Revisiting the Epidemiology of Viral Hepatitis C in Rural Areas in Egypt: Results from a Screening Campaign (original) (raw)
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Hepatitis C in a community in Upper Egypt: I. Cross-sectional survey
The American journal of tropical medicine and hygiene
The prevalence of antibody to hepatitis C virus (anti-HCV) was determined in a cross-sectional survey in a village in Upper Egypt. Exposure and demographic characteristics were obtained through a questionnaire. Antibody to hepatitis C virus was assessed using a second generation enzyme immunoassay, and the presence of HCV RNA was tested using a reverse transcriptase-polymerase chain reaction. Collection of blood samples was targeted at those > or = 5 years old, and obtained from 62.8%. This report describes the community, the HCV infection characteristics of the subjects, and evaluates some factors associated with presence of anti-HCV. Of the 6,031 participants, 522 (8.7%) were anti-HCV positive. Prevalence was higher among males than females (11.3% versus 6.5%; P < 0.001). It was greater among those > 30 years of age than among those < or = 30 years of age (20.0% versus 3.6%; P < 0.001). Those who were less educated, farmed, provided health care, and were currently m...
Hepatology, 2000
This report describes a cross-sectional survey of the prevalence of antibodies to hepatitis C virus (anti-HCV) in a rural Egyptian community in the Nile Delta. One half of the village households were systematically selected and examined by questionnaire and testing sera for anti-HCV and HCV RNA. Blood samples were obtained from 3,888 (75.4%) of 5,156 residents H5 years of age; an additional 111 samples were obtained from children younger than 5 years. Overall, 973 (24.3%) of 3,999 residents were anti-HCVpositive, and the age-and gender-adjusted seroprevalence was 23.7%. Anti-HCV prevalence increased sharply with age, from 9.3% in those 20 years of age and younger to G50% in those older than 35 years. Currently or previously married individuals were more likely to be seropositive than those never married, controlling for age (Mantel-Haenszel risk ratio ؍ 1.8; 95% CI: 1.3, 2.6). Of the 905 anti-HCV-positive samples tested, 65% were also positive for HCV RNA. Active schistosomal infection was not associated with anti-HCV status; however, history of antischistosomal injection therapy (reported by 19% of anti-HCV positives) was a risk for anti-HCV (age-adjusted risk ratio ؍ 1.3; 95% CI: 1.2, 1.5). This study, the largest community-based survey to date, supports earlier reports of high levels of anti-HCV among adults in rural areas of Egypt, although many of those who are seropositive will not have active liver disease. The large reservoir of HCV infection in the community provides an opportunity to investigate risk factors for transmission, the natural history of infection and effectiveness of preventive methodologies, and raises concern about the prospect of an increasing incidence of chronic liver disease in the coming decades. In the United States and Europe, hepatitis C virus (HCV) infection has been detected in 1% to 2% of the general population and fewer than 1% of volunteer blood donors. 1-3 Abbreviations: HCV, hepatitis C virus; anti-HCV, antibodies to HCV; RR, risk ratios. From the
Changing pattern of hepatitis C virus spread in rural areas of Egypt
Journal of Hepatology, 2005
Background/Aims: To identify patterns of HCV spread in the Nile Delta of Egypt. Methods: Residents in a Nile Delta village were invited to participate in a cohort study of HCV infection. Risk factors for past or current infection were identified at cohort intake using generalized estimated equations models. Attributable fractions were calculated for all independent risk factors.
Incidence and risk factors for hepatitis C infection in a cohort of women in rural Egypt
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2008
A prospective cohort study of the incidence and risk factors for hepatitis C virus (HCV) infection was performed in 2171 pregnant women in three rural Egyptian villages who were HCV antibody (anti-HCV) and RNA (HCV-RNA) negative at baseline. During an average of 2.2 years follow up, 25 incident cases were observed, giving an estimated HCV incidence of 5.2/1000 person-years (PY). The infection rate correlated with community anti-HCV prevalence in pregnant women, while the perinatal incidence rate of 11.2/1000 PY was almost five times that of the non-perinatal rate (2.3/1000 PY). The data suggested iatrogenic perinatal risk factors were associated with infection in one village, while health education reduced infections in another. Among the 25 incident cases, eight were HCV-RNA negative when they were first found to be anti-HCV positive and one-third of the 15 viraemic cases with follow-up data available cleared their HCV-RNA after an average of 1.3 years. None of the 25 incident cases were jaundiced or had symptoms of hepatitis but elevated serum alanine aminotransferase levels confirmed hepatitis in nine. Our data suggest that asymptomatic HCV infections frequently occurred during the perinatal period but often cleared and that educating medical personnel on safe practices possibly reduced HCV transmission.
Al-Azhar Medical Journal, 2020
Background: Hepatitis C virus (HCV) is one of the hepatitis viruses that transmitted through blood or blood products. HCV has been implicated as a major reason of chronic liver disease and hepatocellular carcinoma worldwide. Objective: This study aimed to determine the seroprevalence of HCV antibodies among community in Luxor governorate, Egypt. Moreover to assess if there is any association with the population group, sex, age and other different risk factors. Patients and methods: We randomly selected 745 blood samples; from males and females of different ages (20-65 years). Samples were collected from Luxor governorate, Egypt. Seras from all subjects were tested for hepatitis C virus antibodies using rapid test method and confirmed by the enzyme linked immunosorbent assay (ELISA third generation). Results: Our results showed that 584 (78.40 %) of the community were males and most of them aged between 31 and 50 years. Thirty two (5.48%) from blood samples of males were anti-HCV seropositive, and the highest prevalence of anti-HCV (7.22%) of age groups from 41-50 years. One hundred and sixty one (21.60%) from the community were female and most of them aged between 41-65 years. Six (3.73%) of female subjects tested positive for anti-HCV and the highest prevalence of anti-HCV (4.87%) was with age groups from 31-40 years. Four risk factors reflecting high mechanisms of HCV transmission have been associated with HCV infection including residing in rural areas, no education, blood transfusion, and dental treatment. Exposures to surgery and history of schistosomiasis showed low association with Anti-HCV. Among the community exposures, were blood donation and alcohol consumption but these associations were not important. Conclusion: This study has been conducted to determine the prevalence rate of anti-HCV among community in Luxor governorate, Egypt.
