CHAPTER ONE

INTRODUCTION

 1.1 Background

Hepatitis is an inflammation of the liver characterized by the presence of inflammatory cells in the tissue of the organ (Ryder et al., 2001). It may occur with limited or no symptoms, but often leads to jaundice. Hepatitis is acute when it last less than six months and chronic when it persist longer. A group of viruses known as the hepatitis viruses cause most of the hepatitis worldwide , but it can also be due to toxins (notably alcohol, certain medication and plants) ( Ahmedin  et al., 2004) .The hepatitis virus is found in the blood and other body fluid and is transmitted from person to person, the most common route of infection includes blood transfusion and blood product when there is no screening for blood born viruses , medical or dental intervention in countries where equipment is not adequately sterilized mother to infant during childbirth, sexual transmission( in the case of hepatitis B) sharing equipment for injections drugs , sharing toothbrushes, or other house hold articles and body piercing if done using unsterile equipment (Redmond et al .,2007) . The hepatitis B virus is spread between people through contact with the blood or other body fluids (semen, vagina fluid and saliva) of an infected person, while hepatitis C is spread through direct contact with infected blood. Rarely it can be passed on  through body fluid (Ahmad  et al .,2006).

Hepatitis B is a major disease of serious global public health proportion. It is preventable with safe and effective vaccine that have been available since 1982 (Mohammed et al ., 2003). Of the 2 billion people who have been infected with the hepatitis B virus ( HBV) globally, more than 350 million have chronic ( long life) infection and  are at risks of serious illness and death from cirrhosis and hepatocellular carcinoma(Asfaw ; Zufan  et al ., 2011). Hepatitis C is a viral infection of the liver and is the most common blood-born (direct contact with human blood) infection. The major causes of HCV infection worldwide are use of unscreened blood transfusion and re- use of needles and syringes that have not been adequately sterilized. Almost 50% of the all cases become chronic carriers and are at risk of liver cirrhosis and liver cancer .It is estimated that burden of HCV in the world is 13%(Solomon et al ., 2013), WHO estimated that the prevalence of HBV in Africa is 10%(Belay et al ., 2012) . In Cameroon with estimated population of 27 million has a prevalence of 4.9% of hepatitis C and the prevalence of hepatitis B is 11.2% (Ahmed et al., 2016; Bigna et al., 2017).  The prevalence of Hepatitis B and C in Buea are 5.7% and 1.9% respectively ( Nkeneh  et al ., 2017). People with viral hepatitis who develop end-stage complications such as cirrhosis have a high risks of mortality .(Ally et al .,2017).Thus the current study aimed at investigating the prevalence and possible  factors associated with Hepatitis B and C infection among patients in Mount Mary hospital

1.2 Statement of problem

Hepatitis B and C are major health problems that causes thousands of death worldwide because of end stage liver diseases, hepatitis B and C affect people of all age groups .Although there is a vaccine against hepatitis B. In recent years the prevalence of both infection has increased especially in the sub-Saharan region including Cameroon.

During the researcher clinical internship practice, there were many patients diagnosed of hepatitis B and C. There is scarcity of data on hepatitis B and C coinfection in Buea South West Region. What is the current burden of HBV and HCV co- infection among patients attending Mount Mary Hospital? Thus the need for this study.

1.3 Research questions

What knowledge do patients attending Mount Mary Hospital have on hepatitis B and C viral infection?

What is the prevalence of hepatitis B and C co-infection among patients attending Mount Mary Hospital?

What are the factors associated with hepatitis B and C co- infection among patients attending Mount Mary Hospital.

1.4 Research Objectives

1.4.1 General Objective

To determine the prevalence and factors associated with hepatitis B and C co-infection among patients attending Mount Mary Hospital.

1.4.2 Specific Objectives

To assess the knowledge of hepatitis B and C co-infection among patients attending Mount Mary Hospital.

To determine the prevalence of hepatitis B and C co-infection among patient attending Mount Mary Hospital.

To identify the factors associated with hepatitis B and C co-infection among patients attending Mount Mary Hospital.