COVID-19 Update - This is to inform you that the Government of India has announced a complete lockdown in India 22nd March 2020 to 14th April 2020. As a result, our offices will now be closed till 14th April 2020 and all our employees will be working from home. Office telephones will not be answered, and therefore you are requested to direct all your queries related to manuscript submission, review process, publication etc. at below mentioned details.,, Mob. 8826373757, 8826859373, 9910947804

Print ISSN:-2581-4753

Online ISSN:-2581-4761


Current Issue

Year 2019

Volume: 5 , Issue: 4

  • Article highlights
  • Article tables
  • Article images

Article view: 77

Article download: 68

Wadekar, Sathish J V, and Krishna: Awareness of Hepatitis B infection among second year medical students and their vaccination status


Viral hepatitis refers to the inflammation of the liver caused by hepatitis viruses which are heterogeneous group of viruses that belong to different families and are hepatotropic. Hepatitis viruses consists of types A, B, C, D, E, G. Many other viruses such as yellow fever virus, cytomegalovirus can cause sporadic hepatitis.1 Hepatitis B is an acute systemic infection with major pathology in the liver, caused by Hepatitis B virus (HBV) and transmitted by multiple routes with parenteral route being most common in developing countries.2 It commonly produces an acute self-limiting infection, which may be either subclinical or symptomatic. Persistent HBV infection may cause hepatic complications like chronic hepatitis, fulminant hepatitis, cirrhosis of liver and hepatocellular carcinoma.3 HBV infection is one of the major health concerns worldwide with a global incidence of approximately 4.5 million cases per annum and a highly lethal disease causing approximately 620,000 deaths per annum globally due to chronic hepatitis, cirrhosis, and hepatocellular carcinoma.4

Parenteral drug abusers, multiple transfusions, hemodialysis, tattooing and multiple sexual partners have been identified as common modes of HBV transmission in the developed world. Blood, semen, saliva and vaginal secretions transmit the disease. In health-care settings, un-sterilized needles and syringes are the most common factors for HBV transmission. In low socio-economic settings, horizontal transmissions of HBV through contact with infected family member have also been reported.5 Hepatitis B infection are common due to lapse in the sterilization technique of instruments or due to the improper hospital waste management as 10% to 20% health care waste is regarded hazardous and it may create variety of health risk.6 In fact HBV infection is more infectious as compared to HIV infection. Transmission rate after percutaneous exposure to blood is much higher (about 50%) than that of Humanimmunodeficiency virus (HIV).7 India has intermediate endemicity of Hepatitis B, an estimate of 2-5% general population is chronically infected with hepatitis B.8

HBV is preventable with a safe and effective vaccine, the first vaccine against cancer due to HBV infection.9 HBV vaccines has been available since 1982. World Health Organization implementations of mass immunization programs has dramatically decreased the incidence of HBV infection and liver cancer.10 HBV infection has been recognized as an important occupational hazard for health care workers.11 Prevention against any disease is proportional to knowledge, attitude and practice (KAP) of the population. Health care workers should familiarize themselves with ‘‘universal precautions ’’, which is defined by Center for Disease Control, as a set of precautions designed to prevent transmission of HIV, HBV, and other blood-borne pathogens.12 Knowledge regarding the HBV and safety precautions is needed to minimize the health care associated infections among health personnel.13 Hence the present study is conducted to assess the awareness of hepatitis B infection among second year medical students and to know their vaccination status.

Materials and Methods

A cross-sectional study was conducted among 136 second year medical students of Chamarajanagar Institute of Medical Sciences, Chamarajanagar. First year, final year medical students and those who did not give consent to participate in the study were excluded from the study. A questionnaire was used for data collection. The questionnaire included 12 questions about routes and modes of transmission, symptoms, sequelae, treatment and prevention of HBV. The students were also asked about their vaccination status and the reasons for not getting vaccinated.

Statistical analysis

Analysis was done using MS Excel. The collected data were entered in MS excel sheet and were expressed in percentages.

Ethical considerations

Ethical clearance was obtained from the Institutional Ethical clearance committee of Chamarajanagar Institute of medical sciences, Chamarajanagar.


