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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 31  |  Issue : 4  |  Page : 401-405

Knowledge and associated factors for the uptake of hepatitis B vaccine among nonmedical undergraduate students in a private university in Ekiti State, Nigeria


1 Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
2 Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria

Date of Submission01-Apr-2022
Date of Decision31-May-2022
Date of Acceptance08-Jun-2022
Date of Web Publication27-Aug-2022

Correspondence Address:
Dr. Olusegun Elijah Elegbede
Department of Community Medicine, Afe Babalola University, Ado-Ekiti
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/NJM.NJM_48_22

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  Abstract 


Background: Hepatitis B is a life-threatening viral infection that causes acute and chronic diseases of the liver. Hepatitis B infection is endemic in Nigeria with a national pooled prevalence rate of 9.5%. However, a safe and effective vaccine that offers the protection against hepatitis B virus (HBV) is available. Aim: This study assessed the knowledge of hepatitis B vaccine and the associated factors for the uptake of the vaccine among non medical undergraduate in a Private University in Ekiti State. Materials and Methods: This survey is a cross-sectional study involving 420 nonmedical undergraduate students of a private university in Ekiti State, Nigeria, using a multistage sampling technique. Data were collected using a structured pretested self-administered questionnaire between March and May 2019. Analysis was done using SPSS version 23, and the level of significance was taken as P < 0.05. Results: The mean age of respondents was 20.3 ± 2.7 years. Almost half of the students (47.4%) were within the age range of 15–19 years. Females constitute 51.4% of the respondents and mostly practiced Christianity (77.4%). The majority of respondents had good knowledge of HBV vaccine (77.6%). Just a little over a quarter (26. 9%) of the respondents have taken one or more doses of hepatitis B vaccine. There was a statistically significant association between respondents' age (P = 0.032), the college of study (P = 0.006), and good knowledge of HBV vaccine (P < 0.001) and uptake of hepatitis B vaccine. The factors associated with uptake of hepatitis B vaccine include older age group (25–29 years), studentship in the college of science, and good knowledge of hepatitis B vaccine. Conclusion: The majority of respondents had good knowledge of hepatitis B vaccine. Associated factors identified for uptake of hepatitis B vaccine include age (25–29) years, studentship in faculty of science, and good knowledge of hepatitis B vaccine. It is recommended that health education about hepatitis B and its vaccine should be offered to undergraduates to increase the uptake of hepatitis B vaccine.

Keywords: Hepatitis B, tertiary institution, undergraduate students, uptake, vaccine


How to cite this article:
Elegbede OE, Alabi AK, Alao TA, Sanni TA. Knowledge and associated factors for the uptake of hepatitis B vaccine among nonmedical undergraduate students in a private university in Ekiti State, Nigeria. Niger J Med 2022;31:401-5

How to cite this URL:
Elegbede OE, Alabi AK, Alao TA, Sanni TA. Knowledge and associated factors for the uptake of hepatitis B vaccine among nonmedical undergraduate students in a private university in Ekiti State, Nigeria. Niger J Med [serial online] 2022 [cited 2022 Oct 5];31:401-5. Available from: http://www.njmonline.org/text.asp?2022/31/4/401/354852




  Background Top


Hepatitis B is a life-threatening viral infection that causes acute and chronic diseases of the liver.[1] The World Health Organization estimated that as at 2019, about 269 million people were living with chronic hepatitis B infection with about 1.5 million new infections yearly.[1] Out of these, the African and Pacific regions accounted for about 68% of those infected.[2] Hepatitis B infection is endemic in Nigeria with a national pooled prevalence rate of 9.5%.[3] Left untreated, one in four people living with the virus eventually develop liver problems.[4] Hepatitis B infection can spread from mother to child, through exposure to infected blood and body fluids, and needlestick injuries, including tattoos, piercing, and high-risk behaviours including multiple sexual exposures, drug use, and injections.[1],[5] These high-risk behaviours are indulged by adolescents and young adults, including University students.[6] Moreover, about 5% of healthcare-related injections remain unsafe.[2] Hepatitis B virus (HBV) coinfection with human immunodeficiency virus has also been reported, as about 1% of people living with HBV are also infected with HIV.[4] Chronic hepatitis B infection can lead to liver cancer and it has been estimated that after tobacco, chronic HBV infections are the most important cause of cancer worldwide.[7] However, a safe and effective vaccine that offers 98%–100% protection against HBV is available[1] Vaccination with hepatitis B vaccine has been listed as a strategy to eliminating viral hepatitis by the year 2030.[8] Hepatitis B vaccines have been part of routine immunization for infants in Nigeria, also most of the awareness campaigns and uptake drives and researches have been among health-care workers and medical students, this research will, therefore, serve as a baseline for data and intervention among nonmedical undergraduate students. This study, however, aims to assess the knowledge of hepatitis B vaccine and associated factors for the uptake of hepatitis B vaccine among non medical undergraduates in a private University in Ekiti State, Nigeria.


