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Badur S, Öztürk S, AbdelGhany M, Khalaf M, Lagoubi Y, Ozudogru O, Hanif K, Saha D. Hepatitis A in the Eastern Mediterranean Region: a comprehensive review. Hum Vaccin Immunother 2022; 18:2073146. [PMID: 35617508 PMCID: PMC9621081 DOI: 10.1080/21645515.2022.2073146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/10/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION With 583 million inhabitants, the Eastern Mediterranean Region (EMR) is a worldwide hub for travel, migration, and food trade. However, there is a scarcity of data on the epidemiology of the hepatitis A virus (HAV). METHODS The MEDLINE and grey literature were systematically searched for HAV epidemiological data relevant to the EMR region published between 1980 and 2020 in English, French, or Arabic. RESULTS Overall, 123 publications were extracted. The proportion of HAV cases among acute viral hepatitis cases was high. HAV seroprevalence rate ranged from 5.7% to 100.0% and it was decreasing over time while the average age at infection increased. CONCLUSION In the EMR, HAV remains a significant cause of acute viral hepatitis. The observed endemicity shift will likely increase disease burden as the population ages. Vaccinating children and adopting sanitary measures are still essential to disease prevention; vaccinating at-risk groups might reduce disease burden even further.
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Salari N, Kazeminia M, Hemati N, Ammari-Allahyari M, Mohammadi M, Shohaimi S. Global prevalence of hepatitis C in general population: A systematic review and meta-analysis. Travel Med Infect Dis 2022; 46:102255. [PMID: 35007756 DOI: 10.1016/j.tmaid.2022.102255] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 12/14/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND According to published reports from the World Health Organization, it is estimated that more than 3% of the world's population is infected with HCV. Given the impact of various factors on the prevalence of HCV in the world's population and the lack of general statistics around the world, this study aims to review the studies conducted in this field and statistical analysis of the results of general statistical studies on the prevalence of HCV in the world population. METHODS In this study, systematic review and meta-analysis of information of the studies related to the prevalence of HCV in the world using keywords including: Prevalence, HCV, Hepatitis C, Healthy Population, Healthy subjects, and General Population in SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (WoS) databases and Google Scholar search engine were extracted without time limit until April 2020. In order to perform the analysis of qualified studies, the model of random effects was used, and the inconsistency of studies with I2 index was investigated. Data analysis was performed with Comprehensive Meta-Analysis (Version 2). RESULTS In a study of 98 studies with a total sample size of 236,964 people in the world, the overall prevalence of HCV was 1.8% (95% CI: 1.4%-2.3%). Also, according to the subgroup analysis in different continents; the highest prevalence of HCV in the African continent was 7.1% (95% CI: 4.4-11.5%). CONCLUSION The results of this study show that the prevalence of hepatitis C in the world's population, especially in Africa, is almost high. Therefore, the officials of the World Health Organization should design measures to prevent the spread of this infection.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mohsen Kazeminia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Niloufar Hemati
- Department of Internal Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | | | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia.
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Bahar M, Pervez MT, Ali A, Babar ME. In Silico Analysis of Hepatitis B Virus Genotype D Subgenotype D1 Circulating in Pakistan, China, and India. Evol Bioinform Online 2019; 15:1176934319861337. [PMID: 31320794 PMCID: PMC6610437 DOI: 10.1177/1176934319861337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
The focus of this study was the computational analysis of hepatitis B virus (HBV)
genotype D subgenotype D1 in Pakistan, China, and India. In total, 54 complete
genome sequences of HBV genotype D subgenotype D1 were downloaded from National
Center for Biotechnology Information (NCBI). Of these, 6 complete genome
sequences were from Pakistan, 14 were from China, and 34 were from India.
Sequence alignment showed less than 4% divergence in these sequences. C and X
genes showed divergence of less than 3%. Comparison over the S gene showed more
than 97% similarity among the nucleotide sequences of genotype D subgenotype D1.
The identity and similarity matrix of 54 nucleotide sequences of HBV genotype D
subgenotype D1 from Pakistan, China, and India revealed more than 93% identity
and 93% similarity. Phylogenetic analysis highlighted that complete genome
isolates of HBV circulating in Pakistan had the closest evolutionary
relationship with its neighboring countries China and India. China’s (HQ833466)
and Pakistan’s (AB583680.1) isolates shared the same ancestor. Gene structure
analysis showed that “P” gene exons were the longest, about three-fourth of the
genome size, whereas gene “S” had the second longest coding regions with 2 exons
and 1 intron. However, “C” and “X” genes had 1 smallest exon. X proteins had
proven role in spreading of the HBV infection diseases. For HBx analysis, 1 X
protein sequence of HBV genotype D subgenotype D1 belonging to each country was
obtained. Homology models of the 3 X proteins generated using SWISS-MODEL
revealed GMQE (Global Model Quality Estimation) = 0.1. Global and local quality
estimate scores including Z-scores for Qualitative Model Energy
Analysis (QMEAN) C-beta, all-atom, solvation, and torsion energy scores were
similar indicating good quality, accuracy, and reliability of the predicted
models. Three-dimensional (3D) visualization showed similar structures and
Ramachandran plots showed a high percentage of protein residues into the
favorable region for X protein models.
