Epidemiology and Associated Risk Factors of Hepatitis E Virus Infection in Plateau State, Nigeria

Abstract

A cross-sectional study in Nigeria was undertaken to determine the epidemiology, seroprevalence, and associated risk factors, of hepatitis E virus (HEV). A total of 462 subjects were used for the study, categorized into four groups: apparently healthy persons, pregnant women, HIV positive subjects, and animal handlers. Information was obtained from subjects using interviewer-administered questionnaire. Blood samples were collected and analyzed for HEV antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA) technique. Results obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 17.0 statistical software. The overall seroprevalence of IgG and IgM was 42.7 and 0.9%, respectively. Animal handlers had the highest seroprevalence (66.7%). The associated risk factors for IgM seroprevalence were rural dwelling (P = 0.039, odds ratio (OR) 3.3, 95% confidence interval (CI) 0.7–15.4), blood transfusion (P < 0.001, OR 9.6, 95% CI 2.6–35.6), attending to animals (P = 0.032, OR 4.9, 95% CI 0.9–26.6), and waste disposal (P < 0.001). Factors associated with IgG were age (P = 0.044), location (P < 0.001), marital status (P < 0.001), formal education (P < 0.001), farming as occupation (P < 0.001), rural dwelling (P = 0.001), waste disposal (P < 0.001), alcohol consumption (P = 0.001, OR 2.4, 95% CI 1.4–4.0), open defecation (P < 0.001, OR 2.9, 95% CI 1.4–5.7), attending to animals (P < 0.001, OR 2.3, 95% CI 1.6–3.4), consuming unwashed fruits/vegetables (P < 0.001, OR 4.2, 95% CI 0.3–54.1), and stream/river as a source of drinking water (P < 0.001, OR 3.6, 95% CI 1.6–7.8). Preventive public health measures should be reinforced among all communities, particularly domestic animal handlers and pregnant women. Potable water should be provided for all communities. Data suggest that HEV remains an under-recognized and significant public health problem, warranting further attention and research.

Acute Hepatitis E Virus infection in two geographical regions of Nigeria

“…Our finding is in congruence with the rates of 0.9% reported in a study among different populations including apparently healthy individuals in Plateau state [28] but differs from 1.7% reported among ARV naïve and experienced HIV patients in Ibadan [29]. Though varied rates of HEV IgM have been reported in other endemic regions of the world among different populations [30][31][32].…”

Human Hepatitis E Virus among Apparently Healthy Individuals in Ogbomoso, South-Western Nigeria

“…The finding might be attributed to increased exposure of males to contaminated water, contaminated food sources and respective sanitary conditions as compared to females [2]. This disagrees with the reports of Junaid et al [6], Ekanem et al [15] and Ofosu-Appiah et al [11] where higher prevalence was recorded among females as compared with males.…”

“…This difference may be ascribed to difference in geographical location, From previous studies in Nigeria, the prevalence observed in this study is lower than a 5.5% prevalence recorded in Ogbomoso [1] among individuals infected with HIV, 8.3% prevalence observed in Ekiti [3], 31.1% in Plateau [6], 7.7% in Cross river [15]. The difference in the prevalence may be ascribed to differences in the sensitivity and specificity of the assay used in various studies, difference in study groups, socio-economic, cultural, hygienic and climatic conditions.…”

“…Since the discovery of HEV, several outbreaks of the infection have been reported among pregnant women [6], HIV positive individuals [1], sick individuals [3], animal handlers [7] as well as apparently healthy individuals [8]. Thus, apparently healthy individuals are considered a high risk group for HEV infection in endemic areas; however, this assumption is based on outbreak reports only, as no studies have been performed comparing exposure to HEV among this group.…”

“…In Nigeria, seroprevalences differ considerably, ranging from 5.5% in Ogbomoso [1], 13.4% in Ekiti [3], 17.8% in Lagos [7] to 42.7% in Plateau [6], but little is known on potential risk factors involved in acquiring the virus. Thus, the present study aimed at investigating the seroprevalence of antibodies against HEV and studying potential risk factors, other than through faecal-oral transmission, associated with blood borne transmission in different areas of Ogbomoso.…”