  Materials and Methods Top


This study was carried out in Afe Babalola University, Ado-Ekiti, a Federal Government-licensed, nonprofit private university in Ado-Ekiti, Ekiti State, South-west, Nigeria. It is located on latitude 7.670929°N and longitude 5.307051°E.[9] The university is bounded by Erinfun village to the South, Ijan and Ago Aduloju communities to the North, the Federal Polytechnic, Ado-Ekiti to the West, and Igbogun community to the East. The University is comprised five colleges: Law, Sciences, Medicine, and Health Sciences, Engineering, and Social and Management Sciences. There are currently 36 departments across the various colleges in the university with 10,684 undergraduate students.

The study was a descriptive, cross-sectional study carried out among 420 registered non medical students of the University to assess the knowledge and associated factors for the uptake of hepatitis B vaccine. Undergraduates who had not spend up to six months in the school and predegree students were excluded from the study. A structured pretested, self-administered questionnaire adopted from earlier published literature[10] was used to collect the data on sociodemographic characteristics, knowledge of hepatitis B vaccine, and uptake of hepatitis B vaccine. Data were collected between March and May 2019.

A multistage sampling technique was used to select the eligible students for the study. In the first stage, three colleges out of the four non medical colleges were selected by simple random sampling. College of Engineering, College of Sciences, and College of Social and Management Sciences were selected. In the second stage, four departments were selected by simple random sampling from the list of departments in each of the three colleges earlier selected in the first stage (12 departments were selected). In the third stage, simple random sampling through the balloting method was used to select one level of study in each of the departments that were selected in stage 2 above and questionnaires were then allocated equally (35 questionnaires allocated to each selected level in the selected departments) to each selected level. In the last stage, at each selected level of the study, the lists of students were collected to serve as the sample frame. The sample frame was then divided with the number of allocated questionnaires to get the sample interval. The first respondent within the sample interval was selected through simple random sampling by balloting while subsequent respondents were chosen by applying the sample interval.

The data collected were analyzed using the IBM SPSS (Statistical Package for the Social Sciences) software version 23. Independent variables were sociodemographic characteristics and knowledge of hepatitis B vaccine whereas the outcome variable was hepatitis B vaccine uptake. Data were represented in percentages and frequency tables. Knowledge of hepatitis B vaccine was assessed based on the frequency of right answers to the knowledge of HB vaccine-based questions vis a vis if they are aware, there is an effective vaccine to prevent hepatitis B infection, if hepatitis B vaccine can be given after exposure to the virus for prevention, if full immunization of adults consists of three doses of hepatitis B vaccine, if hepatitis B vaccine is effective for the treatment of acute hepatitis B infection and if hepatitis B vaccine is recommended for young people who indulge in risky behaviours, etc.[10] Ten (10) questions were asked in all and respondents who scored five (5) and above (score ≥50%) were graded as good knowledge while score <5(<50%) was graded as poor knowledge of hepatitis B vaccine. Bivariate analysis was done to assess the relationship between sociodemographic characteristics and knowledge score against the uptake of hepatitis B vaccination. Variables which showed a significant relationship at P < 0.05 were entered in the multivariate logistic regression model for analysis. P value was predetermined at <0.05 and 95% confidence interval (CI). Ethical clearance for this study was obtained from the Health Research and Ethical Committees of the Federal Teaching Hospital, Ido Ekiti, Ekiti State, Nigeria. Permission was also sought from the university authority to conduct the research among undergraduate students, and informed consent was obtained from the respondents. Confidentiality was ensured through anonymous distribution of the questionnaire.