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Affiliation(s)
- Muneeb Bahar
- Department of Computer Science, Virtual University of Pakistan, Lahore, Pakistan
| | - Muhammad Tariq Pervez
- Department of Bioinformatics and Computational Biology, Virtual University of Pakistan, Lahore, Pakistan
| | - Akhtar Ali
- Department of Biotechnology, Virtual University of Pakistan, Lahore, Pakistan
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Al Kanaani Z, Mahmud S, Kouyoumjian SP, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180257. [PMID: 29765698 PMCID: PMC5936963 DOI: 10.1098/rsos.180257] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/13/2018] [Indexed: 05/06/2023]
Abstract
To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations, we systematically reviewed all available records of HCV incidence and/or prevalence from 1989 to 2016, as informed by the Cochrane Collaboration Handbook. This systematic review was reported following the PRISMA guidelines. Populations were classified into six categories based on the risk of exposure to HCV infection. Meta-analyses were performed using DerSimonian and Laird random-effects models with inverse variance weighting. The search identified one HCV incidence study and 341 prevalence measures/strata. Meta-analyses estimated the pooled mean HCV prevalence at 6.2% among the general population, 34.5% among high-risk clinical populations, 12.8% among populations at intermediate risk, 16.9% among special clinical populations, 55.9% among populations with liver-related conditions and 53.6% among people who inject drugs. Most reported risk factors in analytical epidemiologic studies related to healthcare procedures. Pakistan is enduring an HCV epidemic of historical proportions-one in every 20 Pakistanis is infected. HCV plays a major role in liver disease burden in this country, and HCV prevalence is high in all-risk populations. Most transmission appears to be driven by healthcare procedures. HCV treatment and prevention must become a national priority.
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Affiliation(s)
- Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
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Butt AS, Sharif F. Viral Hepatitis in Pakistan: Past, Present, and Future. Euroasian J Hepatogastroenterol 2016; 6:70-81. [PMID: 29201731 PMCID: PMC5578565 DOI: 10.5005/jp-journals-10018-1172] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 11/29/2015] [Indexed: 12/17/2022] Open
Abstract
Viral hepatitis is a major cause of morbidity and mortality worldwide and a rising cause for concern in Asian countries. Weather it is blood borne or water/food borne hepatotropic virus, increasing burden is alarming for Asian countries. In this review we have evaluated the existing data to estimate the burden of viral hepatitis in populations of all age groups nationwide, along with an assessment of the risk factors and preventive and management strategies currently employed in Pakistan. The aim of our work is to consolidate and supplement the present knowledge regarding viral hepatitis in light of past and present trends and to provide future direction to the existing health policies. How to cite this article Butt AS, Sharif F. Viral Hepatitis in Pakistan: Past, Present, and Future. Euroasian J Hepato-Gastroenterol 2016;6(1):70-81.
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Affiliation(s)
- Amna Subhan Butt
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Fatima Sharif
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Mohamoud YA, Miller FD, Abu-Raddad LJ. Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: An analysis using hepatitis C virus as a proxy biomarker. World J Gastroenterol 2014; 20:12734-12752. [PMID: 25278675 PMCID: PMC4177460 DOI: 10.3748/wjg.v20.i36.12734] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/20/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.
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Sule WF, Kajogbola AT, Adewumi MO. High prevalence of anti-hepatitis A virus immunoglobulin G antibody among healthcare facility attendees in Osogbo, Nigeria. J Immunoassay Immunochem 2013; 34:75-82. [PMID: 23323983 DOI: 10.1080/15321819.2012.683502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The objectives of this study were to determine the prevalence of anti-hepatitis A virus (HAV) immunoglobulin G (IgG) antibody and associated factors among residents of Osogbo, a town in Nigeria with inadequate environmental sanitation and a shortage of potable water. This is a health facility-based study. Ninety one consenting, asymptomatic attendees of public healthcare facilities in Osogbo, Osun State, Nigeria, were consecutively selected for this study. Plasma samples of the study participants were tested for the presence of anti-HAV IgG using a HAV Ab Competitive Enzyme Immunoassay test kit. Ninety (98.9%) of the participants were seropositive for anti-HAV IgG antibody; group-specific prevalence was also high, but association of participants' variables with the prevalence could not be obtained due to limited sample size and high group-specific prevalence. Since the hepatitis A vaccine is not currently used in Nigeria, the chance is high that the HAV IgG antibody-positive individuals were naturally infected; consequently Osogbo can be described as highly endemic for HAV infection.
