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American Journal of Public Health Research
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The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

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The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

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Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
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Anne Lanham, Lillian Mwanri

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A Comparative Study on Hepatitis B Surface Antigen Seroprevalence between Outpatients in Public and Private Hospitals within Kaduna Metropolis Nigeria

Waje Timothy*, Muhammad Yusha’u, Dadah Anthony, Maikaje Dominic Bawa

Department of Microbiology, Faculty of Science, Kaduna State University, P.M.B.2339, Kaduna, Nigeria

Abstract: Viral hepatitis which is characterized by inflammation and damage to the liver due to prolong infections by Hepatitis viruses is a rising global problem, especially in developing countries including Nigeria. Over 350 million people suffer chronically from Hepatitis B Virus infection. Hepatitis B surface antigen (HBsAg), though disappears after six months in acute cases, is a marker for the Hepatitis B Virus in chronic infections. Three hundred Outpatients in six hospitals were sampled in this study. One hundred and fifty samples were collected in equal proportion from outpatients in 3 public hospitals and the other 150 samples from 3 private hospitals within the Kaduna metropolis respectively. They were screened for HBsAg which is a marker for HBV infections. A prevalence rate of 9.33% was obtained among outpatients in public hospitals and 10.67% among those in private hospitals. This prevalence rates were both categorized as high based on the World Health Organization endemicity classification for HBV infections. There were significant associations between Rhesus factor (), sharing of clothes or beddings infected persons (), persons from positive family history (), Individual level of education () and seropositivity for HBsAg. These were observed as potential risk factors among outpatients in private hospitals. On the other hand there were no significant associations between the risks factors above and HBsAg seroprevalence among outpatients in public hospitals.

Keywords: Comparative, Hepatitis B Virus, Hepatitis B surface Antigen, Seroprevalence, Public Hospitals, Private Hospitals, Kaduna Nigeria

Citation: Waje Timothy, Muhammad Yusha’u, Dadah Anthony, Maikaje Dominic Bawa, A Comparative Study on Hepatitis B Surface Antigen Seroprevalence between Outpatients in Public and Private Hospitals within Kaduna Metropolis Nigeria. American Journal of Epidemiology and Infectious Disease, 4 (3). 47-63. January 2016. doi:10.12691/ajeid-4-3-2

1. Introduction

Hepatitis B Virus formerly known as the “Dane particle” is among the hepatotropic viruses that cause inflammation and damage to the human liver resulting to hepatitis disease on prolong infections [1]. The Virus pose a significant health problem around the globe and account for about 350 million chronic cases with over 20 million new ones arising yearly [2,3]. Prevalence of the virus is more in developing countries including Nigeria [4]. The Hepatitis B Virus contains an envelope, a double stranded circular DNA, a relatively complex structure and belongs to a class of viruses called Orthohepadnavirus of the hepadnaviridae family [5,6]. Like other Viruses, the Hepatitis B Virus is capable of replication producing viral particles but with a complex surface antigen known as Hepatitis B surfaceAntigen (HBsAg) [4]. The Hepatitis B surface antigen (HBsAg) though disappears during acute infections within six months, still serves as a marker for chronic infection on persistence for a long time [7]. Common complication associated with Hepatitis B Viral infection include chronic liver disease leading to either cirrhosis or hepatocellular carcinoma [8]. The virus can be transmitted through the use of contaminated sharp objects like needles / blades in tattooing or ear piercing, also sexually and through small tissue tears opened to contact with body fluids and secretions like saliva, semen and vaginal secretions from infected persons [1]. Intravenous injections in either medical treatment or on illegal drug use as well as contaminations with traces of blood from infected persons may transmit HBV [7]. Perinatal transmission also occur from mother to unborn infants [9]. Symptoms of Hepatitis B Viral infections among others include: fatigue, loss of appetite, nausea vomiting and dark urine [1,5,6]. Previous studies in Nigeria have reported Incidence of Hepatitis B Viral infections among sickle celled anemic children, prevalence rates of 18% among blood donors at Abubakar Tafawa Balewa University Teaching Hospital Bauchi, 10% among mentally ill persons in the University of Ibadan Teaching Hospital, 12% among outpatients attending a public Tertiary Hospital in Kaduna State, Nigeria,9.2% in a Tertiary institution in North West Nigeria [4,10,11,12,13]. Individual at risk of Hepatitis B infections include injection drug users, health care personnel, blood and organ recipients, haemodialysis patients and staff, highly promiscuous persons and children born by infected mothers [1,9,13]. The use of available vaccines play an important role in the control of the virus [9]. The study was conducted in private and public hospitals to make assessment of the disease burden among outpatients in these hospitals whose patronage is determined by their financial status. Medical bills in the public hospitals are relatively less than those of the private hospitals. More so, all patients are at liberty to choose the type of hospital to attend except on medical referral. This research work aimed at determining the seroprevalence of HBsAg among outpatients and making comparisons between the respective seroprevalence of the study groups in relation to key risk factors. The hypothesis tested is the association between positivity for HBsAg and certain risk factors among the study subjects using Chi Square test for independence between two variables.

