Persisting role of healthcare settings in hepatitis C transmission in Pakistan: cause for concern

2012 ◽  
Vol 141 (9) ◽  
pp. 1831-1839 ◽  
Author(s):  
E. VER HOEVE ◽  
A. J. CODLIN ◽  
F. JAWED ◽  
A. J. KHAN ◽  
L. SAMAD ◽  
...  

SUMMARYTransmission of hepatitis C (HCV) in Pakistan is a continuing public health problem; 15 years ago it was linked to the practice of reusing therapeutic instruments in healthcare settings. We sought to examine current risk factors for HCV transmission in a hospital population in Karachi, Pakistan. We enrolled 300 laboratory-confirmed HCV-positive participants and 300 laboratory-confirmed HCV-negative participants from clinics at Indus Hospital. Independent and significant risk factors for both men and women were: receiving ⩾12 injections in the past year, blood transfusions, having had dental work performed, and delivery in hospital or transfusion for women. Interestingly, being of Mohajir origin or born in Sindh province were protective. Encouragingly, a strong protective effect was observed for those that reported bringing their own needle for injections (59%). The widespread reuse of therapeutic needles in healthcare settings in Karachi remains a major driver of the HCV epidemic.

2015 ◽  
Vol 77 (25) ◽  
Author(s):  
Waqar Al-Kubaisy ◽  
Nor Aini Mohd Noor ◽  
Nik Shamsidah Nik Ibrahim ◽  
Usama Al-Nasirie

Hepatitis C virus (HCV) infection is an important global public health problem affecting approximately 180 million people. Multiple risk factors are associated with HCV transmission among haemodialysis (HD) patients leading to an increased risk for liver-related mortality. Patients undergoing HD may show a decreased humoral and cellular immunity, which lowers the sensitivity of the HCV antibodies (Abs) test resulting in false negative antibody test, thus requiring HCV RNA testing. Our study is to determine the prevalence of HCV markers (antibody RNA and genotype) and risk factors of HCV infection among patients in HD unit in Baghdad. A sample of 54 patients were interviewed. HCV Abs (anti-HCV) was tested using third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia-Tek III) as screening and confirmatory test respectively. Sera of 46 patients (irrespective to anti-HCV results) were subjected to molecular analysis, using the most developed RT-PCR and DNA Enzyme immunoassay (DEIA) method. Seropositive rate of anti-HCV and HCV-RNA were (66.6%) and (60.9%) respectively. Anti-HCV seropositive rate was significantly higher in males (77.1%), and history of blood transfusion (85%). Blood transfusion acts as a significant risk for acquiring HCV (OR 44.2, 95% CI 7.6-256.9). Genotype 4 was the most prevalent (33.3%), followed by genotype 1a (25.9%) and genotype 1b (22.2%). We concluded that, the prevalence of HCV among the haemodialysis patients is high. It is significantly related to gender, duration of dialysis and number of blood transfusion. Blood transfusion acts as a significant risk factor. Molecular test for detection for HCV RNA is necessary and proper nosocomial prevention program should be implemented to prevent HCV transmission.


2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.


2018 ◽  
Vol 9 (06) ◽  
pp. 20251-20256
Author(s):  
Mudassir Khan ◽  
Shahrukh Khan ◽  
Shohra Haider ◽  
Fazal Jalil ◽  
Muhsin Jamal ◽  
...  