Liver International, 2010
Objectives: To estimate hepatitis C virus (HCV) incidence rates and identify risk factors for current HCV transmission with emphasis on the role of living with infected household family members in rural Egypt.Methods: A 4-year population-based, cohort study of seronegative villagers was conducted to identify incident HCV seroconversion cases. A risk factor questionnaire and blood samples for anti-HCV EIA-3 and HCV RNA polymerase chain reaction testing were collected at two rounds of follow-up. Incidence rates, relative risks and 95% confidence interval (CI) were calculated based on a Poisson distribution. A matched case–control analysis to explore specific behavioural predictors of infection was conducted and odds ratios were obtained by conditional logistic regression.Results: Twenty-five participants (11 females) seroconverted in 10 578 person years of follow-up (PY), (incidence rate of 2.4/1000 PY; 95% CI: 1.6–3.5). The median age at seroconversion was 26 years [interquartile range (IQR) 19–35] among males and 20 years (IQR 13–24) among females. The only significant risk factor identified for these cases was receiving injections [adjusted odds ratio (ORadj)=3.3; 95% CI: 1.1–9.8]. Two of the 17 viraemic seroconvertors were infected with the same strain as at least one of their family members.Conclusion: This study identified the important role of injections in spreading HCV infection in this rural community. National healthcare awareness and infection control programmes should be strengthened to prevent further transmission. Screening of families of infected HCV subjects should be an essential part of case management for early detection and management.
Hepatitis c in a community in Upper Egypt: risk factors for infection
The American journal of tropical medicine and hygiene, 2002
This investigation's objective was to identify risk factors for hepatitis C virus (HCV) in a village in Upper Egypt with a moderately high prevalence (8.7%) of antibodies to HCV (anti-HCV). A representative sample of 6,012 (63%) of the 9,581 village inhabitants was included in the study. A questionnaire solicited information regarding risk factors for infection, and blood samples were tested for anti-HCV. Parenteral risks identified in age-adjusted analysis included blood transfusions, dental procedures, hospital admission, surgery, complicated deliveries, history of injection therapy for schistosomiasis, and history of frequent injections. Circumcision was pervasive and was not associated per se with ant-HCV; however, circumcision by an informal, rather than formal, health care provider was associated with anti-HCV among young men and boys. The results did not reveal any unique community-acquired exposures that caused HCV infections: inhabitants who had tattoos, who smoked goza...
HCV burden of infection in Egypt: results from a nationwide survey
Journal of Viral Hepatitis, 2012
Egypt is the country with the largest hepatitis C virus (HCV) epidemic in the world. In 2008, a Demographic Health Survey (DHS) was carried out in Egypt, providing for the first time a unique opportunity for HCV antibody testing on a nationwide representative sample of individuals. Consenting individuals answered a questionnaire on sociodemographic characteristics and iatrogenic exposures, before providing a blood sample for HCV antibody testing by enzyme-linked immunosorbent assay. Factors independently associated with HCV infection were examined through multivariate logistic regression models. Of 12 780 eligible subjects aged 15-59 years, 11 126 (87.1%) agreed to participate and provided a blood sample. HCV antibody prevalence nationwide was 14.7% (95% CI 13.9-15.5%) in this age group. HCV antibody prevalence gradually increased with age, reaching, in the 50-59 years age group, 46.3% and 30.8% in males and females, respectively. It was higher in males compared to females (17.4% versus 12.2%, respectively, P < 0.001), and in rural compared to urban areas (18.3% versus 10.3%, respectively, P < 0.001). In multivariate analysis, age, male sex, poverty, past history of intravenous anti-schistosomiasis treatment, blood transfusion, and living outside of the Frontier Governorates were all significantly associated with an increased risk of HCV infection. In addition, in urban areas, lack of education and being circumcised for females were associated with an increased risk of HCV infection. This study confirmed on a nationwide representative sample the very high HCV antibody prevalence in Egypt. It stresses the urgent need for strengthening prevention efforts, and bringing down the costs of antiviral drugs for countries like Egypt, where the people in the most precarious situations are also those most likely to be infected by the virus.
High prevalence of hepatitis C virus among urban and rural population groups in Egypt
Acta Tropica, 1995
Hepatitis C is a major health problem for Egypt. The aim of this study was to determine the seroprevalence of antibodies to hepatitis C virus among different population groups living in urban and in two different rural areas (Suez Canal and North Sinai) of Egypt. Secondary objectives were to study the possible association between multiple blood transfusions, haemodialysis or Schistosomiasis and the seroprevalence of antibodies to hepatitis C. A seroprevalence of hepatitis C virus in the urban blood donor population of 14.5% was found, confirming other reports. In the two rural areas of the Suez Canal and the North Sinai the seroprevalence was 14.4% and 15.5% respectively, showing a comparable seroprevalence in these three different populations. The seroprevalence was 70.4% in haemodialysis patients, 7.7% in health care workers, and 75.6% in thalassaemic children, thus a seroprevalence among multitransfused or haemodialysed patients comparable to the one described in many other countries. Schistosomiasis does not seem to play a role in the seroprevalence of this disease in Egypt.