  Results Top


Sociodemographic characteristics

The mean age of respondents was 20.3 ± 2.7 years. Almost half of the students (47.4%) were within the age range of 15–19 years. Females constitute 51.4% of the respondents and most practiced Christianity as religion (77.4%). Monthly allowance for majority of the students was between 20,000 and 40,000 nairas [Table 1].
Table 1: Sociodemographic variables of the students

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Knowledge on hepatitis B vaccine

The majority of respondents had good knowledge of HB vaccine (77.6%) [Table 2] and [Table 3].
Table 2: Knowledge of hepatitis B vaccine

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Table 3: Assessment of respondents' knowledge of hepatitis B virus vaccine

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Self-reported uptake of Hepatitis B Vaccine

Only about a quarter of the respondents have taken one or more doses of hepatitis B vaccine. Among those who had received vaccination, about half (49.6%) had received three doses, 29.2% received two doses while the remaining 21.2% received only one dose [Table 4].
Table 4: Self-reported hepatitis B vaccine uptake

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Factors associated with hepatitis B vaccine uptake

There was a statistically significant association between respondents' age (P = 0.032), the college of study (P = 0.006), and good knowledge of HBV vaccine (P < 0.001) and uptake of hepatitis B vaccine [Table 5].
Table 5: Association between demographic variables, knowledge of hepatitis B vaccine and uptake of hepatitis B virus vaccination

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Predictors of hepatitis B vaccine uptake

Binary logistic regression analysis showed that students in the age group of 25–29 years were about three times more likely to take hepatitis B vaccine than those in the age group of 15–19 years (adjusted odds ratio [AOR] 2.627 95% CI (1.180–5.851) (P = 0.018) students in the College of Sciences were twice more likely to take the vaccine than those in Engineering (AOR 2.054 95%CI (1.165–3.621) (P = 0.013) also students with good knowledge of HBV vaccine (P value 0.02, AOR 1.086, 95%CI (1.48–5.926) were about three times more likely to take the vaccine than those with poor knowledge of HBV vaccine [Table 6].
Table 6: Predictors of uptake of hepatitis B virus vaccination using binary logistic regression

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  Discussion Top


The majority of respondents had good knowledge of HBV vaccine (77.6%). This result differs from that of study conducted among medical students in Abakaliki, Ebonyi State, Southeast Nigeria,[11] where a good knowledge of hepatitis B vaccine was 100%. This difference is likely due to the exposure of medical students to information HBV and its vaccine. This finding implies the need for regular health education sessions on HBV and its vaccine among university students.

This study showed that about a quarter of the respondents had taken one or more doses of hepatitis B vaccine. These results differ from studies conducted in Ghana,[12] Kampala, Uganda,[13] and Kenya[14] where higher uptake of hepatitis B vaccine was reported. Among those who had received vaccination in this study, about half (49.6%) had received three doses, 29.2% received two doses while the remaining 21.2% received only one dose. A previous study conducted among public health students in Ghana reported that 30.5% of respondents received three doses of vaccine, 13.7% received incomplete doses while 55.8% of respondents were unvaccinated.[15] The difference in results of these studies and our study could be explained with active hepatitis B vaccination programs in the Medical Schools where the studies were conducted.

This study also identified factors associated with uptake of hepatitis B vaccine to include undergraduate students within the age group of 25–29 years. This result was similar to that which was reported by a cross-sectional study conducted in Ghana[12] where ages 26 and above were identified as a factor for vaccination with hepatitis B vaccine. This might be due to the increased sense of responsibility that comes with increasing age. This result may also imply the need to consider age in interventional programs for hepatitis B vaccine among undergraduates. This study also identified studentship in the College of Science as a factor associated with uptake of hepatitis B vaccine. This might be because the students in the College of Science were likely more exposed to Biology and Virology courses[9] where they had more information about HBV and the vaccine. College of study was similarly reported in previous study conducted among university undergraduates in Uganda,[13] as a factor for hepatitis B vaccine uptake. Good knowledge of HBV vaccine was also identified as another factor associated with hepatitis B vaccine uptake in this study. This finding is supported by the report of another study conducted in Juba city, South Sudan,[16] where the knowledge of HBV prevention through vaccination was identified as a predictor of hepatitis B vaccine uptake. This result implies the need for increase knowledge of HBV vaccine through health education intervention as a strategy to increase the uptake of hepatitis B vaccine among undergraduates.


  Conclusion Top


The majority of respondents had good knowledge of hepatitis B vaccine. Associated factors identified for uptake of hepatitis B vaccine include age (25–29) years, studentship in faculty of science, and good knowledge of hepatitis B vaccine. It is recommended that health education about HBV and its vaccine should be offered to undergraduates so as to increase uptake of hepatitis B vaccine.