The null hypothesis “There is no close/significant association between outpatients HBsAg seropositivity and a particular risk factor”. Seropositivity for HBsAg and a particular risk factor are independent

The alternative Hypothesis “There is a close/significant association between outpatients HBsAg seropositivity and a particular risk factor”. That is, HBsAg seropositivity and a particular risk factor are completely dependent.

The significance of this work was to assess the Hepatitis B Virus disease burden with a view of making key recommendations that could mitigate spread and improve public health among the inhabitants of the metropolis.

2. Materials and Methods

The study was conducted in six hospitals within the Kaduna metropolis. Three hospitals were public and three were private hospitals. Ethical approval was obtained from the Kaduna State Ministry of Health ethical Committee to visit each of the selected hospital. The study population included all gender and children from age one to the elderly at age ninety. Participants were well informed about the study and its relevance and their consents to participate in the study were sought through the use of positive consent forms. Questionnaires were issued to those that responded positively to the consent forms to provide Socio demographic information as well as possibly risk factors associated with HBV transmission [13].

A total of 300 samples were collected in all. Fifty samples were taken from each hospital making 150 samples from 3 public hospitals and 150 from 3 private hospitals [13,14]. Three milliliters of blood was collected intravenously from each consented patient from the different hospitals using a 5 ml syringe and transferred immediately into a plain bottle with the corresponding label for the patient. The samples were taken to the Microbiology laboratory of Kaduna State University, Kaduna for processing.

Serum was separated from each blood sample by centrifuging at 1000 rpm for 5 minutes and used for testing the presence of HBsAg using an in vitro one step rapid test kits for the detection of HBsAg in human serum/Plasma (ISO 13485 Certified Wondfo Biotech Co,Ltd. USA). Positive results were read based on the appearance of distinct color bands in the test region and the control region of the test strip indicating the presence of detectable amount of HBsAg The appearance of color band in only the control region indicate absence of HBsAg (Manufacturer’s instruction or interpretation).The Result was organized according to demographic and other possible risk factors respectively. Chi square test for independence between two variables was used for testing the associations between HBsAg seropositivity and potential risk factors at 5% level of significance.

3. Results

Among the 150 samples from outpatients in public hospitals analyzed, 14 were positive for HBsAg. These accounted for 9.33% of the total samples collected from these hospitals. In contrast, 16 samples were found to be positive for HBsAg making 10.67% of the 150 samples analyzed from outpatients in private hospitals (Table 1).

