Knowledge and educational intervention pertaining to viral hepatitis in adolescent male students of urban and rural Sindh, Pakistan

In Pakistan, collective infection rate of hepatitis B surface antigen [HBsAg] and anti-hepatitis C virus [HCV] is 7.6% where as their prevalence are 2.5% and 5% respectively. Most commonly occurring viral hepatitis is hepatitis C, closely followed by hepatitis B and in males both are common, with hepatitis B seen earlier than hepatitis C. A cross sectional study was conducted on 585 adolescent college boys. Respondents were interviewed after informed consent and ensuring confidentiality. An anonymous questionnaire of close ended questions was completed followed by an educational intervention session. Knowledge regarding types of viral hepatitis was known to 11% urban and 22% rural respondents, while 75% from Karachi and 84% from interior Sindh had awareness that hepatitis B and C are infectious diseases. About 58% urban respondents knew that hepatitis B can develop cirrhosis and lead to liver cancer as compared to 73% rural inhabitants. Knowledge regarding spread of hepatitis B and C by transfusing infected blood or blood products or injury by infected sharp or tattooing/ body piercing was known to 43.5% from Karachi and 40% from interior Sindh. About 45% urban and 19% rural respondents were vaccinated for hepatitis B and reasons for not being vaccinated were non awareness and cost of vaccine. Knowledge regarding all aspects of disease was surprisingly better in the rural than urban population. Low vaccination status makes adolescents vulnerable to hepatitis. It is crucial to generate understanding about the disease in general and vaccination for hepatitis B in particular

Blood pressure, body mass index and waist circumference of school going children of Karachi

Exposure to cardiovascular risk factors during childhood may be associated with the development of atherosclerosis later in life. To determine blood pressure, body mass index and waist circumference in school going children of Karachi. A descriptive cross sectional study was conducted in schools of Karachi. Children from randomly selected public and private sector schools, aged between 8-14 years were included. Height, weight, body mass index, waist circumference and blood pressure of each child were recorded. All children with raised blood pressure were re-evaluated and their detailed history and physical examination was carried out. Of the total 500 children, 41[8.2%] were over weight, [23[9.2%] boys and 18 [7.2%] girls] and 33[6.6%] were obese [21 [8.4%] boys and 12[4.8%] girls]. Waist percentile > 90 was found in 65[26%] boys and 89[35.6%] girls and all obese [33] children had waist percentile >/= 90. Over all 21[4.2%] and 28[5.6%] children had raised systolic and diastolic blood pressure [>/= 95[th] percentile] respectively. With increasing status of body mass index, there was an increase in both systolic and diastolic blood pressure. Over weight and obese children had significantly [p<0.001] higher blood pressure values than children with healthy weight. In obese category, 3[9%] children were hypertensive [systolic and diastolic blood pressure >/= 95[th] percentile], 2[6.%, systolic] and 4[12.% diastolic] were pre-hypertensive [>=90<95] while over weight was marked by hypertension in 3[7.3%] and pre-hypertension in 5[12.2%]. Present findings are in accordance with the definition that 5% of children in any given population would be classified as having high blood pressure and an increase in body mass index and waist circumference was found associated with raised blood pressure. The study recommends a need for measuring blood pressure in children during health maintenance visits, to identify children at greatest risk of obesity in adolescent and suggest interventions before chronic overweight is established. Education department should introduce healthy life style behaviour in school curricula to improve the health of our younger generation

Perception of adolescent females about viral hepatitis in urban and rural Sindh

To assess perception regarding viral hepatitis among adolescent college girls and to evaluate the frequency of vaccination against hepatitis B of urban [Karachi] and rural [District Kambar Shadad Kot] Sindh. A cross sectional study using cluster sampling technique was conducted in five randomly selected intermediate colleges of Karachi and four of district Kambar Shadadkot during January 2008-February 2009. A total number of 500 adolescent college girls of age group 16-19 years were included in the study; 350 from urban and 150 from rural Sindh. A questionnaire was filled comprising of general information regarding viral hepatitis such as; type of hepatitis, mode of transmission, methods of prevention and status of vaccination etc. Respondents were interviewed after a written informed consent and confidentiality was assured. Data was analyzed using SPSS software package. Total respondents were 500; 350 from urban [Karachi] and 150 from rural [district Kambar Shadadkot] Sindh. Knowledge regarding various types of hepatitis was known to only 4% urban and 7% respondents from rural setup, while 54% from Karachi and 30% from interior Sindh had awareness that hepatitis B and C are infectious diseases. Seventy three percent of urban respondents knew that hepatitis B can develop cirrhosis and lead to liver cancer and 51% from rural population had the acquaintance. Immunization against HBV was recognized by 53% respondents of urban population but despite acquaintance only 28% were found vaccinated and the reason cited for non immunization was lack of awareness and cost of vaccine. Only 16% girls were found vaccinated from rural Sindh. Poor knowledge about hepatitis and vaccination against it amongst adolescents is still alarming and strategies need to be developed by the relevant authorities for creating awareness and to vaccinate them