Limitation

Uptake of hepatitis B vaccine was self-reported, therefore may be subjected to recall bias.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Hepatitis B. Available from: https://@www.who.int/news-room/fact-sheets/detail/hepatitis-b. [Last accessed on 2022 Mar 10].  Back to cited text no. 1
    
2.
World Health Organisation. Global Hepatitis Report, 2017. Geneva: World Health Organization; 2017. Available from: https://@www.who.int/publications/i/item/global-hepatitis-report-2017. [Last accessed on 2022 Mar 10].  Back to cited text no. 2
    
3.
Ajuwon BI, Yujuico I, Roper K, Richardson A, Sheel M, Lidbury BA. Hepatitis B virus infection in Nigeria: A systematic review and meta-analysis of data published between 2010 and 2019. BMC Infect Dis 2021;21:1120.  Back to cited text no. 3
    
4.
Centre for Disease Control and Prevention. Vaccination Coverage among Adults in the United States; National Health Interview Survey; 2016. Available from: https://@www.cdc.gov/vaccines/imz-managers/coverage/adultvaxview/pubs-resources/NHIS-2016.html. [Last accessed on 2022 Feb 10].  Back to cited text no. 4
    
5.
Dehghani B, Dehghani A, Sarvari J. Knowledge and awareness regarding hepatitis B, hepatitis C, and human immunodeficiency viruses among college students: A report from Iran. Int Q Community Health Educ 2020;41:15-23.  Back to cited text no. 5
    
6.
Sira J, Brown M, Ambegaokar S, Modin L, Kelly DA. The necessity of education and hepatitis B vaccination for young people: A study of high risk behaviour for blood borne viruses in the United Kingdom. J Child Health Care 2019;23:437-45.  Back to cited text no. 6
    
7.
Chen MS Jr., Dang J. Hepatitis B among Asian Americans: Prevalence, progress, and prospects for control. World J Gastroenterol 2015;21:11924-30.  Back to cited text no. 7
    
8.
World Health Organisation. Global Health Sector Strategy on Viral Hepatitis, 2016-2021. Geneva: WHO; 2018. Available from: https://@www.int/iris/bitsream/10665/246177/1/WHO-HIV-2016.06-eng.Pdf. [Last accessed on 2021 Oct 12].  Back to cited text no. 8
    
9.
Afe- Babalola University, Ado-Ekiti. The University. Available from: https://@www.abuad.edu.ng/the university/. [Last accessed on 2021 Oct 20].  Back to cited text no. 9
    
10.
Abeje G, Azage M. Hepatitis B vaccine knowledge and vaccination status among health care workers of Bahir Dar City Administration, Northwest Ethiopia: A cross sectional study. BMC Infect Dis 2015;15:30.  Back to cited text no. 10
    
11.
Eze NC, Egba EC, Ogbonna JE, Nwamini SN, Nweke PU, Amasianya JS. Knowledge, attitude and uptake of Hepatitis B vaccine among Clinical Medical students of a tertiary institution in Southeast, Nigeria. Asian J Immunol 2020;4:31-6.  Back to cited text no. 11
    
12.
Gyimah AA, Peprah P, Agyemang-Duah W, Frimpong E, Tsiboe AK, Darkwa MA. Hepatitis B vaccination status and associated factors among university students in Ghana: A cross-sectional survey. Public Health and Primary Health Care 2021;8:e2005226.  Back to cited text no. 12
    
13.
Wibabara Y, Banura C, Kalyango J, Karamagi C, Kityamuwesi A, Amia WC, et al. Hepatitis B vaccination status and associated factors among undergraduate students of Makerere University College of Health Sciences. PLoS One 2019;14:e0214732.  Back to cited text no. 13
    
14.
Maina AN, Bii LC. Factors affecting HBV vaccination in a Medical training College in Kenya: A mixed methods Study. BMC Public Health 2020;20:48.  Back to cited text no. 14
    
15.
Osei E, Niyilapah J, Kofi Amenuvegbe G. Hepatitis B knowledge, testing, and vaccination history among undergraduate public health students in Ghana. Biomed Res Int 2019;2019:7645106.  Back to cited text no. 15
    
16.
Alege JS, Gulom G, Ochom A, Kaku VE. Assessing level of knowledge and uptake of hepatitis B vaccination among health care workers at Juba Teaching Hospital, Juba City, South Sudan. Adv Prev Med 2020;2020:8888409.  Back to cited text no. 16
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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