Table 1. Seroprevalence of HBsAg among outpatients attending Public and Private Hospitals in Kaduna metropolis, Nigeria

The highest prevalence in relation to age observed among outpatients in public hospital was within ages 31-40 years (19.05%, mean age = 30.10, CI=30.10 years). However, more prevalence was observed among subjects within ages 11-20 years (28.57%, mean age = 34.30, CI=34.30 years) from outpatients in private hospitals. No positive sample was observed among outpatients within age group 41-90 years in public hospitals. On the other hand a prevalence of 17.86% was observed among those within ages 41-50 years in private hospitals. There was no positive case among outpatients within age group 51-90 years in private hospitals. There were no statistical significant associations between age and seroprevalence of HBsAg in samples from either public (P≤0.28) or private hospitals (P≤0.41) (Table 2).

Table 2. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis Nigeria, in relation to Age

Out of the fifty two male samples analyzed from public hospitals outpatients, three (5.77%) were positive for HBsAg. Ninety eight (98) samples were from females with 11 (11.22%) positive cases. Among the samples from private hospitals, 62 were from males and 8 (12.90%) were found positive for HBsAg while 88 samples from females with 8 (9.09) positive for HBsAg. There were no statistical significant association between Sex and HBsAg seropositivity among outpatients in public (P≤0.28) and private (P≤0.46) hospitals respectively (Table 3).

Table 3. Seroprevalence of HBsAg among outpatients attending Public and Private Hospital within Kaduna Metropolis, Nigeria in relation to Sex

Table 4 shows the seroprevalence of HBsAg in relation to marital status. The highest prevalence of HBsAg was observed among the married attending either public (11.34%) or private hospitals (11.11%).No positive case was observed among the widowed (0.00%), separated (0.00%) and the divorced (0.00%) outpatients in either public or private hospitals. There was no statistical significant association between seropositivity of HBsAg and marital status among samples from public or private hospitals (P≤0.83, P≤0.99) respectively.

Table 4. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relations to Marital Status

Patients from public hospitals with blood group O had the highest seroprevalence of HBsAg (13.51%). No positive case was observed among those with blood group AB (0.00%) On the other hand, analysis of samples of outpatients from private hospitals revealed more seroprevalence of HBsAg to be among those with blood group B (14.71%) with the leas observed amongst blood group A outpatients (8.33%) (Table 5).

Table 5. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relations to Blood Group

Though more Rhesus positive outpatients were encountered in this study (141/i50) from public and (143/150) from private hospitals respectively, 13 (9.22%) were positive among samples from public hospitals and 13 (9.09%) also positive in samples from private hospitals. More prevalence was observed among Rhesus negative outpatients in public (11.11%) and among those from private (42.86%) hospitals respectively. There was no statistical significant association between Rhesus factor and seropositivity for HBsAg among outpatients in public hospitals (P≤0.85) but a significant association was observed between seropositivity for HBsAg and Rhesus factor among samples from private hospitals (P≤0.01) (Table 6).

Table 6. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relations to Rhesus Reaction

There were no statistical significant associations between seropositivity of HBsAg and the respective outpatients’ clinical history at a 0.05 level of significance on samples from both public and private hospitals (Table7).

Table 7. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relation to individual clinical history

No statistical significant association was observed between seropositivity for HBsAg and educational status on samples from public hospitals (). The highest prevalence was observed among Secondary School patients (13.85%).However, there was a significant association between seropositivity for HBsAg and Education Status on samples collected from private hospitals (). The highest prevalence was also observed among secondary school level patients (26.67%) (Table 8).

Table 8. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relation to individual level of Education

The respective social factors in Table 9 showed no statistical significant associations with HBsAg Seropositivity for samples from public hospitals. However, significant associations were observed between some of these factors and HBsAg seropositivity among outpatients in private hospital such as: patients sharing clothes /Beddings (7.46%, P≤0.001 and those from seropositive families (28.57%, P≤0.02).

