Hepatitis B, one of the major and common infectious diseases of the liver world wide it is caused by a small enveloped DNA virus, the hepatitis B virus (HBV). The virus was first discovered as “Australia antigen”, later named hepatitis B surface antigen (HBsAg), in patient blood. Hepatitis B e antigen (HBeAg) was identified several years later as a marker for patients at high risk for transmission of the disease (Tonget al,2005). It is estimated that more than two billion people have been infected by HBV world wide and 350 million people have chronic infection (Unekeet al,2005). When a pregnant woman is infected with HBV, there is a chance she may infect her foetus. It has been reported that 10 -20%of women seropositive for HBsAg transmit the virus to their neonates, but in women who are seropositive for both HBsAg and HBeAg, vertical transmission is approximately 90% (Vranckxet al,1999). Chronic HBV infection have been defined as carriage of HBsAg for at least 6 months and the highest risk (80 – 90%) of chronic infection have been found among infected neonates born to HBeAg positive carrier mothers followed (30%) by children infected before 6 years of age (Hyams,1995). Nigeria is classified among the group ofcountries endemic for HBV infection. Currentlyabout 18 million Nigerians are infected (Sirisenaet al,2002, Jomboet al,2005). Many of these people may not be aware of the infection and hence fail to seek appropriate medical attention therefore progressing to chronic liver disease, cirrhosis and hepatocellular carcinoma. Similarly when pregnant women are involved they constitute a serious health risk not only to their unborn child but also the society at large.
Although, studies have been carried out on HBV in other parts of the country, information is very scarce on the prevalence of HBV among pregnant women attending antenatal care in Federal Medical Centre Makurdi Benue State in comparison to General Hospital Nyanya, Abuja, FCT. As a result guidelines and other adequate information on the prevention and control strategies are lacking. The objectives of this study therefore are to determine the prevalence of hepatitis B virus carrier and infectivity status of carrier pregnant women in Makurdi/Nyanya and to provide information on its prevention and control strategies.
MATERIALS AND METHODS
Study Area :The study will be conducted in Makurdi/Nyanya metropolis which is located in an area covering about 16 square kilometer, in North-Central Nigeria. Its average annual rainfall is 1200mm and the average annual maximum temperature is 33.4oC. Makurdi is endowed with agricultural viability which attract people from many other parts of the country. Consequently, the area is reported to have the highest prevalence of sexually transmitted diseases(Federal Ministry of Health, 2003).
Nyanya is a sprawling cobweb of rusty and decrepit low-cost quarters, nestled on the foot of the rolling green peaks in the central area of Abuja, the Federal Capital Territory.
It is a stone throw from the highbrow Asokoro and Mogadishu Cantonment. It is located along a major route that serves as an artery linking the FCT and central part of the country.
It is a community populated by middle and low class public workers and others in the same category, who cannot afford the high cost of accommodation inside Abuja.
But unfortunately as is the nature of cleverly conceived schemes in this clime, a declining standard of living has set in the area arising from neglect and infrastructural decay, such that to residents and visitors, Nyanya is no more than a slum and an eyesore.
Though it is a satellite town divided into five areas for proper enumeration and served by a General Hospital plus a Squadron 21 Mobile Police Unit and the Nigeria Police Divisional Police Headquarters, its roads are deplorable and without a bus terminal, public park, market and adequate public schools.
Most Nyanya residents can’t access potable water while the sanitary condition in many houses is alarming because they are not linked to the central sewage plant.
Selection of Subjects.
All pregnant women attending antenatal care in the aforementioned hospitals in Makurdi/Nyanya metropolis will be eligible for the study. Participation will be voluntary and each subject involved in the study will give a written consent. The recruitment will be by a simple random sampling method to cover five months period. The ethical approval will be obtained from the ethical committee of Benue State Ministry of Health and Human Board of Services, Makurdi and FCTA Health Board.
The following information will be requested from the subjects in a structured questionnaire; age, occupation,marital status,previous use of contraceptive devices, smoking and alcoholic consumption, knowledge of HBV, any implications during any birth etc.Subjects will be asked whether they have suffer from jaundice or not and their blood group.
Collection of sample/Analysis
Five milliliter (5ml) of blood will be obtained by venopuncture. One milliliter (1ml) of the freshly collected blood will be introduced into an EDTA bottle for ABO blood grouping. The remaining (4ml) will be introduced into a clean test tube, allowed to clot naturally and separated by centrifugation at 1,500 revolutions per minute (rpm). Part of the sera collected will be tested for hepatitis B surface antigen (HBsAg) using latex rapid agglutination slide test kits (Cal – Tech Diagnostic, Inc. USA.) in the laboratories of the hospitals where the samples will be collected. Reactive samples will be stored at –20oC and further confirmed for HBsAg using commercially available enzyme linked immunosorbent assay kit (ELISA) (Bio Rad, France) in immunology laboratory. HBsAg positive samples will also be tested for HBeAg using ELISA kit (ORGENICS, Israel). Statistical Analysis Results will be obtained and subjected to statistical analysis using statistical package for social sciences (SPSS) version 11.Comparison of result from the two hospitals will be done using chi-square test while P values less than 0.05 will be considered significant.