Prevalence of hepatitis B virus among applicants for recruitment into Nigeria police force in Osun State, southwestern Nigeria

INTRODUCTION

Hepatitis is a term that refers to the inflammation of the liver caused by different viruses including hepatitis A, B, C, D and E.¹ It is a viral infection that attacks the liver and is capable of causing both acute and chronic disease, it can be transmitted from mother to child during childbirth and contact with bodily fluids through sexual intercourse with an infected person, unsafe injections and contact with infected blood.² HBV could be asymptomatic causing different presentations such as hepatocellular cancer.³ Acute hepatitis B is discrete in onset and symptoms include headache, loss of appetite, fever, abdominal pain, nausea, malaise etc.⁴ Chronic hepatitis B is referred to as the persistence of hepatitis B surface antigen (HBsAg) over a period of six months.⁴

Globally, the hepatitis B virus is a major public health problem.⁵ The hepatitis B infection’s burden is most common in the western Pacific and African Region where millions of people are chronically infected, similarly, about 20 million and 14 million are infected in the mediterranean and south-east Asia region.² Acute hepatitis B was estimated to be 21,900 cases in 2015, with an incidence of 1.1 cases per 100,000 as estimated by Centre for Disease Control and Prevention.⁴

Although police are less likely to have blood-borne virus exposure compared to other emergency and safety officers or hospital employees.⁶ nevertheless, it is important that the risk of infection be assessed especially from the recruitment level. Periodic screenings are crucial as they are frequently exposed to blood contacts while on duty, in order to minimize the risk of infection and transmission it is important to establish fitting measures to prevent transmission of the hepatitis B virus.³

There have been studies on hepatitis infection among police officers, but none have assessed the prevalence of hepatitis B and C among the applicants for recruitment into the service.^3,7,8

METHODS

This study was a cross-sectional study and it was carried out among 165 selected applicants from the total applicants that came from the 30 LGA for recruitment exercise into the Nigeria police force. The study employed a quantitative method of data collection, based on the report from the 2006 census.⁹ The city is largely dominated by the Yoruba ethnic group. It has an area and population density of 47.0km² and 4,557km² respectively. There are three senatorial districts in Osun state, each senatorial district has 10 local government areas, and each LGAs provided 20 applicants for recruitment exercise into the Nigeria police force.

For the purpose of this study, five out of ten local government areas were randomly selected from each senatorial district via balloting. Eleven applicants were selected from each selected local government using simple random sampling employing the balloting method. The minimum sample size was 150 and was increased to 165 after adjusting for a 10% non-response rate.

The ethical approval for the study was obtained from the ethical committee of Adeleke, university Ede, Osun State Nigeria. Permission to carry out the study was obtained from the commissioner of police Osun state police command and from the Osun State Ministry of Health, Osun State Nigeria. Needed Information was obtained from the applicants' screening registers, information obtained included socio-demographic characteristics, and the screening test results of hepatitis B.

Statistical analysis

Data analysis was done using IBM SPSS software version 25.0, the tabular form was used for results presentation while chi-square and logistic regression were appropriate, statistical level of significance was set at P<0.05.

RESULTS

Table 1 shows the socio-demographic characteristics of the respondents. The majority (80.0%) of the applicants selected were between ages 20-26 years compared to only 20% that were in the 16-19 years age bracket. More than two-thirds (75.1%) of the respondents were males. There were eleven respondents selected from each LGA, which equals 6.67% per local government area (Table 1).

Figure 1 shows the respondents’ level of hepatitis-B status, more than half (56.4%) were found to have tested negative for hepatitis B Virus, while 43.6% tested positive for hepatitis-B virus (Figure 1).

Table 2 shows the association between the respondents’ status of hepatitis-B virus and their socio-demographic characteristics. Although not statistically significant, more of the respondents (46.2%) in the age bracket of 20-26 years tested positive for the hepatitis-B virus screening test compared to only one-third (33.5%) of the adolescents (16-19 years old) that reacted to the screening test of the hepatitis-B virus. More males (46.2%) than females (37.0%) were found to have hepatitis B virus.

#Likelihhod ratio

However, there was a statistically significant association between the respondents’ local governments areas where more of the respondents (81.8%) from Ifedayo and Ife-North, tested positive for hepatitis B virus, followed by Ife-South (72.7%) while Atakumosa East and Obokun have the least proportion of respondents that tested positive to hepatitis B virus (18.2%) (Table 2).

Table 3 shows the binary logistic regression of the outcome variable “Respondents' Hepatitis B Status” and their socio-demographic predictors. For the variable “Local Government Areas” the sub-categories Ila with P value 0.038 (p<0.050) odds ratio: 0.124, and confidence interval 0.017-0.892). Odo-Otin with P value 0.022 (p<0.050) odds ratio: (0.011-0.707), Ede north with P value 0.036 (p<0.050), odds ratio: 0.120 and confidence interval (0.016-0.867). Irewole: p-value 0.038 (p<0.050), odds ratio 0.135, confidence interval (0.017-0.890) and sub-categories Ejigbo and Isokan with p value 0.047, odds ratio 0.135 and 0.132, confidence interval (0.019-0.975) and (0.018 and 0.977) for Ejigbo and Isokan respectively. This shows that applicants from Ila, Ede north and Irewola LGAs are eight times less likely to have hepatitis-B virus, those from Ejigbo and Isokan LGAs are seven times less likely to have hepatitis-B and applicants from Odo-Otin LGA of the state are eleven times less likely to have hepatitis-B compared to other local governments areas (Table 3).

DISCUSSION

The mean age of the respondents was 22.08±2.428, this means age is lower compared to that of Adjei et al, (2008) study where the officers had 38.1 as their mean age, the majority of the respondents were between the age of 20-29 years old.¹⁰ More than two-thirds of the applicants were males which is in line with another study on hepatitis B among policemen in Adiyaman where majority of the policemen were males.³ Similarly, this finding is slightly higher than Adjei’s 2008 study on correlates between HBV among prison inmates and officers in Ghana that reported less than two-thirds of their respondents were females.¹⁰ Looking at the rigours of police officers’ occupation, it is expected that it suits male than females and this could be the likely reason for more male officers than female police officers in most places.

The prevalence of HBV revealed by this study is higher than that of Adjei's (2022) study where less than one-third have HBsAg and much higher than Kölgelier et al, (2015) study on the prevalence of hepatitis B among policemen working in Adiyaman where less than one-tenth tested positive to hepatitis B surface antigen.^10,3

CONCLUSION

The findings of this study show statistically significant associations between the applicants' LGAs and their hepatitis B status, furthermore, binary logistic regression revealed a further relationship that applicants from Ila, Odo-Otin, Ede-North, Irewole and Isokan were less likely to have tested positive for hepatitis. Further study may look into this area to ascertain factors responsible for their low positivity and those predisposing other LGAs to hepatitis B as well as their preventive practices regarding the infection.

ACKNOWLEDGEMENTS

We would like to thank the Nigerian Police Force, Osun State and the Police Clinic in Osun State Nigeria.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Health Research and Ethics Committee, Adeleke University, Ede Osun State, Nigeria and the State Ministry of Health, Osun State Nigeria

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