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Effect of Hepatitis B Awareness Education on Hepatitis B Screening Uptake among University Students in Nigeria

Abstract

Hepatitis B virus (HBV) infection remains an important public health concern because chronic infection may result in liver cirrhosis, liver failure, and hepatocellular carcinoma. University students may be exposed to HBV through unprotected sexual activity, contact with infected blood or body fluids, unsafe tattooing or body piercing, sharing of sharp objects, and other exposure routes. Despite the availability of screening and preventive measures, limited knowledge of HBV transmission, symptoms, complications, vaccination, screening procedures, and treatment may contribute to low uptake of hepatitis B screening among young adults. Hepatitis B awareness education provides an opportunity to improve students' understanding of the infection, identify risk factors, reduce misconceptions, and encourage appropriate use of screening services. Against this background, this study investigates the effect of hepatitis B awareness education on hepatitis B screening uptake among university students in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Literacy Framework. The Health Belief Model explains how students' perceptions of their susceptibility to hepatitis B, perceived severity of infection, perceived benefits of screening, perceived barriers, and cues to action may influence screening uptake. Social Cognitive Theory emphasizes observational learning, self-efficacy, social influence, and environmental factors in the adoption of preventive health behaviours. The Health Literacy Framework emphasizes students' ability to access, understand, evaluate, and apply hepatitis B-related health information when making decisions about screening and prevention. Collectively, these theoretical perspectives provide a suitable framework for explaining how hepatitis B awareness education may influence screening uptake among university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate students enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, and eligible students. Hepatitis B awareness education will be assessed using indicators such as exposure to structured educational sessions, frequency and duration of education, information on HBV transmission, risk factors, signs and symptoms, complications, screening procedures, interpretation of screening results, vaccination, prevention measures, treatment options, confidentiality, and availability of screening services. Hepatitis B screening uptake will be assessed using indicators such as previous screening, recent screening, intention to undergo screening, participation in university or community screening programmes, knowledge of available screening locations, willingness to seek screening after potential exposure, and documented completion of screening where records are ethically and appropriately available. Data will be collected using structured questionnaires, validated hepatitis B knowledge instruments, screening attendance records, university health-service records, and relevant health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to hepatitis B awareness education, and screening uptake. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of hepatitis B awareness education on screening uptake. Where a quasi-experimental design is adopted, screening uptake indicators before and after the educational intervention may be compared to determine changes associated with the programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that hepatitis B awareness education has a significant positive effect on hepatitis B screening uptake among university students in Nigeria. Students who receive structured and accurate education are expected to demonstrate improved knowledge of HBV transmission, risk factors, complications, prevention, vaccination, and screening, as well as greater willingness to utilize screening services. Education may help students understand that hepatitis B can be asymptomatic and that screening provides an important opportunity for early identification and appropriate medical follow-up. Campus-based awareness campaigns, peer education, interactive sessions, and accessible screening services may further encourage participation. However, fear of a positive result, stigma, concerns about confidentiality, misconceptions about hepatitis B, financial barriers, limited access to screening services, and inadequate awareness of available screening locations may reduce uptake. The study therefore expects accessible, confidential, youth-friendly, culturally appropriate, and regularly reinforced hepatitis B awareness education to contribute significantly to improved screening uptake among university students in Nigeria. The study is expected to contribute to the literature on hepatitis B awareness education, hepatitis B screening uptake, viral hepatitis prevention, university student health, health education, infectious disease prevention, vaccination awareness, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, universities, university health services, hospitals, primary healthcare facilities, public health educators, student organizations, development partners, and policymakers regarding strategies for improving hepatitis B prevention and screening among young adults. The study will also provide evidence-based recommendations for integrating hepatitis B education into university health programmes, expanding campus-based screening initiatives, improving access to confidential screening services, strengthening vaccination awareness, reducing stigma and misconceptions, and establishing sustainable hepatitis B prevention and screening programmes across Nigerian universities.

Keywords: Hepatitis B awareness education, hepatitis B screening uptake, hepatitis B virus, university students, viral hepatitis, health education, screening, vaccination, infectious disease prevention, Nigeria, public health.