Indian J Gastroenterol DOI 10.1007/s12664-014-0479-6
LETTER
Knowledge and attitudes of students towards viral hepatitis B and C at the University of Lome A. Bagny & O. Bouglouga & M. A. Djibril & Y. L. Kaaga & A. Dusabe & A. L. M. Lawson & D. H. Sama & D. Redah
# Indian Society of Gastroenterology 2014
Sir: Viral hepatitis B (HBV) and C (HCV) constitute a serious hindrance to public health worldwide and particularly in the sub-Saharan Africa with regard to their frequency and the subsequent complications and socioeconomic consequences they cause [1]. In Togo, those viruses cause fearsome complications such as cirrhosis and hepatocellular carcinoma (HCC), very often among the youth [2]. Research [3–5] shows that a great deal of work needs to be done in the fields of communication and education of the masses in order to raise their awareness about the viral hepatitis B and C. To evaluate the rate of knowledge, attitudes, and behavior in a young population of our country, we engaged on a descriptive study among students who have registered at the University of Lomé for the academic year 2012–2013 in schools and faculties different from the faculty of health. The survey was performed using an anonymous questionnaire of three parts: (1) sociodemographic information, (2) knowledge about viral hepatitis B and C, and (3) behavior and attitude of students on viral hepatitis B and C. Six hundred students (401 male) aged 22.9±7 years (mean+ SD) were included. The study revealed that hepatitis B was better known (71.6 %) than hepatitis C. The media were the main sources of information (91.9 %) that made this knowledge A. Bagny (*) : O. Bouglouga : Y. L. Kaaga : A. L. M. Lawson : D. Redah Department of Gastroenterology, Teaching Hospital Campus, 15BP110 Lomé, Togo e-mail: [email protected] A. Dusabe Psychiatric and Psychological Clinic, Teaching Hospital Campus, 15BP110 Lomé, Togo M. A. Djibril : D. H. Sama Department of Internal Medicine, Teaching Hospital Tokoin, 15BP110 Lomé, Togo
possible. Knowledge about viral hepatitis B and C was quite untouched in the teachings given in our schools (20.5 %). Clinical manifestations such as fever (43.8 %) and asthenia (38.5 %) were remarkably unknown to the students; 26 % of them did not know that viral hepatitis B and C were contagious. The modes of contamination and the risk factors (Table 1) such as intravenous drug habit (41.3 %), tattooing or piercing (24 %), and acupuncture or piercing (14.1 %) were not sufficiently known to the students. To the majority of them (92 %), there exists a modern treatment against viral hepatitis B and C. All of them thought it was abnormal to discriminate against viral hepatitis B- and/or C-infected people. Most of them (87.6 %) used to take particular measures to avoid being contaminated by those diseases. Only 34.7 % of them got vaccinated against hepatitis B. 10.6 % knew they were HBsAg-infected while 2.1 % knew they were carriers of hepatitis C. In contrast to others [3, 5–7], our study addressed students who were not in a medical school. The idea behind this choice was to avoid over-assessment of the knowledge of the students, given the fact that medical students had in their curricula courses on viral hepatitis. Only 20.5 % of the students heard of viral hepatitis in school before; that is what justifies the need to employing many more teachers who can give lessons on viral hepatitis in the public schools of our country. The knowledge of the modes of transmission and risk factors by the students were also insufficient and superficial. Other authors [3, 8] already had underlined in their studies that despite the knowledge of HBV, the subjects of their studies had only superficial and insufficient knowledge of about HBV. Considering the students who had a notion about the existence of HBV and HCV, the rate of their knowledge about the existence of a modern efficient treatment against those viruses and about the existence of a vaccine against HBV was fairly good. However, only 34.7 % of the students were vaccinated, and this is essentially due to the lack of financial means. In Togo, vaccination against HBV is free of charge only when it is incorporated to the extended vaccination
Indian J Gastroenterol Table 1 Knowledge of students about the mode of transmission of viral hepatitis B and C
References
Mode of transmission
Size (n)
Percentage (%)
Nonprotected sexual intercourse Blood transfusion Intraveous drug habit Blood-stained objects
333 313 248 200
55.5 52.1 41.3 33.3
Mother to son transmission Tattooing and/or piercing Acupuncture Drinking out of a hepatitis-infected person’s cup Bite of a mosquito By shaking hands with an infected person