Background: Prevalence of Hepatitis C viral infection and its major risk factors has been found out in population of Batkhela, Khyber Pakhtunkhwa, Pakistan by taking number of volunteers from the interested area. HCV prevalence has not been researched in recent time here in this area, so that’s why we contributed. Materials and Methods: Ab rapid test cassette serum/plasma (USA) kit has been used for the mentioned purpose following by ELISA and finally PCR to find out active infection of virus. ICT positive individuals were reconfirmed by ELISA and then ELISA positive samples were carefully investigated by RT-PCR for Hepatitis C Virus. Results: The study population was of 770 volunteers belonging to the mentioned area of research, 453 males and 317 females. The overall prevalence was found to be 5.32% of HCV in Batkhela. This prevalence ratio was 3.12% in males and 2.20 % in females. 3rd generation ELISA was used to refine ICT positive samples which showed that 37 of the ICT positive samples had antibodies detected by ELISA. To find out active HCV infection, ELISA positive samples were refined by real time PCR which showed 2.98% of prevalence of active HCV infection in Batkhela based on HCV RNA in their blood. Principle Conclusion: Overall prevalence was found 5.32%, contaminated reused syringes and blades at Barbour’s shop, blood transfusion, surgical operations and unhygienic food in stalls etc were found significant risk factors for acquiring HCV infection. Body weakness and pale yellow skin color was common symptom in HCV positive volunteers. Safe sexual activities, blood screening before donation and sterilizing surgical equipment’s can protect us from Hepatitis C Virus.


2020 ◽  
Vol 41 (1) ◽  
pp. 59-71 ◽  
Author(s):  
Torsten Schlosshauer ◽  
Marcus Kiehlmann ◽  
Diana Jung ◽  
Robert Sader ◽  
Ulrich M Rieger

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4


2021 ◽  
Vol 104 (2) ◽  
pp. 233-239

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand


Biomedicines ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. 175
Author(s):  
Sara Kishta ◽  
Ashraf Tabll ◽  
Tea Omanovic Kolaric ◽  
Robert Smolic ◽  
Martina Smolic

Although hepatitis C virus (HCV) RNA may be eliminated from blood circulation by direct-acting antivirals (DAA) therapy as assessed by real-time polymerase chain reaction (PCR), HCV RNA can still be present in liver tissue, and this is known as occult HCV. There has been a lot of controversy surrounding the recurrence of hepatocellular carcinoma (HCC) after DAA treatment of hepatic cells infected with chronic HCV. One of the main risk factors that leads to de novo HCC is the chronicity of HCV in hepatic cells. There are many studies regarding the progression of HCV-infected hepatic cells to HCC. However, there is a lack of research on the different molecular mechanisms that lead to the progression of chronic HCV infection to HCC, as well as on the effect of HCV on the alteration of DNA ploidy, which eventually leads to a recurrence of HCC after DAA treatment. In this review article, we will address some risk factors that could lead to the development/recurrence of HCC after treatment of HCV with DAA therapy, such as the role of liver cirrhosis, the alteration of DNA ploidy, the reactivation of hepatitis B virus (HBV), the role of cytokines and the alteration of the immune system, concomitant non- alcoholic fatty liver disease (NAFLD), obesity, alcohol consumption and also occult HCV infection/co-infection. Clinicians should be cautious considering that full eradication of hepatocarcinogenesis cannot be successfully accomplished by anti-HCV treatment alone.


2020 ◽  
Vol 3 (1) ◽  
pp. 261-266
Author(s):  
O Ochima ◽  
AJ Randawa ◽  
SE Adaji ◽  
GI Ogbu

Hepatitis and TB co-infection in PLWHA is now a major source of co-morbidity and of public health concern. HIV and Hepatitis are two viruses with overlapping epidemics and shared routes of transmission. The clinical course of HCV is accelerated in patients with HIV with resultant end-stage Liver disease as a major cause of death. Most studies in my environment failed to identify significant risk factors for HCV infection thus making intervention difficult. The study was a descriptive cross-sectional study carried out among consecutive consenting HIV positive pregnant women attending the antenatal clinic of ABUTH-Zaria Nigeria. Relevant information was obtained using a structurally administered questionnaire while Enzyme Linked Immunosorbent assay Biotech Laboratories UK was used for anti Hepatitis C antibodies assay. Twenty four of the 285 samples tested positive for anti HCV antibodies giving a co-infection rate of 8.4%. Lack of formal education was associated with HCV-HIV co-infection (p <0.05), odds ratio (OR) 2.5; 95%CI 0.97-6.97. The possible risk factors analyzed including previous blood transfusion and injecting drug use were not associated with HIV- HCV co-infection (p>0.05). This study revealed a high HCV co-infection with significant association with non-formal educational status. Improving female education may be one important strategy for its prevention.