Table 9. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relation to Social Factors

In Table 10, the highest prevalence observed on samples from public hospitals was from Business men and women (14.29%). No positive case was observed among the unemployed attending either public or private hospitals (0.00%) respectively. The highest prevalence observed among outpatients in private hospitals was among unskilled workers (20.00%).The “others” consist of Farmers, Students and clergies (14.29%).There were no significant associations between seropositivity of HBsAg and Occupation for samples from either public (P≤0.52) or private (P≤0.49) hospitals respectively.

Table 10. Seroprevalence of HBsAg among outpatients in Public and Private Hospitals within Kaduna Metropolis, Nigeria in relation to Occupation

4. Discussions

Public hospitals have a higher patronage by patients of low economic status than those of high class. The reverse is the case regarding the patronage of private hospitals. This could probably be due to the high medical bills in the private than those in the public hospitals. Most times, the patronage is determined by financial availability. Patients are at liberty for choice of hospital type to attend for medical attention except in the case of referral. In most cases, the economic base of the patient and family plays a key role in selection of where to seek for medical attention where cost becomes a factor.

The 9.33% and 10.67% prevalence rates observed from outpatients in public and private hospitals respectively are regarded as high according to the World Health Organization categorization of HBV prevalence rates (<2% =low, 2-8%= intermediate and >8% =high) [15]. These indicate that the Kaduna metropolis is highly endemic with the Hepatitis B Virus. The Virus may be wildly circulating among the generality of the population regardless of class or economic status. The rate was observed to be higher among outpatients in private hospitals than those in public hospitals. This suggests that all categories of persons can contract the infection when exposed to the virus regardless of economic status, the more the exposure the more the infections and prevalence. The respective prevalence rates recorded are slightly above the 9.2% previously reported among students of a Tertiary Institution in Northwest Nigeria and less than the 12% reported among patients attending a Public Tertiary Hospital in Kaduna [4,13]. This could probably be due to the difference in the study sites and locations as prevalence rates have been reported to vary between one location and another [13]. The increasing trend observed in the prevalence rates may also suggest either a growing neglect on the use of available vaccines against the HBV or failure to take the booster dose by many persons within the metropolis on the elapse of previous vaccinated period.

There were no statistical significant associations between HBsAg seroprevalence and age for samples from both Public (P≤0.28) and Private hospitals (P≤0.41) respectively. These suggest that, age is not really a barrier or tendency for positivity without exposure to the Virus. It also means that all persons at all ages can be infected when exposed to the HBV. The higher prevalence (19.05%) observed among subjects within age group 31-40 years in Public hospitals suggest that this age group is more exposed than others. This could probably be attributed to the active lifestyles of individuals within this age group. These agrees with a previous report of a higher rate of 14% among study subjects within ages 25-34 years and 0.00% for those ages 45 and above within Kaduna [4]. On the contrary, this contradicts a previous report of high prevalence among subjects with ages above 40 years attending a Public Tertiary Hospital in Kaduna [13]. On the other hand, the absence of any positive case (0.00%) among those 41 years above in public hospitals could probably be due to maturity and responsibility which reduce their exposure to potential risks. On the contrary, the highest prevalence among samples from private hospitals (28.57%) was from subjects within ages 11-20 years while ages 51 years and above had no positive (0.00%) case. This implies that more children and young adolescents were positive for HBsAg in private hospitals than in public hospitals. The absence of any positive case for children within the age group 1-10 years in either of the study subjects group indicate the unlikely presence of mother to child HBV transmitted. This also suggests that children from less economic status are less exposed to HBV as much as those from economically viable families within the metropolis. This is different from a previous report of 17.3% prevalence rate among sickle cell anemic children in Sokoto, Nigeria [16]. The differences could probably be attributed to variations in the immunity of healthy children as compared to that of sickle cell anemic children.