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ul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Haseeb A, Aljadhey H. A cross-sectional assessment of knowledge, attitude and practice among Hepatitis-B patients in Quetta, Pakistan. BMC Public Health 2013; 13:448. [PMID: 23641704 PMCID: PMC3648389 DOI: 10.1186/1471-2458-13-448] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 05/02/2013] [Indexed: 01/06/2023] Open
Abstract
Background Hepatitis-B is a life threatening infection resulting in 0.6 million deaths annually. The prevalence of Hepatitis-B is rising in Pakistan and furthermore, there is paucity of information about Knowledge, Attitude and Practice among Hepatitis-B patients. Better disease related knowledge is important to have positive attitude and that will bring the good practices which will prevent the further spread of infection. This study aimed to evaluate knowledge, attitude and practice of Hepatitis-B Patients in Quetta city, Pakistan. Methods A cross-sectional, descriptive study was undertaken with 390 Hepatitis-B patients attending two public hospitals in Quetta city, Pakistan. Knowledge, attitude and practice regarding Hepatitis-B were assessed using a pre-validated questionnaire containing 20, 7 and 8 questions for knowledge, attitude and practice, respectively. Descriptive statistics were used for elaborating patients’ demographic characteristics and mean scores for knowledge, attitude and practice of Hepatitis-B patients. Inferential statistics (Mann–Whitney U test and Kruskal Wallis tests, p < 0.05) were used to establish association between study variables. Spearman’s rho correlation was used to identify the association between the knowledge, attitude and practice scores. Results Out of 390 patients, 223 (57.2%) were males, with the majority (136, 34.9%) in the age group of 38–47 years. Mean age of the study cohort was 32.6 ± 9.5 years. One hundred and four (26.7%) had primary level education, with 110 (28.2%) working in the private sector. The mean scores for knowledge, attitude and practice were 8.48 ± 2.7, 3.87 ± 1.2 and 2.37 ± 1.0, respectively. Education, locality and occupation were significantly associated with knowledge, attitude and practice scores. Significant positive linear correlations between knowledge-attitude (r = 0.466, p < 0.01) knowledge-practice (r = 0.221, p < 0.01) and attitude-practice (r = 0.224, p < 0.01) were also observed from the study results. Conclusion The findings of this study indicate that Hepatitis-B patients lack a basic understanding of infection control and management. This can result in the further spread of Hepatitis-B infection. Extensive health education campaigns should be provided to the patients in the hospital as well as in community settings for rational control and management of the disease.
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Affiliation(s)
- Noman ul Haq
- Department of Pharmacy, University of Baluchistan, Quetta, Pakistan/Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
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Mohebbi SR, Rostami Nejad M, Tahaei SME, Pourhoseingholi MA, Habibi M, Azimzadeh P, Naghoosi H, Karayiannis P, Zali MR. Seroepidemiology of hepatitis A and E virus infections in Tehran, Iran: a population based study. Trans R Soc Trop Med Hyg 2012; 106:528-531. [PMID: 22835757 DOI: 10.1016/j.trstmh.2012.05.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 05/30/2012] [Accepted: 05/30/2012] [Indexed: 01/02/2023] Open
Abstract
Hepatitis A virus (HAV) and hepatitis E virus (HEV) are enteric hepatotropic viruses and their prevalence is related to the sanitary conditions of the region under investigation. There are only a few studies on the seroepidemiology of these two viruses in the general Iranian population. The purpose of this investigation was to measure the prevalence of hepatitis A and E infections in the general population. Between 2006 and 2007, a cross sectional study was performed in Tehran, Iran. Blood specimens were collected and questionnaires were filled in for 551 persons. Patient sera were tested by ELISA for anti-HEV and anti-HAV IgGs. The χ(2) test and independent t-test were used for statistical analysis and p<0.05 was considered significant. The overall seroprevalence rates of anti-HEV IgG and anti-HAV IgG were 9.3% and 90%, respectively. The prevalence of antibodies to HAV and HEV was greater among men than women and increased with age. However, there was no significant relationship between age and gender with the existence of anti- HAV and HEV IgG antibodies. Our results show the seroprevalence of HAV and HEV antibodies are high and both viruses are endemic in this region. These findings are in accordance with results obtained from previous studies. We recommend that foreign travelers to Iran are vaccinated against HAV.
