Prevalence of hepatitis B seropositivity amongst trauma patients presenting to accident and emergency surgical

Hepatitis B virus (HBV) is a viral disease of orthopeadic importance, with risk of transmission from the patient to the surgeon and from surgeon to the patient. Nigeria has a high prevalence of HBV with many cases of complications of the infection resulting in liver cirrhosis and liver cancer. Trauma is the leading cause of presentation to the hospital and can present a picture of the situation in the community as regards HBV prevalence, thus highlighting the risk of HBV exposure to both the patient and the healthcare provider. Objective: The study assessed the prevalence of hepatitis B seropositivity amongst trauma patients presenting at the Accident and Emergency Surgical department of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State, South-Eastern, Nigeria. Methods: A two year retrospective observational study of trauma patients with hepatitis B screening done during presentation at the Accident and Emergency Surgical department of Alex Ekwueme Federal University teaching Hospital Abakaliki, Ebonyi State, South-East Nigeria. The patient folders and laboratory records was the source of data. Post traumatic patients aged 2 - 70 years that were screened at presentation were consecutively added to the study. Information obtained included the demographic data and the result of hepatitis B screening test. Results: The total number of trauma patients that had hepatitis B screening at presentation to the Accident and Emergency Surgical over a period of 2 years was 953 out of which 84 was reactive while 869 were nonreactive. The prevalence of hepatitis B surface antigen in this group of patients was 8.8%. The distribution of the patient based on gender showed that 636 (66.7%) were males and 317(33.3%) were females. The distribution based on occupation showed that artisans were 95 (10.0%), commercial motorcyclist were 105 (11.0%), farmers were 81 (8.5%), students were 276 (29.0%), civil servants were 121 (12.7%) and traders were 275 (28.9%) patients. Conclusion: The prevalence of hepatitis B surface antigen among trauma patients presenting at the Accident and Emergency Surgical department in the study highlighted the risk to patients and healthcare providers. The higher proportion of male in this study further buttress the knowledge of involvement of more male in trauma which was the group surveyed. The need for proper waste management, adequate and regular cleaning of surfaces, and adequate sanitization of non- critical instruments and proper sterilization of critical instruments were noted. The provision and proper use of personal protective equipments and employing universal precaution in the treatment of all patients will help in reducing transmission. Vaccination of all healthcare providers against hepatitis B is a tool to break the chain of transmission within the accident and emergency if fully deployed.