All 136(100%) students had knowledge regarding the causative agent and organ involvement. 128(94.1%) and 125(91.9%) students were aware of modes of transmission and symptoms respectively. 3(2.2 %) and 5(3.7%) students considered sexual intercourse and transfusion of contaminated blood as the only mode of transmission respectively and 10(7.4%) thought jaundice as the only symptom. 117(86%) knew about carrier state. 132(97%)students considered hepatitis B to be preventable and 116(85.3%) were aware of inclusion of hepatitis B vaccine in national immunization schedule. Most students 125(92%) were aware about route of administration of vaccine as intramuscular and 11(8%) considered either oral, intradermal or subcutaneous route. 106(77.9%) students knew about HBsAg as screening marker and only 68(50%) students had awareness regarding antiviral therapy as treatment method. Other 68(50%) students considered vaccination and immunotherapy as treatment. 133(97.8%) were vaccinated, 2(1.5%) students were incompletely vaccinated and 01(0.7%) was not vaccinated with reason being never thought of vaccination.

Table 1
Awareness of Hepatitis B infection No. %
Causative agent
1. Virus 136 100
2. Bacteria - -
3. Protozoa - -
Mode of transmission
1. Sexual intercourse 3 2.2
2. Transfusion of contaminated blood 5 3.7
3. Vertically from mother to child - -
4. All of the above 128 94.1
1. Loss of appetite 1 0.7
2. Vomiting - -
3. Jaundice 10 7.4
4. All of the above 125 91.9
Causes liver disease?
1. Yes 136 100
2. No - -
Carrier state
1. Yes 117 86
2. No 19 14
Screening for hepatitis B infection
1. HBsAg 106 77.9
2. Anti- HBc 11 8.1
3. Anti- HBe 14 10.3
4. HBeAg 5 3.7
Included in National immunization schedule?
1. Yes 116 85.3
2. No 20 14.7
Route of administration of vaccine
1. Oral 1 0.7
2. Intramuscular 125 92
3. Intradermal 9 6.6
4. Subcutaneous 1 0.7
1. Antiviral therapy 68 50
2. Immunotherapy 19 14
3. Vaccination 49 36
1. Yes 132 97
2. No 4 3
Receivedhepatitis B vaccine?
1. Yes (complete) 133 97.8
2. Yes (incomplete) 2 1.5
3. No 1 0.7
Reason behind not being vaccinated
1. Lack of motivation - -
2. Fear of injection - -
3. Vaccine unavailable - -
4. Never thought of vaccination 1 0.7

Awareness of Hepatitis B infection


Hepatitis B virus infection occurs worldwide and is an important occupational risk for health care workers. Since the introduction of hepatitis B vaccination in our national immunization schedule, the incidence of the disease has decreased much. But to bring it down further health care workers should have knowledge about its transmission, prevention and vaccination.14 Medicals tudents have an important role in creating awareness and improve skills to prevent infectious, occupational risk due to HBV.15,16

Our study showed, students had good knowledge regarding the causative agent and organ involvement. Knowledge regarding HBV transmission is essential to take proper protection during their clinical posting as HBV is more infectious than HIV.17 94.1% students were aware of transmission of hepatitis B and 5.9% considered sexual intercourse and transfusion of contaminated blood as the only mode of transmission. Study done by Paul P et al.18 showed awareness through sexual route at 65.5%, by contaminated needles and syringes at 71.7%, by blood transfusions at 81.8% and vertical transmission at 55.9%. In our study, 86% students knew about carrier state and in study done by Georgia Gioula et al.19 only 47% were aware of carrier state. The knowledge about prevention was good and the students also knew about availability of vaccines, its inclusion in national immunization schedule and route of vaccine administration. Sujatha P et al.20 study showed 88% awareness of prevention by vaccine.

Two decades ago, to overcome the prevalence and burden of hepatitis, vaccination program was initiated and since then it is available all over the country.21 Our study showed very high vaccination status of 97.8%, 1.5% students were incompletely vaccinated and 0.7% non-vaccinated. Study by Singh et al.22 among medical students showed vaccine status of 80%. Regardless of the duration of HBV vaccine protection, medical students should continue to be vigilant in their protection against HBV by refreshing their knowledge with the multi-dose requirements for full HBV protection because they remain a high-risk population.23 There fore, to achieve ultimate goal, it is recommended to apply more studies and surveillance for all future medical students and health care workers to ensure their protection against HBV infection. Besides, health promotion and awareness about the importance of vaccination, is to be more developed.24


Medical students are at high risk of acquiring the hepatitis B infection. Health professionals are exposed to this danger while handling the patients, during investigations procedures in ward, during surgery etc. Overall awareness regarding hepatitis B is relatively good with high vaccination rate of 97.8%. It is recommended to vaccinate all non vaccinated students and measures need to be taken to create complete awareness.

