine the prevalence of HBV infection in children under six years old in Enugu, Nigeria.
- To identify clinical manifestations and risk factors associated with HBV transmission in this pediatric population.
Main Methods:
- A cross-sectional study was conducted with 270 children under six years old in Enugu, Nigeria.
- Participants were screened for HBV using both ICT and ELISA assays.
- Data on demographics, socioeconomic status, clinical signs, symptoms, risk factors, and vaccination history were collected via a structured questionnaire.
Main Results:
- The prevalence of HBV infection, confirmed by ELISA, was 11.5% (31/270) in children under six.
- The ICT kit demonstrated low sensitivity (51.6%) but high specificity (100%) and accuracy (94.4%) for HBV diagnosis.
- Significant risk factors for HBV infection included blood transfusion, shared items, tattooing, and history of surgery. Vaccination showed a strong protective effect (OR: 0.068, p < 0.0001).
Conclusions:
- Hepatitis B virus (HBV) infection is prevalent in young children in Enugu, Nigeria, with an 11.5% infection rate.
- The routinely used ICT test is less reliable for diagnosing HBV infection compared to ELISA.
- Shared items, blood transfusions, tattooing, and surgical history are significant risk factors, while vaccination offers protection against HBV infection.
Background:
Though measures are being put in place for the management of Hepatitis B virus (HBV) infection in Nigeria, children remain the most vulnerable to develop chronic hepatitis. Routine screening in children is therefore necessary for effective control. However, the performance of the commonly used immunochromatographic test (ICT) strips has been challenging. Also, identifying the risk factors of transmission in this age group is of importance for the implementation of preventive measures. Hence, the goal of this study was to assess the test performance of the routinely used ICT strip and identify the associated clinical manifestations and risk factors of HBV.
Methods:
A cross sectional study involving 270 children below six years of age was conducted at ESUTH and Favor Child Pediatrics Hospital in Enugu, Nigeria. The subjects were screened for HBV by ICT and ELISA assays and a structured questionnaire was used to obtain participants data including demographic, socioeconomic, signs and symptoms, risk factors and vaccination.
Results:
BBased on ELISA, 31 out of 270 children were positive for HBV with an infection rate of 11.5%. ICT kit showed a low sensitivity of 51.6% in diagnosing HBV but was highly specific (100%) and accurate (94.4%). HBV infection was not associated with sex (χ2: 0.209; p = 0.401). The prevalence of HBV infection was similar in all the age group and HBV infection was not associated (χ2: 2.099; p = 0.914) with age group. All the clinical manifestations were not associated (p > 0.05) with HBV infection. Blood transfusion, shared items, tattoo marks and history of surgery associated significantly (p < 0.05) with HBV infections having odd ratios of 4.247, 4.224, 3.134 and 3.195 respectively. The vaccination rate was 55.2% (159/270) and only 3 (1.1%) out of 159 vaccinated subjected contracted the infection (OR: 0.068, p < 0.0001).
Conclusions:
HBV was prevalent (11.5%) in children below six years old in Enugu metropolis. Moreover, the routinely used ICT test was less reliable than ELISA in diagnosis HBV infection. More so, shared items, blood transfusion, tattooing and history of surgery were potential risk factors while vaccination served as a protective factor against the infection.
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