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Affiliation(s)
- Seyed Reza Mohebbi
- The Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, 7th floor, Taleghani Hospital, Yaman Ave., Velenjak, PO Box 19835-187, Tehran, Iran.
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ul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Aljadhey H. A cross sectional assessment of knowledge, attitude and practice towards Hepatitis B among healthy population of Quetta, Pakistan. BMC Public Health 2012; 12:692. [PMID: 22917489 PMCID: PMC3490724 DOI: 10.1186/1471-2458-12-692] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 08/13/2012] [Indexed: 01/06/2023] Open
Abstract
Background Hepatitis B (HB) is a serious global public health problem. This study aims to evaluate Knowledge, Attitude and Practice (KAP) towards Hepatitis B (HB) among healthy population of Quetta city, Pakistan. Methods A cross sectional, descriptive study was undertaken. One thousand healthy individuals (aged 18 years and above) were approached for the study. KAP towards HB was assessed by using a pre validated questionnaire. Descriptive statistics were used for elaborating patients’ demographic characteristics. Inferential statistics (Mann–Whitney U test and Kruskal Wallis test) were used for comparison while Spearman’s rho correlation was used to identify association between the study variables. All analyses were performed using SPSS 16.0. Results Out of 1000 distributed questionnaires, 780 were returned with a response rate of 78.0%. Four hundred and twenty (53.8%) respondents were male with mean age of 32.76 ± 9.40 year. Two hundred and eight (26.7%) had intermediate level of education and 354 (45.4%) were unemployed. Mean scores for knowledge, attitude and practice were 8.74 ± 2.7, 3.72 ± 1.2 and 2.76 ± 1.1 respectively. Significant and positive linear correlations between knowledge-attitude (r = 0.296, p < 0.01) knowledge-practice (r = 0.324, p < 0.01) and attitude-practice (r = 0.331, p < 0.01) were observed. Area of residence (locality) was the only variables significantly associated with mean KAP of the study respondents. Conclusion Results from the current study heighted poor KAP of healthy population towards HB. The positive linear correlations reaffirms that better knowledge can lead to positive attitude and subsequently in good practices. This will further help in prevention and management of HB. Therefore, extensive health educational campaign should be provided to general population and especially to the residents of rural areas.
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Affiliation(s)
- Noman ul Haq
- Department of Pharmacy, University of Baluchistan, Quetta, Pakistan.
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Sievert W, Altraif I, Razavi HA, Abdo A, Ahmed EA, Alomair A, Amarapurkar D, Chen CH, Dou X, El Khayat H, Elshazly M, Esmat G, Guan R, Han KH, Koike K, Largen A, McCaughan G, Mogawer S, Monis A, Nawaz A, Piratvisuth T, Sanai FM, Sharara AI, Sibbel S, Sood A, Suh DJ, Wallace C, Young K, Negro F. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int 2011; 31 Suppl 2:61-80. [PMID: 21651703 DOI: 10.1111/j.1478-3231.2011.02540.x] [Citation(s) in RCA: 417] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The hepatitis C pandemic has been systematically studied and characterized in North America and Europe, but this important public health problem has not received equivalent attention in other regions. AIM The objective of this systematic review was to characterize hepatitis C virus (HCV) epidemiology in selected countries of Asia, Australia and Egypt, i.e. in a geographical area inhabited by over 40% of the global population. METHODOLOGY Data references were identified through indexed journals and non-indexed sources. In this work, 7770 articles were reviewed and 690 were selected based on their relevance. RESULTS We estimated that 49.3-64.0 million adults in Asia, Australia and Egypt are anti-HCV positive. China alone has more HCV infections than all of Europe or the Americas. While most countries had prevalence rates from 1 to 2% we documented several with relatively high prevalence rates, including Egypt (15%), Pakistan (4.7%) and Taiwan (4.4%). Nosocomial infection, blood transfusion (before screening) and injection drug use were identified as common risk factors in the region. Genotype 1 was common in Australia, China, Taiwan and other countries in North Asia, while genotype 6 was found in Vietnam and other Southeast Asian countries. In India and Pakistan genotype 3 was predominant, while genotype 4 was found in Middle Eastern countries such as Egypt, Saudi Arabia and Syria. CONCLUSION We recommend implementation of surveillance systems to guide effective public health policy that may lead to the eventual curtailment of the spread of this pandemic infection.
