Annals of African Medicine

: 2013  |  Volume : 12  |  Issue : 1  |  Page : 55--56

Prevalence of hepatitis B virus surface antigen among healthy asymptomatic students in a Nigerian University

Maryam Aminu1, Emmanuel E Okachi1, Sani M Abubakar2, Abdullateef Yahaya2,  
1 Department of Microbiology, Faculty of Science, Ahmadu Bello University, Zaria, Nigeria
2 University Health Services, Main Campus, Ahmadu Bello University, Zaria, Nigeria

Correspondence Address:
Maryam Aminu
Department of Microbiology, Faculty of Science, Ahmadu Bello University, Zaria

How to cite this article:
Aminu M, Okachi EE, Abubakar SM, Yahaya A. Prevalence of hepatitis B virus surface antigen among healthy asymptomatic students in a Nigerian University.Ann Afr Med 2013;12:55-56

How to cite this URL:
Aminu M, Okachi EE, Abubakar SM, Yahaya A. Prevalence of hepatitis B virus surface antigen among healthy asymptomatic students in a Nigerian University. Ann Afr Med [serial online] 2013 [cited 2023 Mar 29 ];12:55-56
Available from:

Full Text


Hepatitis B is one of the most infectious diseases in the world and a major public health problem. [1],[2] About 5% of world population are asymptomatic carriers and 350 million people worldwide are chronic carriers of hepatitis B virus (HBV). [1] Chronic HBV infection is a major risk factor for deaths from cirrhosis and liver cancer. [1],[2],[3] The infection has reached hyper-endemic levels in Nigeria, [3] with the sero-prevalence of hepatitis B virus surface antigen (HBsAg) estimated to range from 10% to 40%. [4] This study determines the prevalence of HBsAg amongst healthy asymptomatic students in Ahmadu Bello University (ABU), Zaria, Nigeria, and assesses the possible associated risk factors.

Two (2) ml of blood was collected from 200 consenting students during the months of July and August 2009. Each student completed a questionnaire used to obtained information on risk factors. Sera were separated by centrifugation at 1500 rpm for 5 min and screened for HBsAg using rapid immunochromatographic test kits. All sera and the test strips were allowed to equilibrate to room temperature (15-30°C) prior to testing. Positive sera were confirmed with ELISA (Beijing King Hawk, Pharmaceutical Co., Ltd. SFDA, China). Pearson Chi-square was calculated at 95% confidence interval and p value ≤ 0.05 was considered significant.

Out of the 200 sera analysed, 25 (12.5%) were positive for HBsAg. Male students were more likely (14.4%: 17/118) to be infected with HBV than female students (9.8%: 8/82) [odds ratio (OR) =1.56, 95% CI = 0.638−3.800, χ2 = 0.957, df = 1, P = 0.225]. The highest incidence of HBsAg (31.3%: 5/16) was insignificantly (χ2 = 7.237. df = 3, P = 0.065) detected among students <18 years of age [Table 1]. Further analysis of the results showed a higher prevalence of 13.8% (21/152) in students below 30 years compared to 8.3% (4/48) in students above 30 years (OR = 1.76, 95% CI = 0.574−5.418). Married students had the highest prevalence of HBsAg (13.9%: 5/36) compared to single students (11.8%: 19/161). One third (33.2%: 64/200) of the students were not aware of hepatitis B and the mode of transmission. Knowledge of the virus was mostly gotten from discussion with friends and from lectures.{Table 1}

The risk factors studied were unprotected sex, mouth-to-mouth kissing, blood transfusion, reused razor blade cuts, public barbing saloon clipper cuts, manicure and pedicure cuts, needle stick injury, reused needles, syringes and lancets, and scarification. There was no statistically significant relationship between HBsAg and all the risk factors studied (P > 0.05). However, students who had been cut with reused razor blade (OR = 2.32, 95% CI = 0.883−6.093) and those that had needle stick injury (OR = 1.66, 95% CI = 0.680−4.055) were more likely to be infected.

The high (12.5%) prevalence of HBsAg obtained in this study suggests that hepatitis B is common among students in the campus and may be due to its mode of transmission. Hepatitis B virus can be transmitted via contact with all bodily fluid (including saliva, semen, sweat, breast milk, tears, urine, vaginal secretions, and faeces) and by frequent and prolonged close personal contact with an infected person. [1],[2] Close personal contact is a characteristic seen in Main Campus, ABU, Zaria, where more than six students stay in a room in the hostel. Importantly, lack of knowledge of hepatitis B by one third of the students studied is alarming, especially when the virus is highly infectious and is hyper endemic in Nigeria. This finding, coupled with the high prevalence obtained, may increase the likelihood of further spread among students on campus. Students with reused razor blade cut and needle stick injury were more likely to be infected with HBV because the virus has very low-infective dose and is stable and infectious on environmental surfaces [1],[2] and other objects such as tooth brush. [4]

Therefore, there is an urgent need to step up hepatitis B health education campaign through means other than electronic and print media, as media was the least means through which the students in this study got to know about hepatitis B. Screening and vaccination of students during the first year of study is recommended since HBV vaccine has been shown to be protective. [4],[5] We propose further studies to identify factors associated with the spread of hepatitis B in Nigeria. We think our result may not reflect the true prevalence of HBV amongst students since HBsAg marker is not detected during the window period of the infection.


1Shepard CW, Simard EP, Finelli L, Fiore AE, Bell BP. Hepatitis B virus infection: Epidemiology and vaccination. Epidemiol Rev 2006;28:112-25.
2Willey JM, Sherwood LM, Woolverton CJ. Human diseases caused by viruses and prions: Direct contact diseases: Viral hepatitides. In: Willey JM, Sherwood LM, Woolverton, CJ, editors. Prescott's Microbiology. 8 th ed. New York: The McGraw Hill Companies International Edition. 2011. p. 919-21.
3Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg sero-prevalence and endemicity. Vaccine 2012;30:2212-9.
4Forbi J, Pennap G, Silas-Ndukuba C, Agabi Y, Agwale S. Serological markers and risk factors for hepatitis B and hepatitis C viruses among students in a Nigerian university. East Afr J Public Health 2009;6:152-5.
5Odusanya OO, Alufohai E, Maurice FP, Ahonkhai VI. Five-year post vaccination efficacy of hepatitis B vaccine in rural Nigeria. Hum Vaccin 2011;7:625-9.