Source of Funding


Conflict of Interest




R Madiha Mahmoud Awareness about hepatitis B virus infection (HBV) among students of medical and health colleges Hail University, Hail, KSAInt J Adv Res2018410561062


S M Biradar V S Kamble S Reddy Hepatitis B infection and vaccination: knowledge and attitude among medical studentsInt J Community Med Public Health20152395398


P Paul B Arumugam Knowledge and awareness regarding hepatitis B infection among medical and dental students: a comparative cross sectional studyInt J Res Med Sci2015323522356


4.Oyebimpe Jumoke Adenlewo Peter Olalekan Adeosun Olawunmi Adedoyin Fatusi Medical and dental students attitude and practice of prevention strategies against hepatitis B virus infection in a Nigerian universityPan Afr Med J20172833


Wajiha Raza Knowledge, Attitude and Practices (KAP) of Medical students towards Hepatitis B and CAnn Pak Inst Med Sci200842116120


G Velvzhi K Senthil G Sucilathangam C Revathy Knowledge and Attitude of Medical Students towards Hepatitis B InfectionInt J Curr Microbiol App Sci201656570576


M R Giri J K Panda A K Sahoo Hepatitis B awareness and vaccination status among first year medical studentsInt J Community Med Public Health20163530532


A V Sareetha H Nagabushan K H Supriya Effect of educational intervention on knowledge, attitude and practice of hepatitis B vaccine among medical studentsInt J Basic Clin Pharmacol20187992997


Samir M Othman M Abubakir Saleh P Nazar Shabila Knowledge about hepatitis B infection among medical students in Erbil city Iraq. European Sci J20133299305


Nazir Ibrahim Amr Idris Hepatitis B Awareness among Medical Students and Their Vaccination Status at Syrian Private UniversityHepatitis Res Treatment201417


Zaki M. Eisa A Saleh Eifan Saleh A. Eifan A Basheer Al-Sum Awareness of Viral Hepatitis B and C Infection among First Year Medical Sciences Students in Jazan UniversityPublic Health Res201225167173


Y M Mesfin K T Kibret Assessment of Knowledge and Practice towards Hepatitis B among Medical and Health Science Students in Haramaya University Ethiopia. PLoS ONE201381179642


Anjali Singh Shikha Jain Prevention of Hepatitis B; knowledge and practices among Medical studentsHealthline201122811


M S Akhter Asm Rizwan M Wahiduzzaman Vaccination Status and Awareness of Hepatitis B among Undergraduate Medical Students of Two Medical Colleges in BangladeshMed Today20162812729


A H Al-Hazmi Knowledge, attitudes, and practice of medical students regarding occupational risks of hepatitis B virus in College of Medicine, Aljouf UniversityAnn Med Health Sci Res201551319


Nazir Ibrahim and Amr Idris. Hepatitis B Awareness among Medical Students and Their Vaccination Status at Syrian Private UniversityHepatitis Res Treat201417


Anjali Singh Shikha Jain Prevention of Hepatitis B-Knowledge and Practices Among Medical StudentIndian Med Gazette20125255


P Paul B Arumugam Knowledge and awareness regarding hepatitis B infection among medical and dental students: a comparative cross sectional studyInt J Res Med Sci2015323522356


Georgia Gioula Knowledge of medical students about Hepatitis BAristotle Univ Med J20083535558Georgia Gioula


P Sujatha K Sowmya Sudha Assessment of Knowledge regarding Hepatitis B among Medical Students in Rangaraya Medical CollegeInt J Interdiscip Multidiscip Stud (IJIMS)2014174547


Asghar Ali Shigri Mohammad Ali Leghari Samreen Mazhar Mahwish Bano Mahwish Bano. Knowledge, attitude and practice of hepatitis B among dental and medical students of private medical university, Karachi. Pak Oral DentalPak Oral Dental J 2015351111115


S P Singh G C Mishra A K Mittal Hepatitis B vaccination among Medical College students: Results of a surveyIndian J Gastroentrorol2000193334


F A Ghomraoui Medical students awareness of and compliance with the hepatitis B vaccinein a tertiary care academic hospital: An epidemiological studyJ Infect Public Health201696065


Doaa Ali Aish Alsultan Hepatitis B Vaccination Status among Medical Students at King Faisal UniversityInt J Sci Res2016564447


© 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND license (