165 144 85 342
27.5 24 14.1 57
16 57
02.6 09.5
1. Benie J, Tiembre I, Ekra D, et al. Connaissances attitudes et pratiques du personnel de santé sur l’hépatite virale B dans la commune de Treichville. Cah sante publique. 2008;7:7–16. 2. Bouglouga O, Bagny A, Djibril MA, et al. Aspects épidémiologiques diagnostiques et évolutifs d la cirrhose hépatique dans le service d’hépato-gastroentérologie du CHU Campus de Lomé. J Rech Sci Univ Lomé(Togo). 2012,série D, 14:1-7. 3. Lohouès-Kouacou MJ, Ouattara A, Assi C, et al. Impact positif d’un film éducatif sur la connaissance de l’hépatite virale B par les élèves à Agnibilékro en Cote d’ivoire. J Afr Hepatol Gastroenterol. 2013;7: 22–6. 4. Bagny A, Bouglouga O, Djibril MA, et al. Connaissances, attitudes et pratiques du personnel soignant sur le risque de transmission des hépatites virales B et C en milieu hospitalier au Togo. Méd Santé Trop. 2013;23:300–3. 5. Prodanovska-Stojcevska V, Isjanovska R, Popova-Ramova E. HCV infection awareness in nursing students. Arth Hig Rada Toksikol. 2010;61:197–201. 6. Anjum Q, Siddiqui H, Ahmed Y, et al. Knowledge of students regarding hepatitis and HIV/AIDS of a private medical university in Karachi. J Pak Med Assoc. 2005;55:285–8. 7. Kagan I, Ovadia KL, Kaneti T. Perceived knowledge of blood-borne pathogens and avoidance of contact with infected patients. J Nurs Scholarsh. 2009;41:13–9. 8. Thaver AM, Kamal A. Impact of information sources on the knowledge of adolescents about hepatitis B. J Pak Med Assoc. 2010;60: 1072–5. 9. Cormier M. The role of hepatitis C supports groups. Gastroenterol Nurs. 2005;28:4–9. 10. Zacks S, Beavers K, Theodore D, et al. Social stigmatization and hepatitis C virus infections. J Clin Gastroenterol. 2006;40:220–4.
program (EVP) of children below 2 years old. These results show the need there is to encourage the setting up of measures of prevention of viral hepatitis B and C. All our students (100 %) were against the principle of discriminating against infected persons. Our results are contrary to those of other researchers [5, 9, 10] who showed in their studies before us that there was a tendency to stigmatize HBV- and HCV-infected people. The knowledge of students about viral hepatitis B and C viruses were insufficient and superficial and particularly with regard to clinical manifestations, risk factors, and prevention measures.
LETTER
Knowledge and attitudes of students towards viral hepatitis B and C at the University of Lome A. Bagny & O. Bouglouga & M. A. Djibril & Y. L. Kaaga & A. Dusabe & A. L. M. Lawson & D. H. Sama & D. Redah
# Indian Society of Gastroenterology 2014
Sir: Viral hepatitis B (HBV) and C (HCV) constitute a serious hindrance to public health worldwide and particularly in the sub-Saharan Africa with regard to their frequency and the subsequent complications and socioeconomic consequences they cause [1]. In Togo, those viruses cause fearsome complications such as cirrhosis and hepatocellular carcinoma (HCC), very often among the youth [2]. Research [3–5] shows that a great deal of work needs to be done in the fields of communication and education of the masses in order to raise their awareness about the viral hepatitis B and C. To evaluate the rate of knowledge, attitudes, and behavior in a young population of our country, we engaged on a descriptive study among students who have registered at the University of Lomé for the academic year 2012–2013 in schools and faculties different from the faculty of health. The survey was performed using an anonymous questionnaire of three parts: (1) sociodemographic information, (2) knowledge about viral hepatitis B and C, and (3) behavior and attitude of students on viral hepatitis B and C. Six hundred students (401 male) aged 22.9±7 years (mean+ SD) were included. The study revealed that hepatitis B was better known (71.6 %) than hepatitis C. The media were the main sources of information (91.9 %) that made this knowledge A. Bagny (*) : O. Bouglouga : Y. L. Kaaga : A. L. M. Lawson : D. Redah Department of Gastroenterology, Teaching Hospital Campus, 15BP110 Lomé, Togo e-mail: [email protected] A. Dusabe Psychiatric and Psychological Clinic, Teaching Hospital Campus, 15BP110 Lomé, Togo M. A. Djibril : D. H. Sama Department of Internal Medicine, Teaching Hospital Tokoin, 15BP110 Lomé, Togo
