European Journal of Cardiovascular Medicine

Hepatitis B is a common but also serious infectious disease of the liver because of its severe pathological consequences like chronic hepatic insufficiency, cirrhosis of liver and hepatocellular carcinoma. Infections usually occurs during early childhood, may be asymptomatic but often leads to chronic carrier state and are capable of transmitting disease for many years. More than 2000 million people are infected with HBV at some time of their life (WHO 2002) [1]. In spite of such serious consequences HBV has been over shadowed by HIV, which it deserves and as a result HBV has taken back seat in the mind of medical administration all over the world specially in India, but the virus continues to play its natural history of disease. In India many reports are available about the incidence of HBV in general urban population. In females the carrier rate of HBsAg has been studied only from cities and that too in mothers or from tribal population, but there is no report available in literature about incidence of HBV in general female population of rural India. Inspite of the fact that rural females are most neglected community of Indian society, irrespective of cast and religion. They have to carry out all the household and field work till they are completely bed ridden. Maximum they get is medical consultation from unregistered medical practitioners or quacks. The present work has been undertaken with a view to study the health status of rural female population in relation to systemic infections like Hepatitis B which affects future life of the subjects. The incidence of HBV was studied in the general female population among different age groups.

The present work was carried out in Department of Microbiology Santosh Medical College & Hospital, Ghaziabad from September 2006 to March 2010.This institute drain large rural population of western U.P. including Meerut, Dadri, Hapur, Bulandshar, Dhollana, Modinagar . Samples were collected from patients both from outpatient & indoor department. The test was carried out by commercially available kits including ELISA (S.D. make 3.0) & rapid (hepacard –immunopak and Viruchek-orchid) . Positive sample were stored at - 20° C for further study.

Table 1: HBsAg positivity in different age group

Table 2: Showing HBV positivity in female Population report by different investigators

OBSERVATION

In the present study 5035 female subjects grouped in 8 designated group A to H were studied for the presence of HBsAg (Table1). This included subject of youngest neonate and old of 90 years. Maximum no. of subjects belonged to age group C (21-30years), 2590 (51.5%) followed by group D (31-40years) 863(17.1%) and B (11-20years) 787(15.6%). Positivity for HBsAg was maximum in group G (61-70years) 21.9% and group H (71yrs and above) 19.5%. The youngest positive case in present study was a neonate and oldest subject of 90 years old lady.

Five thousand and thirty five female subjects belonging to rural population of western U.P. ,ranging between age of neonate to 90 years were screened for presence of HBsAg. Out of 5035 subjects screened for HBsAg, 256(5.084%) were found to be positive. The youngest subject positive for HBsAg was a neonate and oldest lady was of 90 years age. The maximum HBSAg positivity was found in the oldest group i.e. (61-70years) and group H (71 years and above) and it was 21.9% and 19.3% respectively. In the age group C (21-30 years) and Group D (31-40 years) to which highest numbers of subjects were screened showed a positivity of 4.2% and 4.5% respectively. Group C and D age groups most important for rural ladies not only because of its sexually active age group but also because they have shoulder full responsibilities of house, children, and husbands and in laws. These age groups are also important because mother to child transmission of HBsAg may also occur if the female is positive for HBsAg and later this will increase the problems of rural female and family both mentally and economically. Incidentally there is increase in the incidence of HBsAg positivity after 40 years also. There is no report available in literature about incidence of HBsAg positivity in rural population of India. Various Investigators have detected HBV markers in mothers of urban population or in tribal population but not in rural population. Reports available from neighboring areas like Delhi [2-6], Aligarh [7] and Chandigarh [4]. The reports from Delhi itself showed wide variation about HBV positivity ranging from 0.82% in the study of Varghese et al(2004) [12], to 9.5% by Prakash et al (1998) [8] Table 2. Other Investigators have reported figures ranging between the above two extremes, Abbas et al (2001) 1 found HBV positivity -1.01%, Panda et al (1991) [7] 2.26%, Shahini et al (2004) [10] 2.22% in the mothers only. From Aligarh Sharma et al (1996) [11] reported positivity of 10.19% among mothers. In contrast from Chandigarh, Biswas et a l(1989) [3] reported 2.3% positivity in 1000 cases while Gupta et al (1996) [5] reported 2,48% of positivity in a study in their 2337 subjects. From Bombay (now Mumbai) Khatri et al (1980) [6] reported only 0.62% and From Kolkata Banerjee et al (2003) [2] reported 2.81 % positivity. In the present study the HBV positivity in rural population in females of western U.P. is nearer and slightly on higher side to those reported from studies of urban population of Delhi by Chakravorty et al (1997)-4.25% and Banerjee et al -3.75%, but these data are from urban population who are educated and relatively better of economically in contrast to rural population which is by and large uneducated and relatively poor. Higher percentage of positivity clearly reflects the status of rural population. Concluding, a good vaccination strategy, information and education may will definitely reduce the incidence of HBsAg positivity in them and thereby have a positive impact on female health status of rural India.

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