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Affiliation(s)
- William Sievert
- Monash Medical Centre and Monash University, Melbourne, Vic., Australia
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Waheed Y, Bin-Rahat T, Safi SZ, Qadri I. Epidemiological patterns and risk factors associated with hepatitis B virus in Pakistani population. ASIAN BIOMED 2010; 4:547-554. [DOI: 10.2478/abm-2010-0069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractHepatitis B virus prevalence is increasing in Pakistani population. National level estimates regarding the prevalence are missing. People are unaware of the risk factors involved in HBV transmission. The objective of the study was to review the prevalence, genotypes, and risk factors associated with HBV transmission in Pakistani Population. Literature search was done by using keyword HBV prevalence, genotypes and risk factors from Pakistani population at Pubmed, PakMediNet and Google scholar. Six different studies showed that the percentage prevalence of HBV in general population was 4.61±0.73%, and 21 different studies showed the percentage prevalence of 2.33±0.46% in blood donors. High prevalence of 7.94±1.49% and 12.86±4.52% were observed in multi transfused and IDU populations. Six different studies showed that the major prevalent genotype was D. Awareness regarding various risk factors involved in-viral transmission was very low. Prevalence of HBV was very high in multitransfused populations due to non-implementations of international standards regarding blood transfusions. Barbers were unaware of the risk factors associated with their shops in viral transmission. Practices of unsterilized dental and surgical instruments and recycling of syringes were major factors in viral transmission. Massive awareness and vaccination programs are required to decrease the future burden of HBV from Pakistani population.
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Affiliation(s)
- Yasir Waheed
- NUST Center of Virology and Immunology, National University of Sciences & Technology, Islamabad 44000, Pakistan
| | - Talha Bin-Rahat
- NUST Center of Virology and Immunology, National University of Sciences & Technology, Islamabad 44000, Pakistan
| | - Sher Zaman Safi
- NUST Center of Virology and Immunology, National University of Sciences & Technology, Islamabad 44000, Pakistan
| | - Ishtiaq Qadri
- NUST Center of Virology and Immunology, National University of Sciences & Technology, Islamabad 44000, Pakistan
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Rauf A, Nadeem MS, Ali A, Iqbal M, Mustafa M, Latif MM, Latif MZ, Ahmed N, Shakoori AR. Prevalence of hepatitis B and C in internally displaced persons of war against terrorism in Swat, Pakistan. Eur J Public Health 2010; 21:638-42. [PMID: 20601693 DOI: 10.1093/eurpub/ckq084] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hepatitis B and C are the most common blood-borne liver infections worldwide. According to the recent estimates, 270-300 million people worldwide are infected with hepatitis C virus (HCV) and more than 2 billion people have been infected with the hepatitis B virus (HBV). Transmission of these viruses is carried out by exposure to infectious blood or body fluids containing blood. METHODS Five-hundred and ninety (290 males and 300 females, 5-65 years) internally displaced persons (IDPs) from Swat area of northern Pakistan were screened for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using immune-chromatography kits. The subjects, positive for virus-related antibody, were further confirmed for viral RNA (for HCV) and DNA (for HBV) in the blood by polymerase chain reaction (PCR) amplification. The virus of PCR-confirmed HCV-individuals was further genotyped and the prevalence of HCV infection was determined with respect to age, sex, history of exposure to blood or surgical operation and different types of liver diseases. RESULTS The HCV infection was found to be the predominant liver infection in the population which was 91% of the positive cases, as against 9% of HBV. Among the HCV-positive subjects (68% females, 32% males) 56% were asymptomatic. No co-incidence of HBV and HCV was found in any subject. Genotype 3a was the dominant strain of HCV followed by 2a > 3b > 1b > 1a, 2b. CONCLUSION The viral hepatitis among the apparently healthy population of a relatively natural and pollution free environment refers to an alarming condition about liver infections, particularly of HCV, in Pakistan.
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Affiliation(s)
- Abdul Rauf
- School of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore 54590, Pakistan.
