J Ayub Med Coll Abbottabad 2008;20(1) http://www.ayubmed.edu.pk/JAMC/PAST/20-1/Zuberi.pdf 91 APPRAISAL OF THE KNOWLEDGE OF INTERNET USERS OF PAKISTAN REGARDING HEPATITIS USING ON-LINE SURVEY Bader Faiyaz Zuberi, Faisal Faiyaz Zuberi*, Aneel Vasvani, Nabiha Faisal, Salahuddin Afsar, Javeria Rehman, Beenish Qamar, Batool Jaffery Department of Medicine, Dow University of Health Sciences, Karachi, *The Aga Khan University Hospital, Karachi, Pakiostan Background: Hepatitis B and hepatitis C are global health care problems causing morbidity and mortality. Much of it could be prevented by better education of the masses regarding its spread. The study was conducted to assess the knowledge base of internet users of Pakistan to help in formulating education strategies. Methods: A survey questionnaire consisting of 20 close ended questions was designed and hosted on a website. The responses submitted at the website were auto-emailed to the author. Results: A total of 1024 complete responses were included. The survey shows increased level of awareness according to the educational status. The knowledge status of lowest education level was also adequate possibly due to access to internet to these respondents. Conclusion: Internet users in Pakistan have adequate core knowledge regarding hepatitis. Key Words: Hepatitis, HBV, HCV, Survey INTRODUCTION Hepatitis B and hepatitis C are the major health problems globally casting an enormous burden on health care system and major source of patient’s misery. 1-3 These are also an important cause of hepatocellular carcinoma and are likely to remain a serious health problem resulting in substantial morbidity and mortality for several decades to come. 4,5 The prevalence of HBV varies greatly in different areas of world. The HBV virus is endemic worldwide with the areas of highest endemicity being China, Southeast Asia, Sub Sahara Africa, most Pacific island and the Amazon basin. 6 Approximately 30% of the world’s population (2 billion) has serological evidence of hepatitis B virus infection and among them 350 million have chronic HBV infection. About 75% of the entire chronically infected carrier world wide is found in Asia and at least one million die from liver cirrhosis and liver cancer each year. 7,8 The prevalence of hepatitis C virus (HCV) varies tremendously in different parts of the world, with the highest incidence in the Eastern parts of the globe compared with the Western parts. 9 Approximately 170,000,000 people worldwide and 4,000,000 in the United States are infected with HCV, 3–4 million people are newly infected each year perinatal transmission from mother to foetus or infant is also relatively low but possible (less than 10%). 10-13 Furthermore, certain groups of individuals such as intravenous drug users are at increased risk of acquiring this disease irrespective of the geographical location. Although the main route of transmission is via contaminated blood, curiously enough in up to 50% of the cases no recognizable transmission factor/route could be identified. Pakistan is also facing the huge burden of these diseases. A community based study in Hafizabad, showed a prevalence of 4.3% of HBV and 6.5% of anti-HCV in the residents. In northern Pakistan, 3.3% of healthy blood donors were HBs Ag positive, 4% were anti-hepatitis C virus positive. 14 Pakistan is a developing country and has poor health indicators. It ranks 134 th of the 174 countries on the human development index of the United Nations. 15 In Pakistan, over one-third of the people are living in poverty and have a fragile health structure; many patients cannot afford the costly treatment of these diseases. Estimated cost of treatment of hepatitis B and C are 286.6 billion rupees and 235.2 billion rupees per annum respectively. 16 Prevention is the only strategy against the worldwide epidemic of viral hepatitis. Concrete measures are required to develop a strategy to educate the public regarding the risk factors. For an effective mass education strategy, base line knowledge of the society needs to be assessed. The objective of this study is to determine the knowledge base of the internet users regarding hepatitis . MATERIAL AND METHODS A survey questionnaire consisting of 20 close ended questions was designed. In some questions only one response could be selected while in others more than one selection was possible. The questionnaire was hosted on the principal author’s personal website. Form mail software was enabled thus the responses submitted by the visitor on the website were instantly emailed to principal author. Invitation emails to participate in the survey were sent to people on contact lists of all authors with request to forward them to their contacts. The survey was hosted during the period April-July 2006. After this period the form was removed from the website. A data file with corresponding variables was created in the SPSS version 14.0 and responses from the emails were entered by two separate keypunchers. The data entered by two was compared and all non matching data was checked with response emails again and corrected. Responses from only people residing in Pakistan were selected. Using SPSS frequencies of responses were computed, responses