1.1 Introduction
Hepatitis B virus continues to be among the significant global challenges, and its prevention is doubtable among nursing students due to the lack of knowledge or exposure to risky behaviors in their clinical practices. This study was conducted to assess nursing students at a selected campus in Rwanda about their knowledge, attitudes, and practices towards hepatitis B prevention. Hepatitis B is one of the most infectious diseases in the world and a major public health problem. About 5% of world population is asymptomatic carriers and 350 million people worldwide are chronic carriers of hepatitis B virus (HBV) (Willey et al., 2011).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
The World Health Organization (WHO) estimates at more than 2 billion the number of people infected with the Hepatitis B Virus (HBV) in the World. An estimated 240 million people are chronic carriers of HBV, making HBV infection the tenth leading cause of death. More than 600,000 people die every year from complications of hepatitis B. Liver cancer is the worst consequence of HBV infection and is the second leading cause of deaths due to cancer in the World. Sub-Saharan Africa (SSA) has the highest prevalence of Hepatitis B with 80 million people carriers of HBV and a prevalence ranging from 5% to 10% in the adult population (World Health Organization, 2016).
Hepatitis B virus is one of the significant global challenges, and about 257 million people live with hepatitis B virus (HBV) infection, whereby a significant number of 887000 died in 2015 from its complications (WHO, 2017). Many studies have found that HBV prevention is doubtable among nursing students due to the lack of knowledge or exposure to risky behaviors in their clinical practices. For instance, in Asia, one study found that nursing students had good knowledge of HBV but still had risky behaviors during their practices (Khan et al., 2017). Contrary, another study on the same continent has found that undergraduate students had poor knowledge (Al-redha et al., 2017).
In Africa, there is a lack of awareness about Hepatitis B, its transmission route, and modes of prevention among students entering into the profession (Mesfin et al., 2013). This is a challenge because these students are highly exposed to accidental blood and low uptake of HBV vaccine (Abdela et al., 2016). Early exposure of these students to clinical services is also one factor that increases their risk of acquiring and transmitting infections, including HBV (Ojulong et al., 2013). These results are very similar to the studies done in Sub-Saharan Africa among students (Noubiap et al., 2013).
Hepatitis is considered a severe public health concern, its prevalence is not well known, and the mortality related to these infections is poorly characterized. However, some current estimates compiled from various studies provided Hepatitis B prevalence among different groups. HBV confection is 4.3% among people living with HIV (Umutesi et al., 2017) and 4.1% among blood donors in the whole country, with a big number in the Central and Eastern regions (Twagirumugabe et al., 2017). Besides, 3.1% of pregnant women in Kigali were seropositive for HBsAg (Nyamusi et al., 2017).
Considering the magnitude mentioned above of HBV prevalence in Rwanda, assessing nursing students about HBV prevention would be a top priority since they get in contact with those clients. During the clinical training, students are exposed to body fluids, which makes them be at high risk of contracting HBV once their knowledge, attitudes, and practices are not addressed (Abdela et al., 2016). Therefore, students should be well educated on preventing HBV and taking the vaccine ((Khan et al., 2017; Noubiap et al., 2013). Although there are measures taken across the literature, there is limited knowledge of how nursing students in Rwanda prevent HBV in the clinical settings. Therefore, the researchers sought to assess the knowledge, attitude, and practice towards preventing hepatitis B virus among nursing students at a selected campus. The infection has reached hyper-endemic levels in Nigeria, with the prevalence of hepatitis B virus surface antigen (HBsAg) estimated to range from 10% to 40% (Forbi et al., 2009).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to assess the Knowledge, Attitude and Practice of Hepatitis B Infection Prevention among Nursing Students.
1.3 Statement of Problems
Investigation revealed that there is a lack of awareness about Hepatitis B, its transmission route, and modes of prevention among students entering into the profession (Mesfin et al., 2013). This is a challenge because these students are highly exposed to accidental blood and low uptake of HBV vaccine (Abdela et al., 2016).
Early exposure of these students to clinical services is also one factor that increases their risk of acquiring and transmitting infections, including HBV (Ojulong et al., 2013). These results are very similar to the studies done in Sub-Saharan Africa among students (Noubiap et al., 2013).
1.4 Aim and Objectives of Study
The aim of the study is to examine the Knowledge, Attitude and Practice of Hepatitis B Infection Prevention among Nursing Students. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the Hepatitis B surface antigen among Nursing Students in the area under study;
- To estimate the prevalence of Hepatitis B and its correlates among Nursing Students in the area under study;
- To evaluate the attitude and practice of Nursing students towards hepatitis b infection prevention;
- To examine the knowledge of Nursing students towards hepatitis b infection prevention; and
- To estimate the Socio-demographic Characteristics of Nursing students towards the prevalence of hepatitis B in the area under study.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What do you understand about Hepatitis B surface antigen among Nursing Students?
- What is the prevalence of Hepatitis B and its correlates among Nursing Students in the area under study?
- What is the knowledge of nursing students towards hepatitis b infection prevention?
- What is the attitude and practice of nursing students towards hepatitis b infection prevention?
- What are the Socio-demographic Characteristics of Nursing students towards the prevalence of hepatitis B in the area under study?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: The Socio-demographic Characteristics of Nursing students does not instigate the prevalence of hepatitis B in the area under study
- H1: The Socio-demographic Characteristics of Nursing students instigate the prevalence of hepatitis B in the area under study
Hypothesis Two
- H0: There are no significant factors inhibiting the prevention practice of hepatitis b infection prevention among Nursing Students
- H1: There are significant factors inhibiting the prevention practice of hepatitis b infection prevention among nursing students
1.7 Significance of Study
This research work when completed and implemented it will help the Nursing students to be informed about Hepatitis B surface among students, and the estimation of prevalence of Hepatitis B. This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of the research is focused on the Knowledge, Attitude and Practice of Hepatitis B Infection Prevention among Nursing Students in Enugu State Teaching Hospital (ESUTH), Nigeria.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Technical Terms
Hepatitis B: A serious liver infection caused by the hepatitis B virus that's easily preventable by a vaccine.
Prevalence: Prevalence is the proportion of a particular population found to be affected by a medical condition at a specific time.
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