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Waheed Y, Shafi T, Safi SZ, Qadri I. Hepatitis C virus in Pakistan: a systematic review of prevalence, genotypes and risk factors. World J Gastroenterol 2009; 15:5647-5653. [PMID: 19960560 PMCID: PMC2789216 DOI: 10.3748/wjg.15.5647] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 07/31/2009] [Accepted: 08/07/2009] [Indexed: 02/06/2023] Open
Abstract
In Pakistan more than 10 million people are living with Hepatitis C virus (HCV), with high morbidity and mortality. This article reviews the prevalence, genotypes and factors associated with HCV infection in the Pakistani population. A literature search was performed by using the keywords; HCV prevalence, genotypes and risk factors in a Pakistani population, in Pubmed, PakMediNet and Google scholar. Ninety-one different studies dating from 1994 to May 2009 were included in this study, and weighted mean and standard error of each population group was calculated. Percentage prevalence of HCV was 4.95% +/- 0.53% in the general adult population, 1.72% +/- 0.24% in the pediatric population and 3.64% +/- 0.31% in a young population applying for recruitment, whereas a very high 57% +/- 17.7% prevalence was observed in injecting drug users and 48.67% +/- 1.75% in a multi-transfused population. Most prevalent genotype of HCV was 3a. HCV prevalence was moderate in the general population but very high in injecting drug users and multi-transfused populations. This data suggests that the major contributing factors towards increased HCV prevalence include unchecked blood transfusions and reuse of injection syringes. Awareness programs are required to decrease the future burden of HCV in the Pakistani population.
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Affiliation(s)
- Yasir Waheed
- NUST Center of Virology and Immunology, National University of Sciences & Technology, Sector H-12 Islamabad, Pakistan.
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Ahmed M, Munshi SU, Nessa A, Ullah MS, Tabassum S, Islam MN. HIGH PREVALENCE OF HEPATITIS A VIRUS ANTIBODY AMONG BANGLADESHI CHILDREN AND YOUNG ADULTS WARRANTS PRE-IMMUNIZATION SCREENING OF ANTIBODY IN HAV VACCINATION STRATEGY. Indian J Med Microbiol 2009. [DOI: 10.1016/s0255-0857(21)01753-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ali SA, Donahue RMJ, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis 2009; 13:9-19. [PMID: 18835208 PMCID: PMC2651958 DOI: 10.1016/j.ijid.2008.06.019] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 06/20/2008] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Pakistan carries one of the world's highest burdens of chronic hepatitis and mortality due to liver failure and hepatocellular carcinomas. However, national level estimates of the prevalence of and risk factors for hepatitis B and hepatitis C are currently not available. METHODS We reviewed the medical and public health literature over a 13-year period (January 1994-September 2007) to estimate the prevalence of active hepatitis B and chronic hepatitis C in Pakistan, analyzing data separately for the general and high-risk populations and for each of the four provinces. We included 84 publications with 139 studies (42 studies had two or more sub-studies). RESULTS Methodological differences in studies made it inappropriate to conduct a formal meta-analysis to determine accurate national prevalence estimates, but we estimated the likely range of prevalence in different population sub-groups. A weighted average of hepatitis B antigen prevalence in pediatric populations was 2.4% (range 1.7-5.5%) and for hepatitis C antibody was 2.1% (range 0.4-5.4%). A weighted average of hepatitis B antigen prevalence among healthy adults (blood donors and non-donors) was 2.4% (range 1.4-11.0%) and for hepatitis C antibody was 3.0% (range 0.3-31.9%). Rates in the high-risk subgroups were far higher. CONCLUSIONS Data suggest a moderate to high prevalence of hepatitis B and hepatitis C in different areas of Pakistan. The published literature on the modes of transmission of hepatitis B and hepatitis C in Pakistan implicate contaminated needle use in medical care and drug abuse and unsafe blood and blood product transfusion as the major causal factors.
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Affiliation(s)
- Syed Asad Ali
- Institute for Global Health, Division of Pediatric Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203-1738, USA.
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Kaya D, Guler E, Ekerbicer HC, Dilber C, Karabiber H, Guler S, Davutoglu M, Ciragil P. Hepatitis A seroprevalence and its relationship with environmental factors in children of different age groups in Kahramanmaras, Eastern Mediterranean region of Turkey. J Viral Hepat 2007; 14:830-4. [PMID: 18070285 DOI: 10.1111/j.1365-2893.2007.00886.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Hepatitis A infections are influenced by environmental and socioeconomic factors. Epidemiologic studies regarding hepatitis A virus (HAV) infection in Turkey have not previously examined these factors. We investigated HAV seroprevalence and its association with sociodemographic factors among children of various ages in the Eastern Mediterranean region of Turkey. The study included 1142 children (603 male and 539 female) between ages of 6 months and 18 years. Seropositivity in the whole group was 57.2%. HAV prevalence rates according to age groups were as follows: 35.5% in 6-23 months group, 19.2% in 2-5 years group, 74.3% in 6-10 years group, 83.0% in 11-14 years group, 92.8% in 15-18 years group. Risk factors that influenced seropositivity were; dense population, over-crowded families, excessive number of siblings, low socioeconomic status and low education of the mother. As HAV seroprevalence in children older than 6 years of age is high, we recommend hepatitis A vaccination in this region after the first year of life.
