Knowledge and awareness on hepatitis B infection among adult population in some selected villages in Keranigonj , Dhaka , Bangladesh

This cross sectional descriptive study was conducted among the rural people in some selected villages in Keraniganj upazila, Dhaka, Bangladesh from November 2015 to April 2016 to determine the knowledge and awareness about hepatitis B (HB) infection. The sample was collected using non-probability (purposive) method from the available people in the villages. The sample size was 200. The age most of the respondents were in the 26-35 age range; male respondents were higher than that of female and most of the respondents were married. The majority of respondents (60%) had primary and secondary education level, 42% were housewife, 40% had monthly family income range at 5000-10000 Taka, 45% had >5 persons in their family, 51% lived in pacca house, 52.5% drunk water from deep tube-well, and 82.5% did nothing for purification of water and 80% used sanitary latrine. The results of the study revealed that only 43.5% had knowledge on HB and 37.9% knew about HB from doctors. In case of mode of transmission, risk group and prevention of HB, 50.6% thought it is spread by water, 40.2% thought sex workers are more prone to develop HB and only 29% thought HB can be prevented by vaccination. This study indicates that there is a lack of awareness about HB, its route of transmission and modes of prevention among the rural people and appropriate measures are needed to increase correct awareness on HB for prevention purpose.

the liver and caused by hepatitis B virus (HBV).It is infectious and the most common cause of chronic hepatitis, liver cirrhosis and hepato-cellular carcinoma. 1Globally two billion people are infected with HBV, and millions of them have chronic (lifelong) infections that kill more than one million people globally each year.In the Middle East and Indian sub-continent, HBV infection is of intermediate endemicity with chronic HBV It is obvious that for many diseases, having appropriate knowledge, attitude and practice may reduce the probability of disease acquisition among at risk populations.In reality, there is little knowledge about infectious diseases and acceptance of preventive measures could be improved by educating people. 6There have been several studies that evaluated the HBV knowledge of Asian minorities in the United States of America such as Vietnamese and Cambodians in Seattle and Vietnamese students in Massachusetts and according to the findings, the knowledge level of the studied subjects was mostly low. 7,8On the other hand, studies on Singaporean people showed that their knowledge was suitable. 9,10HBV continues to be a major health problem in worldwide including Bangladesh.Vaccination against HBV is now introduced in the expanded programme on immunization.However, there is a large number of populations still not aware of hepatitis and its consequences.
Knowledge-surveys are representative of a specific population to collect information on what is known, believed and done in relation to a particular topic, and are the most frequently used study tool in health-seeking behavior research.Knowledge is usually assessed in order to determine how far community knowledge corresponds to biomedical concepts.If it is needed to deliver a good health service to mass people with limited facilities then awareness about the common diseases and involvement of the people in health care delivery system is an emergent part.This study was carried out to determine the level of knowledge and the vaccination coverage of HB virus in a rural population.

Materials and Method
This descriptive type of cross sectional study was conducted among rural people in Keraniganj upazila, Dhaka, Bangladesh from November 2015 to April 2016 to determine the knowledge and awareness about HB infection.The sample was collected purposively from the availability of the population, and data were collected by using a pretested a structured questionnaire.The sample size was 200.The data carriage rate of 2-5% among general population. 2 Bangladesh is one of the most densely populated countries of the world with poor socioeconomic a hygienic conditions.The incidence of different kinds of liver diseases like hepatitis, cirrhosis and liver cancers is common in Bangladesh.About 4-7% of the population have HB and 1-3% have hepatitis C.About 3.5% of pregnant women have HBV infection.It was reported in a study that 2.3% of girls in a school were diagnosed with HB. 3 It is shocking that about 70% of those living with liver disease are completely unaware of their illness.
Most of the liver diseases are preventable by awareness.The National Liver Foundation of Bangladesh is a non-profit organization started with the aim of prevention, treatment, education and research on liver diseases in Bangladesh. 4 HB was the first to be discovered in 1965 by Baruch Blumberg.Most people who were infected long ago with HBV or hepatitis C virus are unaware of their chronic infection and so can unknowingly transmit the infection to other people.HB, often referred to as the "secret killer," is the most dangerous type of viral hepatitis despite the dramatic increase in the treatment and effective vaccination against the disease.In Africa, the prevalence rate of HB was 10-15%.The 2009 Ghana Health Service report released very scary figures suggesting an increase in the prevalence rate of HB from 8:1 in 2005 to 6:1 in 2009. 5This means one out of every sixth person is infected with the disease.There has also been an increase in the number of deaths associated with the disease. 5o strategies are helpful for reducing HBV infection: first, case finding and targeted education and immunization for reducing vertical, sexual and household transmission, and second, universal vaccination and promotion of safe sex practices at community level.After graduating from high school, adolescents may go to college or start a job; in either case, they go to a more open social circumstance and would be more exposed to HBV. were processed and analyzed using Microsoft computer.Results were reported using descriptive statistics and expressed as percentage (%) where appropriate.

