Sharing of Personal Sanitary Kits as One Risk Factor of Horizontal Transmission of Hepatitis B among Children Resident at Orphanage

Abstract

BACKGROUND: Hepatitis B is a disease that infects the liver and is caused by the infection of a hepatitis B virus (HBV), and is becoming a global health issue, especially in developing countries including Indonesia. Hepatitis B can be transmitted through several ways such as infected bodily fluids. Indeed, children who live together in an orphanage are prone to having a high chance of transmitting Hepatitis B to each other. AIM: The purpose of this study was to analyze the factors associated with the prevalence of infected Hepatitis B. METHODS: This research used casecontrol study methodology by taking 15 positive case samples and 33 controlled uninfected patients and was conducted in six orphanages in Kupang Municipality in NTT between July 2019 and November 2019. There were 310 orphanage residents participating in this research. RESULTS: The research denotes that variables of using a shared toothbrush, nail clipper, and shaver show a significant connection with their Hepatitis B status (p < 0.05). A further analysis also indicates that using a shared shaver and toothbrush for 12.6 times has a high risk of being infected by Hepatitis B compared to those who do not share their personal items. CONCLUSION: Vaccinations and meeting the basic needs of every child in orphanages are essential in order to minimize the risk of Hepatitis B transmission.

Prevalence of Hepatitis B in Healthy Population in Kupang City, East Nusa Tenggara, Indonesia

“…The orphans mostly live in one large room, shared between an average of 10-20 people, allowing for frequent close contact between the residents. 6 They also commonly share personal hygiene products like toothbrushes, nail clippers, razors, towels, and soaps, increasing the possibility of HBV transmission among them. 6,28 The HBsAg prevalence in the prison inmates group, as one of the high-risk groups for HBV transmission, was 16.5%, higher than the average HBsAg prevalence of 13.4% in the general population.…”

“…6 They also commonly share personal hygiene products like toothbrushes, nail clippers, razors, towels, and soaps, increasing the possibility of HBV transmission among them. 6,28 The HBsAg prevalence in the prison inmates group, as one of the high-risk groups for HBV transmission, was 16.5%, higher than the average HBsAg prevalence of 13.4% in the general population. The prevalence rate of chronic hepatitis B infection among prison inmates was generally higher (1.0-3.7%) in comparison with the general population.…”

“…Several comprehensive strategies to reduce the risk of HBV transmission in NTT are (1) mandatory HBsAg testing in pregnant women and prophylactic administration for babies born to HBsAg-positive mothers; (2) universal hepatitis B vaccination in newborns; (3) additional vaccination/booster for children and adolescents who were not previously vaccinated; (4) vaccination in adults with high risks of HBV infection, especially the healthcare workers and hepatitis B patients' household contacts. [6][7][8][9][10][21][22][23][24][25][26]37 Early hepatitis B screening in pregnant women should also be complemented by administering hepatitis B vaccination and antiviral therapy during pregnancy to reduce the risk of perinatal HBV transmission. [35][36][37] Regular hepatitis B screening in high-risk population groups will help identify those infected with the virus and minimize the risk of horizontal transmission by advocating for good personal hygiene habits and discouraging personal sharing items.…”

“…3,4 In high HBV endemic areas, hepatitis B is transmitted from mother to child at birth or through horizontal transmission via exposure to infected blood. 5,6 Around 90% of less-than-a-year-old children who are infected will develop chronic HBV infections, while in people who are infected as adults, only 5% will develop chronic infections. 5 HBV diagnosis is based on detecting the hepatitis B surface antigen (HBsAg), with chronic HBV infection characterized as HBsAg persistence in the blood for more than six months.…”

“…16 A similar study in six orphanages in Kupang reported 15 HBsAgpositive children out of 310 subjects. 6 Considering the high HBV transmissions in NTT, HBV prevalence data on healthy populations and high-risk populations in NTT are required to identify the proportion of HBV carriers in the people that can potentially transmit HBV infections to others. This data can also be used as baseline data to improve hepatitis B prevention, management, and treatment programs in NTT.…”