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Affiliation(s)
- D Kaya
- Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Jafri W, Jafri N, Yakoob J, Islam M, Tirmizi SFA, Jafar T, Akhtar S, Hamid S, Shah HA, Nizami SQ. Hepatitis B and C: prevalence and risk factors associated with seropositivity among children in Karachi, Pakistan. BMC Infect Dis 2006; 6:101. [PMID: 16792819 PMCID: PMC1539007 DOI: 10.1186/1471-2334-6-101] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2006] [Accepted: 06/23/2006] [Indexed: 12/17/2022] Open
Abstract
Background Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age. Methods The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology. Results 3533 children were screened for HBsAg and anti-HCV. 1826 (52 %) were males. 65 (1.8 %) were positive for HBsAg, male to female ratio 38:27; mean age 10 ± 4 years. 55 (1.6 %) were positive for anti-HCV with a mean age 9 ± 4 years. 3 (0.11%) boys were positive for both HBsAg and anti-HCV. The overall infection rate was 3.3 % in the studied population. Hepatitis BsAg was more prevalent in subjects who received therapeutic injections 45 (69.2%) positive [Odd Ratio OR = 2.2; 95% Confidence interval CI: 1.3–3.6] inspite of using new needle and syringe 44 (67.7%) positive [OR = 2.2; 95% CI: 1.3–3.7] and vaccination in the government healthcare facilities 46 (70.7 %) positive with [OR = 3.0; 95% CI: 1.4–6.4]. These factors were not significant in anti-HCV positive cases. Conclusion There is a need to educate general population regarding HBV and HCV infection and risks associated with inappropriate therapeutic injections. Hepatitis B vaccine should be administered to all newborns regardless of maternal HBsAg status.
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Affiliation(s)
- Wasim Jafri
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Nadim Jafri
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Javed Yakoob
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Islam
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Tazeen Jafar
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Saeed Akhtar
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Saeed Hamid
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Hasnain Ali Shah
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Jacobsen KH, Koopman JS. The effects of socioeconomic development on worldwide hepatitis A virus seroprevalence patterns. Int J Epidemiol 2005; 34:600-9. [PMID: 15831565 DOI: 10.1093/ije/dyi062] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hepatitis A virus (HAV) infection confers long-term immunity, so mathematical analysis of age-specific seroprevalence in populations can reveal changes in the infection rate over time. HAV transmission is related to access to clean drinking water, personal hygiene and public sanitation. METHODS We used an SIR (susceptible-infectious-recovered) compartmental model with age structure to fit a time-dependent logistic function for HAV force of infection for 157 published age-seroprevalence data sets. We then fit linear regression models for socioeconomic variables and infection rate. RESULTS The proportion of the population with access to clean drinking water, the value of the human development index (HDI), and per capita gross domestic product (GDP) are all inverse predictors of HAV infection rates. Declining infection rates were observed in 65.6% of the surveys. Discussion This work demonstrates the utility of HAV seroprevalence studies to reveal patterns of change in force of infection and to assess the association between socioeconomic risk factors and transmission rates.
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Affiliation(s)
- K H Jacobsen
- Department of Epidemiology, University of Michigan, Ann Arbor MI, USA.
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Wallace MR, Hale BR, Utz GC, Olson PE, Earhart KC, Thornton SA, Hyams KC. Endemic infectious diseases of Afghanistan. Clin Infect Dis 2002; 34:S171-207. [PMID: 12019465 DOI: 10.1086/340704] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The current crisis in Afghanistan has resulted in an influx of Western military personnel, peacekeepers, humanitarian workers, and journalists. At the same time, unprecedented numbers of internally displaced persons and refugees have overwhelmed much of the already fragile infrastructure, setting the stage for outbreaks of infectious diseases among both foreigners and local populations. This review surveys the literature concerning the infectious diseases of Afghanistan and south-central Asia, with particular emphasis on diseases not typically seen in the Western world.