Results
Table 1 shows that the most of the respondents were in the 26-35 age range; male respondents were higher than that of female and most of the respondents were married.The majority of respondents (60.0%) had primary and secondary education level, 42.0% were housewife, 40.0% had monthly family income range at 5000-10000 Taka, 45% had >4 persons in their family, 51.0% lived in pacca house, 52.5% drunk water from deep tube-well, and 82.5% did nothing for purification of water and 80.0% used sanitary latrine.
Fig. 1 shows that according to their knowledge about HB, most of the respondents (113, 56.5%) did not know about HB.
Table 2 shows that according to the source of knowledge about HB, the proportion of the respondents knew about HB from doctor, health assistant, media, neighbor, friend and kobiraj was 37.9%, 25.3%, 20.8%, 6.9%, 5.7% and 3.4%, respectively.
Table 3 shows that according to their knowledge about HB transmission, the proportion of respondents knew about HB transmission by water, blood, multiple use of syringe, touch, sexual activity and air was 50.6%, 40.2%, 3.4%, 2.3%, 2.3% and 1.2%, respectively.Fig. 2 shows that according to their knowledge about prevention of HB, most of the respondents (142, 71.0%) did not think that HB is preventable, only 58 (29.0%) of them thought.

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Table 4 shows that according to their knowledge about high risk group to develop HB, the proportion of respondents knew about high risk groups as sex worker, drug abuser, working abroad, others, driver, health assistant and doctor was 40.2%, 33.3%, 9.2%, 8.1%, 5.7, 2.3% and 1.2%, respectively.
Table 5 shows that according to their knowledge about HB prevention, 55.2% of the respondents thought HB is preventable told that it can be prevented by vaccination, followed by safe drinking water (32.8%), by safe sex (8.6%) and others (3.4%).Fortunately, HBV infection is largely preventable by vaccination.Transmission of infection is rare in persons who have been immunized. 13The general characteristics of the respondent in this study revealed that The age most of the respondents were in the 26-35 age range; male respondents were higher than that of female and most of the respondents were married.The majority of respondents (60.0%) had primary and secondary education level, 42.0% were housewife, 40.0% had monthly family income range at 5000-10000 Taka, 45.0% had >5 persons in their family, 51.0% lived in pacca house, 52.5% drunk water from deep tube-well, and 82.5% did nothing for purification of water and 80.0% used sanitary latrine.

Discussion
[15] According to the source of knowledge about HB, the proportion of the respondents knew about HB from doctor, health assistant, media, neighbor, friend and kobiraj was 37.9%, 25.3%, 20.8%, 6.9%, 5.7% and 3.4%, respectively.In a study, Misra et al found that source of information regarding HB included television (75.0%), newspapers (55.0%), and radio (26.0%). 16According to their knowledge about HB transmission, the proportion of respondents knew about HB transmission by water, blood, multiple use of syringe, touch, sexual activity and air was 50.6%, 40.2%, 3.4%, 2.3%, 2.3% and 1.2%, respectively; whereas 71.0% of the nursing students in Tamil Nadu, India had correct knowledge about mode of transmission.14Another study conducted among the students of University of Kassala, Sudan reported poor knowledge on causative agents and mode of transmission. 17 this study, according to knowledge about high risk group to develop HB, the proportion of respondents knew about high risk groups as sex worker, drug abuser, working abroad, others, driver, health assistant and doctor was 40.2%, 33.3%, 9.2%, 8.1%, 5.7, 2.3% and 1.2%, respectively.Most of the respondents (71.0%) did not think whether HB is preventable, only 29.0% of thought that it is preventable.According to their knowledge about HB prevention, 55.2% of the respondents thought that HB is preventable told that it can be prevented by vaccination, followed by safe drinking water (32.8%), by safe sex (8.6%) and others (3.4%).A study carried out among the nursing students in Tamil Nadu, India showed that 69.3% had correct knowledge that it is a vaccine preventable disease. 14is study indicates that there is a lack of awareness about HB, its route of transmission and modes of prevention among the rural people and appropriate measures are needed to increase correct awareness on HB for prevention purpose.

Fig. 1 .
Fig. 1.Distribution of the respondents whether they knew about HB or not, (n = 200).