possible. Knowledge about viral hepatitis B and C was quite untouched in the teachings given in our schools (20.5 %). Clinical manifestations such as fever (43.8 %) and asthenia (38.5 %) were remarkably unknown to the students; 26 % of them did not know that viral hepatitis B and C were contagious. The modes of contamination and the risk factors (Table 1) such as intravenous drug habit (41.3 %), tattooing or piercing (24 %), and acupuncture or piercing (14.1 %) were not sufficiently known to the students. To the majority of them (92 %), there exists a modern treatment against viral hepatitis B and C. All of them thought it was abnormal to discriminate against viral hepatitis B- and/or C-infected people. Most of them (87.6 %) used to take particular measures to avoid being contaminated by those diseases. Only 34.7 % of them got vaccinated against hepatitis B. 10.6 % knew they were HBsAg-infected while 2.1 % knew they were carriers of hepatitis C. In contrast to others [3, 5–7], our study addressed students who were not in a medical school. The idea behind this choice was to avoid over-assessment of the knowledge of the students, given the fact that medical students had in their curricula courses on viral hepatitis. Only 20.5 % of the students heard of viral hepatitis in school before; that is what justifies the need to employing many more teachers who can give lessons on viral hepatitis in the public schools of our country. The knowledge of the modes of transmission and risk factors by the students were also insufficient and superficial. Other authors [3, 8] already had underlined in their studies that despite the knowledge of HBV, the subjects of their studies had only superficial and insufficient knowledge of about HBV. Considering the students who had a notion about the existence of HBV and HCV, the rate of their knowledge about the existence of a modern efficient treatment against those viruses and about the existence of a vaccine against HBV was fairly good. However, only 34.7 % of the students were vaccinated, and this is essentially due to the lack of financial means. In Togo, vaccination against HBV is free of charge only when it is incorporated to the extended vaccination
Indian J Gastroenterol Table 1 Knowledge of students about the mode of transmission of viral hepatitis B and C
References
Mode of transmission
Size (n)
Percentage (%)
Nonprotected sexual intercourse Blood transfusion Intraveous drug habit Blood-stained objects
333 313 248 200
55.5 52.1 41.3 33.3
Mother to son transmission Tattooing and/or piercing Acupuncture Drinking out of a hepatitis-infected person’s cup Bite of a mosquito By shaking hands with an infected person
165 144 85 342
27.5 24 14.1 57
16 57
02.6 09.5
1. Benie J, Tiembre I, Ekra D, et al. Connaissances attitudes et pratiques du personnel de santé sur l’hépatite virale B dans la commune de Treichville. Cah sante publique. 2008;7:7–16. 2. Bouglouga O, Bagny A, Djibril MA, et al. Aspects épidémiologiques diagnostiques et évolutifs d la cirrhose hépatique dans le service d’hépato-gastroentérologie du CHU Campus de Lomé. J Rech Sci Univ Lomé(Togo). 2012,série D, 14:1-7. 3. Lohouès-Kouacou MJ, Ouattara A, Assi C, et al. Impact positif d’un film éducatif sur la connaissance de l’hépatite virale B par les élèves à Agnibilékro en Cote d’ivoire. J Afr Hepatol Gastroenterol. 2013;7: 22–6. 4. Bagny A, Bouglouga O, Djibril MA, et al. Connaissances, attitudes et pratiques du personnel soignant sur le risque de transmission des hépatites virales B et C en milieu hospitalier au Togo. Méd Santé Trop. 2013;23:300–3. 5. Prodanovska-Stojcevska V, Isjanovska R, Popova-Ramova E. HCV infection awareness in nursing students. Arth Hig Rada Toksikol. 2010;61:197–201. 6. Anjum Q, Siddiqui H, Ahmed Y, et al. Knowledge of students regarding hepatitis and HIV/AIDS of a private medical university in Karachi. J Pak Med Assoc. 2005;55:285–8. 7. Kagan I, Ovadia KL, Kaneti T. Perceived knowledge of blood-borne pathogens and avoidance of contact with infected patients. J Nurs Scholarsh. 2009;41:13–9. 8. Thaver AM, Kamal A. Impact of information sources on the knowledge of adolescents about hepatitis B. J Pak Med Assoc. 2010;60: 1072–5. 9. Cormier M. The role of hepatitis C supports groups. Gastroenterol Nurs. 2005;28:4–9. 10. Zacks S, Beavers K, Theodore D, et al. Social stigmatization and hepatitis C virus infections. J Clin Gastroenterol. 2006;40:220–4.
program (EVP) of children below 2 years old. These results show the need there is to encourage the setting up of measures of prevention of viral hepatitis B and C. All our students (100 %) were against the principle of discriminating against infected persons. Our results are contrary to those of other researchers [5, 9, 10] who showed in their studies before us that there was a tendency to stigmatize HBV- and HCV-infected people. The knowledge of students about viral hepatitis B and C viruses were insufficient and superficial and particularly with regard to clinical manifestations, risk factors, and prevention measures.