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Shah U, Habib Z, Kleinman RE. Liver failure attributable to hepatitis A virus infection in a developing country. Pediatrics 2000; 105:436-8. [PMID: 10654972 DOI: 10.1542/peds.105.2.436] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In young children hepatitis A virus (HAV) infections are usually subclinical events. However, HAV is also associated with progressive hepatic failure and even death in some patients. This study was undertaken to characterize the course of hepatitis A-related acute liver failure in children from a developing country where hepatitis A is endemic and produces significant morbidity. Patients <15 years of age with confirmed hepatitis A, seen at the Aga Khan University Hospital between January 1991 and August 1998 were identified using the patient registry. Of the 2735 patients seen with hepatitis A, 232 were admitted to the hospital. Of these 30 patients developed progressive hepatic dysfunction and liver failure. During this period, 45 children were admitted with liver failure attributable to other causes. Of the patients admitted with hepatitis A-related liver failure, 25 (83.3%) were encephalopathic at presentation and 36.7% of the patients died. The prothrombin time was the most significant predictor of survival. There was a significant difference between those who survived and those who died on discriminant analysis with respect to age, grade of hepatic encephalopathy, duration of hospitalization, prothrombin time, and duration of jaundice when taken as a group. There is a striking prevalence of liver dysfunction progressing to hepatic failure among children seen at a hospital in Karachi, Pakistan. This study demonstrates the significant morbidity and mortality that can attend HAV infections in children in a developing country despite tertiary medical facilities. The risk of HAV and its sequelae could probably be effectively reduced in these settings with improved sanitation and universal immunization.
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Bhurgri Y, Bhurgri A, Hassan SH, Zaidi SH, Rahim A, Sankaranarayanan R, Parkin DM. Cancer incidence in Karachi, Pakistan: first results from Karachi Cancer Registry. Int J Cancer 2000; 85:325-9. [PMID: 10652421 DOI: 10.1002/(sici)1097-0215(20000201)85:3<325::aid-ijc5>3.0.co;2-j] [Citation(s) in RCA: 97] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
No cancer incidence data from Pakistan have been published in the 5 decades since independence. Incidence data for the period 1995-1997 from the population of the Karachi South district (1.7 million) are presented here. A total of 4,268 new cancer cases were registered during this period: 2,160 cases in males and 2,108 cases in females. Overall, 95.3% of the incident cases were microscopically verified. The incidence rates for all cancers combined were 80.5 per 100,000 (crude) and 136.7 per 100,000 (age- standardised rates [ASR]) for males and 91.8 (crude) and 163.2 per 100,000 (ASR) for females. In males, lung cancer (ASR 20.3) was the most frequently recorded malignancy followed by oral cavity (ASR 13.8) and larynx cancer (ASR 8.6). In females, breast was the most common site of cancer, accounting for one third of female cancers (ASR 51.7), followed by oral cavity (ASR 14.1) and ovarian cancer (ASR 10.2). Karachi reports the highest incidence of breast cancer for any Asian population, except Jews in Israel. Tobacco smoking is estimated to be responsible for 40% of cancers in males and tobacco chewing for a further substantial proportion of head and neck cancers.
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Affiliation(s)
- Y Bhurgri
- Department of Pathology, Dow Medical College, Karachi Cancer Registry, Government of Sindh, Pakistan
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Parker SP, Khan HI, Cubitt WD. Detection of antibodies to hepatitis C virus in dried blood spot samples from mothers and their offspring in Lahore, Pakistan. J Clin Microbiol 1999; 37:2061-3. [PMID: 10325381 PMCID: PMC85032 DOI: 10.1128/jcm.37.6.2061-2063.1999] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/1998] [Accepted: 03/15/1999] [Indexed: 11/20/2022] Open
Abstract
Dried blood spot samples from mothers and their offspring attending the obstetric and pediatric departments of two hospitals in Lahore, Pakistan, were tested for antibodies to hepatitis C virus (HCV). The seroprevalence of HCV in the women was 6.7% (95% confidence interval [CI], 4.3 to 9.1), and that in the children was 1.3% (95% CI, 0.34 to 2.26). Four anti-HCV immunoglobulin G (IgG)-positive children had mothers that were anti-HCV IgG negative, which suggested that their infection was community acquired.
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Affiliation(s)
- S P Parker
- Virology Department, Camelia Botnar Laboratories, Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom.
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Abstract
In contrast to our understanding of hepatitis C virus infection in adults, relatively little is known about the evolution and treatment of HCV infection in pediatric patients. Children at risk for HCV infection include recipients of multiple blood-product transfusions, organ transplantation and infants born to HCV-infected mothers. A proportion of HCV-infected pediatric patients do not have an identifiable risk factor. HCV infection is commonly detected in children previously presumed to have non-A, non-B hepatitis and cryptogenic liver disease. HCV infection usually leads to mild chronic liver disease in children but is also associated with chronic active hepatitis and cirrhosis. Interferon therapy is effective in a proportion of patients with chronic hepatitis C.
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Affiliation(s)
- R P González-Peralta
- Division of Gastroenterology and Hepatology, Department of Pediatrics and Section of Hepatobiliary Diseases, University of Florida College of Medicine, Gainesville, Florida 32610-0296, USA
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