The higher prevalence observed in females (11.22%) against 5.77% in males in public hospitals could be attributed to the difference in the number of females encountered (98/150) against the number of males (52/150). This trend agrees with a previous study which documented a higher prevalence of 19.40% in females against 7.8% among males in Kaduna [4]. However, the prevalence in males (12.90%) attending private hospitals was higher than that of females (9.09%). This suggests that more positive males attend private hospitals than public hospitals

Though a previous study within Kaduna reported higher prevalence in males (11.10%, 324/600) than in females (6.90%, 276/600) [13]. The trend observed in this study shows that the number of samples taken from a particular gender play a key role in determining the prevalence rate. The higher the number of samples collected for a particular gender the more the chances for higher prevalence rate. The probability values for outpatients in public () and private () hospitals respectively at 5% level of significance indicated no statistical significant association between gender and HBsAg seropositivity. These also imply that gender is not really a predisposition factor or a tendency to HBV infection without exposure but as females are at risk, so do males are on exposure to the Virus [4].

The higher rates observed among the married attending both public (11.34%) and private (11.11%) hospitals respectively could be as a result of the large number of married subjects sampled in the respective study groups. This is different from previous reports of 9.5% among singles (Students) in ABU Zaria,13% higher rates among singles in Kaduna both in 2015 and 13.20% reported among the widowed ages 15-59 years in 2012 in the Anhui province of China [4,13,17]. The differences in this observations from these previous reports could probably be due to variations in lifestyles and locations hence prevalence rate have been reported to vary with location [13]. However, this study revealed the same trend in terms of the determinant of the rate; the higher the number of samples collected for a particular marital status, the higher the prevalence rate.

This study revealed individuals with blood group O (Table 5) to be common and more in population than those with other blood groups [18]. This could explain the high prevalence of 13.51% among subjects with blood group O in public hospitals. The absence of any positive case among patients with blood group AB could be due to the fewer number of samples (6/150) taken from this group. On the other hand, the prevalence rate of 14.71% found among outpatients with blood group B in private hospitals suggests that more of these subjects were seropositive regardless of the sample size. The lowest prevalence rate of 8.33% recorded among those with blood group A for patients attending private hospitals show a similar trend for subjects in private hospitals. These suggest that subjects with Blood group A in both study groups were less seropositive to HBV than those with other Blood groups. The absence of statistical significant associations between HBsAg seropositivity and blood group among outpatients in public () and private () hospitals respectively indicate that all blood groups can be infected when exposed to the Virus. This also implies that having a particular blood group does not guaranty safety when exposed to the Hepatitis B Virus.

Based on this study, more Rhesus positive individuals are common than Rhesus negative individuals (Table 6). This confirms a similar previous report in Iran [19]. Rhesus factor is important in this study because Rhesus negative factor have been associated with HBV infection [20]. The absence of a significant association between Rhesus factor and HBsAg seropositivity for outpatients in public hospitals () suggests that the Rhesus status of these patients did not impact significantly on their seropositivity. On the other hand, The close statistical association observed between Rhesus factor and HBsAg seropositivity of outpatients in private hospitals () suggests that the Rhesus factor contributed significantly on the patients HBsAg seropositvity. More so, Rhesus negative individuals showed to be more susceptible to HBV infections than Rhesus positive persons. These could be the reason for the higher prevalence observed among Rhesus negative than Rhesus positive outpatients in both public(11.11%,9.22%) and private(42.86%,9.09%%) hospitals respectively.

The higher prevalence revealed among those with hypertension (15.39%,) in public hospitals and diabetics (18.18%, ) in private hospitals did not signify these diseases are potential risk without contact with the Virus (Table 7). As healthy individuals are predispose to infection when exposed to the virus, so do these individuals are when they come in contact with the Virus. Though a double risk to HBV infection has been reported among diabetics, an equal predisposition has also been reported among diabetics and non diabetics in Ethiopia [21,22].

