A Study Done by a Demonstrator and Two Professors in Public Health and Community Medicine Department in Faculty of Medicine in Assiut and New Valley University to Assess Knowledge, Attitude ,and Practice of Rural Population in a Remote Governorate ( New Valley ) Towards Hepatitis B and C Viruses

This study is a research aiming to identify knowledge , attitude and practice of population in a village in a remote governorate towards viral hepatitis B and C . It involves home visit interviews with population in this village with the use of questionnaire involving questions asked by the researcher that would be orally answered by the participants to be recorded in papers by the researcher.

PICO : What is the knowledge , practice and attitude of people in a village in a remote governorate towards viral hepatitis B and C ?

Introduction :

There are 5 main strains of the hepatitis virus , named alphabetically A, B, C , D and E and while they share in their ability to cause liver disease , they are different regarding mode of transmission , severity , geographical distribution and methods of prevention (1).

In particular of these 5 strains , both viral hepatitis B and C lead to chronic disease in hundreds of milions of people and are the leading cause of liver cirrhosis , liver cancer and viral hepatitis deaths (2) and good news that a WHO study predicted that four and half million premature viral hepatitis related deaths could be prevented in developing countries by 2030 through vaccination , screening tests , drugs and health education (3 ).

WHO estimated about 300 million people have chronic hepatitis B with chance of about 1.5 new infection yearly (4) with a systematic review and meta analysis of published studies from 2000 to 2022 revealed around 3.67 % prevalence of HBV in overall population in Egypt based on HBsAG with similar incidence in urban and rural areas ,2.4% and 2.15% respectively and the lowest prevalence among children less than 20 years old with history of vaccination aginast HBV as a compulsory vaccination in Egypt thus signifies high vaccination coverage among this age group(5) .

Further steps could be taken to decrease prevalence of HBV in Egypt include blocking chain of infection at mother -infant transmission , increasing the scale of the existing vaccine ,and adopting strategies aiming at screening and treatment(6).

Egypt launched the campaign of "100 Million SIHA" in 2018 and one of the goals of this campaign was screening for viral hepatitis C . After identification of cases through rapid antigen test in this campaign, cases had been directed to further testing and treatment with antiviral medications to cure the infection (6) . The official declaration of progress of Egypt in hepatitis C elimination with reduction in its prevalence10% to 0.38% in overall population in around 10 years has been announced in October 2023 (7) .

Previous study conducted in Egypt in 2013 showed that HCV is more prevalent among lower socioeconomic population sections . The HCV prevalence rate was higher in rural than urban areas with 12% in comparison to 7 % . and in the lowest wealth quintile than the highest quintile with 12% in comparison to 7 % (8). According to another study in 2014 , it showed high transmission rate of HCV in Egypt with each HCV could transmit infection to 3.54 subjects (9).

Although significant improvement in control measures in healthcare settings over the past decade, several areas in the domain of primary prevention have not been adequately addressed , such as limiting HCV transmission via IV drug use , sex workers ,and barbershops and several studies point to a poor knowledge of HCV mode of transmission and management (10) .

Rationale :

There is a need to measure knowledge,attitude , and practice regarding hepatitis virus B and C among population in rural areas of remote governorates as poor knowledge and bad practices are limiting factors in HCV elimination and descreasing HBV prevalance in Egypt

Eligibility Criteria:
Inclusion Criteria:

* Population in a Village in Elkharga in New Valley Governorate aged 18 years and older

Exclusion Criteria:

* 1- Population below age of 18 years 2- Population refusing to participate in the study