ABSTRACT
Background: Undiagnosed hypertension is a major public health problem causing severe cardiovascular disorders that are responsible for a high proportion of morbidities and mortalities, especially among adults living in low-income countries. However, there is a paucity of information that describes its epidemiology in Ethiopia. This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among adults in Durame town, southern Ethiopia. Methods: A community-based cross-sectional study was conducted from July to September 2022. Data were collected from 526 randomly selected adults aged ≥18 years using a pre-tested questionnaire. The binary logistic regression models were used to identify factors associated with undiagnosed hypertension. Results: The prevalence of undiagnosed hypertension among adults in Durame town, southern Ethiopia, was found to be 14.0% (95% CI: 11.2-17.1). Family history of hypertension [AOR = 6.9, 95% CI: (3.62, 13.27)], drinking too much alcohol [AOR = 5.7, 95% CI: (2.97, 10.75)], physical inactivity [AOR = 2.5, 95% CI: (1.34, 4.73)], consuming street foods regularly [AOR = 2.8, 95% CI: (1.28, 6.01)], and seeking healthcare for hypertensive symptoms without serious illness [AOR = 2.4, 95% CI: (1.28, 4.56)] were significantly associated with developing undiagnosed hypertension. Conclusion: The study has revealed that one in seven adults had undiagnosed hypertension in the study area. Thus, interventions to prevent hypertension should target increasing awareness among people with a family history of hypertension, controlling excessive alcohol consumption, promoting physical exercise, regulating street food markets, and improving the health-seeking behavior of adults in urban settings.
ABSTRACT
BACKGROUND: The detection of hepatitis B virus surface antigen (HBsAg) in serum remains the mainstay in diagnosing and screening of hepatitis B virus (HBV) in most developing countries. The absence of HBsAg in the blood may not indicate the absence of circulating HBV and might be infectious. Thus, this study aimed to estimate the burden and its cryptic transmission risks of occult hepatitis B infection (OBI) among HBsAg negative healthy individuals in Southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from September 2020 to January 2021. Serum samples were collected and assayed for HBsAg and HBV core antibody (anti-HBc) seromarkers using enzyme-linked immunosorbent assay (ELISA). In anti-HBc positive samples, HBV DNA was detected using real-time polymerase chain reaction (RT-PCR). Data were entered into Epi-Data version 3.1, cleaned, and analyzed using SPSS version 21.0. Descriptive and logistic regression analyses were employed. Statistical significance was decided at p < 0.05. RESULTS: A total of 346 were individuals included in this study; 34 (9.8%) were tested positive for HBsAg. The rest 312 (90.2%) negatively tested were further assayed for anti-HBc, and 115 (36.7%) were found positive implying previous exposure to HBV, and 21 (18.3%) out of 115 anti-HBc positives had HBV DNA signifying OBI. The HBV DNA concentration below 200 IU/mL was 85.7%. A high rate of OBI was observed among individuals who had multiple sexual contacts, a family history of hepatitis, and tattooing. CONCLUSION: In this study, the prevalence of OBI is high. This indicates the burden of HBV is considerable since screening is exclusively dependent on HBsAg which will not eliminate the possibility of residual cryptic transmission through blood donation, organ transplantation, perinatal transmission, and other contacts. Our results demonstrate that nucleic acid-based testing (NAT) should be an essential part of screening to prevent missing OBI.
ABSTRACT
BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver-associated morbidity and mortality for millions of people globally. Ethiopia is one of the viral hepatitis-endemic countries with no national strategy for surveillance and limited data. As such, this study aimed to investigated the extent and associated risk factors of HBV and HCV among community members in southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from January 2020 to August 2020. A structured questionnaire was used to collect behavioral and sociodemographic data. Serum samples were collected and assayed for seromarkers of HBV (HBsAg, anti-HBc, and anti-HBs) and HCV (anti-HCV) using ELISAs. In HBsAg-positive samples, HBV DNA was further quantified using RT-PCR. Data were entered into EpiData 3.1 and analyzed using SPSS 21.0. Descriptive statistics and logistic regression analysis were employed. RESULTS: The study included 693 participants. Seromarkers for HBsAg, anti-HCV, anti-HBc, and anti-HBs were found to be 9.5%, 1.4%, 31.1%, and 14.3%, respectively. In 66 HBsAg positives, 57 (86.4%) had quantifiable HBV DNA. Prevalence of current HBV infection (HBsAg+, anti-HBc+, anti-HBs-) and lifetime exposure (positive for either HBsAg or anti-HBc) to HBV were 8.7% and 31.9%, respectively, and 63.1% of participants were vulnerable or had no evidence of prior HBV infection (HBsAg-, anti-HBc-, anti-HBs-). On multivariate logistic regression analysis, multiple sexual contacts, family history of hepatitis infection, alcohol consumption, and khat chewing were significantly associated with HBV. The seroprevalence of HBV was relatively high in this study area. CONCLUSION: This study showed high prevalence of HBV infection, but low prevalence of HCV. This indicates that HBV is a major health problem in this community. Population-based surveillance, care, and treatment, as well as behavioral change and education programs, should be enhanced to minimize risk exposure.