Education is important in this study as it determines an individual enlightenment and knowledge base which characterized lifestyles and safety of social exposure. An individual educational status plays a key role in the quality of life and management of exposure to the Hepatitis B Virus. This study revealed no significant associations between HBsAg seropositivity and individual level of education among subjects attending public hospitals (). This suggests that educational level did not impact significantly to the positivity of the subjects to HBV. On the hand, the high significant association observed between level of education and seropositivity for HBsAg among subjects attending private hospitals () indicate the significant impact of Education on the subjects positivity for HBsAg. The higher prevalence recorded among those with secondary schools level of education in public (13.85%) and private (26.67%) hospitals respectively is in agreement with a previous report among pregnant women at secondary level of education in south western, Nigeria (60%, ) [23]. This could be attributed to the active lifestyles and effect of youthful exuberance of the study subjects as well as inadequate knowledge about dangers and risks associated with HBV transmission.

The higher prevalence noted among subjects from HBV positive families in public (16.67%) and private (28.57%) hospitals respectively suggest HBV can easily be spread across family members if not properly managed. This also implies individuals of high economic status from HBV positive families are at a significant risk for the infection compared to those from very low economic status with HBV positive family members within the metropolis (,). This could probably contribute to the high significant association observed between HBsAg seropositivity and persons Sharing clothes and Beddings attending private hospitals (7.46%, ). Similar reports have been documented among students attending a Tertiary Institution North West Nigeria and among newly admitted students (36.67%) in the University of Jos, Nigeria [13,24].

Occupation was not significantly associated with HBsAg seropositivity either among outpatients in public hospitals () or among those in private hospitals (). This could probably be due to the absence of health personnel among the study subjects. This study revealed a high prevalence of 14.29% among patients in Business attending public hospitals and 20.00% among unskilled workers (Carpenters, Drivers, Motor Mechanics, Technicians, Menial job workers) attending private hospitals. This could probably be contributed by the lifestyles of this category of subjects. There were no positive cases (0.00%) among the unemployed in either hospital group probably due to economic hardship which could limit their exposure to lifestyles that predisposed them to HBV infection. This result contrasts a report of previous study among pregnant women in South West Nigeria which documented higher prevalence (40%) among the employed [23]. This could be due to location differences and the number of subjects sampled per occupation in a particular location. Those individuals with occupation captioned “Others” included: Students, Farmers, Public Servants and Politicians. Analysis of samples from this group of subjects revealed a high prevalence of 9.09% among those attending public hospitals and 14.29% among those attending private hospitals. This higher prevalence observed among the subjects in private hospitals could be due to lifestyle differences compared to those attending public hospitals. High prevalence have been reported among students (8.7%) and Farmers (18.2%) in Kaduna and 16.67% among newly admitted students at the University of jos, Nigeria [3,13]. Also, this high prevalence obtained in this category in this study could probably be due to the large number of positive cases obtained from students or farmers which are known to be potential victims to of HBV infections.

5. Conclusion and Recommendations

The results of this study confirm previous reports that HBV infection is a growing Public Health problem in Nigeria. The high prevalence rates of 9.33% and 10.67% obtained from outpatients in public and private hospitals respectively revealed that Kaduna metropolis is a highly endemic city for the Virus regardless of class or status. Potential risk factors observed within the metropolis include: Rhesus factor particularly Rhesus negative individuals, Sharing of clothes/Beddings with HBV positive persons, Presence of HBV positive family members and Secondary school level of Education.

There is need for more public sensitization and enlightenment about potential risks for HBV infection as well as timely immunization against the virus. Also, Government needs to subsidize the drugs for treatment of infected cases particularly to assist those that cannot afford. There are some families with more than one positive case; this could spell economic hardship and painful suffering. There is also the need for more research work to be carried out on Hepatitis B viral Proteins, pathogenesis, treatment and control in order to mitigate spread and reduce the disease burden among the population within the metropolis and other parts of the world.

Conflict of Interest

I declare that I have no conflict of interest.

References

Appendix

Chi square test of independence for 2 variables at 5% level of significance - for the journal.

Table 1. Prevalence of HBsAg among patients attending public Hospitals within Kaduna in relation to age

, =Chi Square, Oi=Observed Number of Cases in category i, Ei=Expected Number of cases in i.