2013 ◽  
Vol 50 (2) ◽  
pp. 117-122 ◽  
Author(s):  
David Timm KVITKO ◽  
Gisele Alsina Nader BASTOS ◽  
Maria Eugênia Bresolin PINTO

Context The hepatitis C is a severe public health problem worldwide because its consequences. Studies which aim at determining the prevalence of risk factors are really important to understand the problem. Objective To estimate the prevalence and factors associated with some risk factors for the disease in a community, called Restinga, located in the city of Porto Alegre, RS, Brazil. Method This paper is based on a population-based cross-sectional study, with systematic sampling and proportional to the size of census tracts in which 3,391 adults answered a standardized questionnaire. Results The prevalence of blood transfusion among the people who were interviewed was 14.98%, 60.83% of those had it before 1993. A total of 16.16% of the people had a tattoo, 7.23% wore a piercing, 1.09% said they had already injected illicit drugs and 12.39% reported previous hospitalization. Prevalence ratios showed that tattoos were more common among young people, piercings among women and illicit drugs among men. Conclusions To summarize, the recognition of risk factors for hepatitis C enables proper screening of possible carriers of the hepatitis C virus, thus enabling a reduction in virus shedding. However, being only possible if health services are prepared to deal with hepatitis C virus, through education and public awareness.


Author(s):  
M. U. Iduh ◽  
K. Mohammed ◽  
I. Isah ◽  
O. F. Ashcroft ◽  
M. K. Garba ◽  
...  

Background: Gastro Intestinal Helminths infection is one of the major health burdens in developing countries particularly in Sub -Saharan Africa. It has been estimated to affect about 2.5 billion people globally and 250 million people are thought to be ill as a result of such infections, the majority being children. Aims: The study aimed to determine the prevalence and associated risk factors of gastro intestinal helminths infections among people of Wamakko and Tambuwal local government area in Sokoto state. Study Design: This was a cross-sectional, descriptive study. Place and Duration of Study: The study was conducted among Hausa- Fulani in wamakko and Tambuwal area in Sokoto, from June 2019 to October 2019. Methodology: Parasitological examination was carried out on stool samples from 243 participants using microscopy following formal ether concentration methods. Results: Finding revealed that 29 (12%) were positive for gastro intestinal helminths infections. Males recorded more prevalence (11.9%) than the females (11.8%). Conclusion: Gastro intestinal helminths parasites continue to remain a serious public health problem in North-western Nigeria. Low level of education, occupational status, and poor water supply seems to be among significant risk factors for these infections. Creating awareness, increase level of sanitation, good water supply and de-worming programme among school children will reduce prevalence and intensity of gastro intestinal helminths parasitic infections in the study area.


Author(s):  
Shada M. Alharbi ◽  
Abdullah K. Alghanem ◽  
Hanan A. Alessa ◽  
Raghad S. Aldoobi ◽  
Fatimah A. Busayli ◽  
...  

In the different healthcare settings, evidence shows that healthcare workers can be exposed to various work-related hazards, which might be ergonomics, biological, psychological, and physical hazards. Work-related musculoskeletal disorders are frequently reported among the different healthcare workers, and estimates indicate that surgeons are the most commonly affected. Disorders and injuries related to the backbone, shoulders, wrist, and knees are mainly reported by healthcare workers as relevant ergonomic hazards. In the present literature review, we have discussed the commonest ergonomics that have been reported in the literature among healthcare workers. Musculoskeletal disorders as back, knee, and wrist pain are the most frequently reported among the different settings. We have also assessed the different reasons that might attribute to the development of such events, and increased workload and working hours, in addition to the harmful postures are the main reasons that have been reported in the literature. Each clinical and surgical setting might be associated with significant risk factors over others, and therefore, specific interventions should be applied within these settings to enhance satisfaction among healthcare workers. Healthcare authorities are mainly responsible to achieve this. However, further epidemiological investigations are still needed to adequately plan the righteous interventional programs.


Sign in / Sign up

Export Citation Format

Share Document