An investigation into predictors of hepatitis e virus (HEV) and its preventative strategies in Walvis Bay, Erongo Region, Namibia.

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Namibia University of Science and Technology


Hepatitis E Virus (HEV), which is a viral liver infection was declared an epidemic in the year 2017 in Namibia. Subsequent to this declaration, the Ministry of Health and Social Services (MoHSS) called for a behavioural change effort in six affected regions in Namibia. Therefore, through this study, predictors such as cultural beliefs, demographics and socioeconomic factors of Hepatitis E virus and its preventative strategies among the Walvis Bay informal settlement residents was determined. The study helped in understanding and identifying perceptions on the predictors of the Hepatitis E virus outbreak among residents in Walvis Bay. The study employed both qualitative and quantitative methods using an exploratory descriptive design. In-depth interviews (n = 20 health care workers and Hepatitis E virus sufferers) guided by an interview guide was conducted with key informants, structured selfadministered questionnaires were distributed to 264 households, and records were reviewed from the Ministry of Health and Social Services, in the Walvis Bay State Hospital’s Health Information System (HIS). Quantitative data were analysed using Microsoft Excel of 2016 and Statistical Package for Services Solutions (SPSS) version 26, whereas content analysis was done for qualitative data illustrated through codes and verbatim quotes using ATLAS.ti 9. The correlation of dependent and independent variables was determined using Chi-square tests and one-way Multivariate Analysis of Variance (ANOVA). The study identified complex cultural beliefs such as eating food with own hands (mean =0.93), washing hands in one bucket (mean =0.67), shaking hands when greeting (mean=0.66) and the use of traditional medicine (mean=0.45). As indicated in the Walvis Bay epidemiological curve, the fluctuation of confirmed cases in each week was observed with the total of 206 cases, majority (57%) being male. Positive associations (p value =3.841) between the identified complex cultural beliefs and the population’s socio-demographic characteristics were determined. Finally, the use of traditional medicine, lack of HEV interventions to the affected communities and the socio-demographic factors were identified as the main obstacles to the health care management of HEV in Otweya informal settlement, Walvis Bay. The results of this current study showed that there are different traditional and cultural practices such as the use of traditional medicine (Oukoreb, Kamaku, Nara !Nomab) and hand hygiene practices (Shaking hands when greeting, washing hands in one bucket of water, vi eating with hands without cutlery and eating together in one plate) act as predictors of HEV prevalence in Otweya informal settlement of Walvis Bay. HEV cases were high in the informal settlements and there were positive associations between the socio-demographic of the population and cultural beliefs that would lead to the prevalence of HEV. Based on the results of this study, it is recommended to understand and identify shared main cultural beliefs of the community with health needs for effective interventions to curb and prevent diseases such as HEV at the informal settlements of Namibia. Recommendations were made to assist policy makers to design effective integrated primary health care strategies to serve the communities in informal settlements in Namibia.


Report presented in fulfilment of the requirements for the degree of Master in Health Science in the Faculty of Health and Applied Science.


Hepatitis E, Walvis Bay, Erongo Region


Nghihangwa, J.P.L. (2022). An investigation into predictors of hepatitis e virus (HEV) and its preventative strategies in Walvis Bay, Erongo Region, Namibia. (Unpublished master's thesis). Namibia University of Science and Technology, Windhoek.