For the different ages, =. Oi=Non- italicized Figures in the table, Ei=Italicized Figures.

Such that

Tabulated critical value for 8 df at 0.05=15.5100- null hypothesis accepted

Table 1. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna Metropolis in relation to age

The Chi Square Critical region for df 8=15.5100 null hypothesis accepted

Table 2. Afrequency distribution Table for ages of patients from Public hospitals in Table 1

The mean age is given by

M₁= Middle age for the Age Range.

F₁=Number of persons tested in the age range /frequency.

N=Total number of persons in the study/Sample Size= 150.

==30.10 years

i) The Standard Deviation

==14.55 years.

ii) The standard error of the mean age=

=Standard Deviation=14.55 Years.

N=Sample Size=150

==1.19

The 95% Confidence Interval (CI) of the mean age in years in the study is given by

CI=

=Mean age=30.10 Years.

Probability.

=8 (Nine age ranges used)

=1.19

Therefore, the 95% CI for the mean age is

CI =30.10

=30.10 Years.

Table 2. Afrequency distribution Table for ages of patients from Private hospital in table 2

The mean age is given by

M₁= Middle age for the Age Range.

F₁=Number of persons tested in the age range /frequency.

N=Total number of persons in the study/Sample Size=150.

==34.30 years

i) The Standard Deviation

==15.45 years.

ii) The standard error of the mean age=,

=Standard Deviation=15.45 Years.

N=Sample Size=150

==1.26

The 95% Confidence Interval (CI) of the mean age in years in the study is given by

CI=

=Mean age=34.30 Years.

Probability

=8 (Nine age ranges used)

=1.26, therefore, the 95% CI for the mean age is

CI =34.30

=34.30 Years.

Table 3. Prevalence of HBsAg among patients attending public Hospitals within Kaduna Metropolis in relation to Sex

=.=+=1.1908=0.28.

The Chi Square Critical Region for 1 df at 0.05 is 3.8400. null hypothesis accepted

Table 3. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna in relation to Sex

=.==0.5548=

critical value f or 1 df at 0.05=3.8400 null hypothesis accepted

Table 4. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to Marital Status

=.=

The chi square Critical region for DF=4 at 0.05 is 9.4900 null hypothesis accepted

Table 4. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in relation to Marital Status

The chi square Critical region for DF=4 at 0.05 is 9.4900,null hypothesis accepted

Table 5. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to Blood Group

The Chi Square critical value tabulated for the df =3 is 7.8100 null hypothesis accepted

Table 5. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in relation to Blood Group

The Chi Square critical region tabulated for the DF=3 at 0.05 significance is 7.8100 null hypothesis accepted

Table 6. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to Rhesus Factor

=.=+=0.0358

Null hy

The Chi Square critical region tabulated for the DF=1 at 0.05 significance is 3.8400

Table 6. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in relation to Rhesus Factor

=.=+. =7.9316.

The Chi Square critical region tabulated for the DF=1 at 0.05 significance is 3.8400. Null hypothesis rejected, alternative hypothesis accepted.

Table 7. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to individual Clinical history

Table 7. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in relation to individual Clinical history

Table 8. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to individual level of education

The Chi square critical value tabulated for 3 df at 0.05 is 7.8100

Table 8. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in relation to individual level of education

The Chi square critical value tabulated for df 3 at 0.05 level of significance is 7.8100.

Table 9. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to social factors

Table 9. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in relation to social factors

Table 10. Prevalence of HBsAg among patients attending Public Hospitals within Kaduna metropolis in relation to Occupation

The Chi square critical value for 4 df at 0.05 is 9.4900 accept null hypothesis

Table 10. Prevalence of HBsAg among patients attending Private Hospitals within Kaduna metropolis in in relation to Occupation

The Chi square critical value for df= 4 at 0.05 is 9.4900. accept null hypothesis.

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