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THE SERO-PREVALENCE OF HEPATITIS B, HEPATITIS C AND CO HEPATITIS B AND C INFECTION AMONG CHILDREN WITH SICKLE CELL ANAEMIA SEEN IN HEALTH FACILITIES IN JOS
Abstract
The understanding of the viral causes of hepatitis has improved within the last two decades. The
prevalence of hepatitis B virus and hepatitis C virus infections differs from place to place where
transmission occurs through various avenues including household contacts, traditional and
cultural practices and factors related to hospitalization.
Sickle Cell Anaemia is an inherited blood disorder. Children with this disorder, who are prone
to complications, get treated with traditional practices or require frequent procedures during
hospitalization which all carry potential risks of transmitting hepatitis B and C virus infection.
Due to paucity of data on prevalence of hepatitis B and C virus among children with sickle cell
anaemia in Jos, this study was carried out to determine the prevalence of hepatitis B and C virus
infection in children with sickle cell anaemia in Jos. This was achieved by determining the sero
prevalence of hepatitis B, C and B and C co-infection, determining the role and influence of
demographic characteristics on the prevalence of hepatitis B and C infections and determining
the risk factors for hepatitis B and C infection in children attending sickle cell clinics in Jos.
Using stratified sampling, 319 subjects attending sickle cell clinics of 4 health facilities (tertiary
and secondary) in Jos, Plateau State were selected. Five millilitres of blood were drawn from
each subject and tested for the surface antigen marker for hepatitis B and antibody marker for
hepatitis C using the ACON and PISTIS OneStep test strips respectively.
Four (1.3%) of the subjects were HBV positive, 9 (2.8%) were HCV positive and 1 hepatitis B
and C co-infection (0.3%). There were significant associations between place of residence
among those residing outside the state capital but within Plateau State and hepatitis C
(p=0.005) as well as co hepatitis B and C infection (p=0.003). The following demographic factors had significant associations with hepatitis C: Subjects born before 2006, the period when there was full implementation of blood screening for hepatitis C in Jos, were at more risk of being sero-positive for hepatitis C (p=0.04). There was also an association between the duration the subjects had been diagnosed with Sickle Cell Anaemia (<5years, 5-10 years and > 10 years) with being sero-positive for hepatitis C (p=0.018). No association was seen between hepatitis B or C with gender, tribe, health facilities nor social class (p>0.05).
Uvulectomy was significantly associated with hepatitis B (p=0.013, OR 38.63, CI 2.2:673.97)
while uvulectomy (p=0.006, OR 7.36, CI 1.9:28.46), tattoos (p<0.001, OR 19.25, CI
1.58:234.75) close contact of more than 4 persons sharing the same room (p<0.001, OR 13.5,
CI 3.25:56.14) and exposure to family member with history of hepatitis C (p<0.001, OR 38.63,
CI2.2, 673.97) were significantly associated with hepatitis C.
There was no association seen with formal education and employment status of the parents,
scarification/marks, ear piercing, circumcision, a history of an ulcer, exposure to a family
member with hepatitis B, immunization to hepatitis B, overcrowding of more than 7 in a house,
hospital admissions, blood transfusion, needle injections, jaundice, a hepatomegaly and liver
function test (p< 0.05) for both hepatitis B and C.
The prevalences of hepatitis B and C infection and hepatitis B and hepatitis C co-infection
were lower than those seen in other places in Nigeria. Sickle cell children residing within
Plateau State but outside Jos as well as those diagnosed for more than 9 years had significant
risk of seropositivity for hepatitis C. There was no difference in prevalence of either hepatitis
B or C in the immunised and non-immunised subjects.
