| BMC Gastroenterology | |
| Epidemiologic study of chronic hepatitis B virus infection in male volunteer blood donors in Karachi, Pakistan | |
| Sarffraz Hussain Jafri3  Farrukh Hassan3  Salman Adil1  Muhammad Younus2  Saeed Akhtar2  | |
| [1] Department of Pathology and Microbiology, Aga Khan University, Karachi 74800, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi 74800, Pakistan;Husaini Blood Bank, Karachi, Pakistan | |
| 关键词: Pakistan; volunteer blood donors; risk factors; hepatitis B virus surface antigen, prevalence; hepatitis B virus; | |
| Others : 1211729 DOI : 10.1186/1471-230X-5-26 |
|
| received in 2005-01-22, accepted in 2005-08-08, 发布年份 2005 | |
PDF
|
|
【 摘 要 】
Background
The magnitude of chronic infection with hepatitis B virus (HBV) varies substantially between the countries. A better understanding of incidence and/ or prevalence of HBV infection and associated risk factors provides insight into the transmission of this infection in the community. The purpose of this investigation was to estimate the prevalence of and to identify the risk factors associated with chronic infection with HBV, as assessed by HBV surface antigen (HBsAg) positivity, in asymptomatic volunteer male blood donors in Karachi, Pakistan.
Methods
Consecutive blood donations made at the two large blood banks between January 1, 1998 and December 31, 2002 were assessed to estimate the prevalence of HBsAg positivity. To evaluate the potential risk factors, a case-control study design was implemented; cases (HBsAg positives) and controls (HBsAg negatives), were recruited between October 15, 2001 and March 15, 2002. A pre-tested structured questionnaire was administered through trained interviewers to collect the data on hypothesized risk factors for HBV infection. Sera were tested for HBsAg using commercially available kits for enzyme linked Immunosorbant assay-III.
Results
HBsAg prevalence in the male volunteer blood donors was 2.0 % (7048/351309). Multivariate logistic regression analysis showed that after adjusting for age and ethnicity, cases were significantly more likely than controls to have received dental treatment from un-qualified dental care provider (adjusted odds ratio (OR) = 9.8; 95% confidence interval (CI): 2.1, 46.1), have received 1–5 injections (adjusted OR = 3.3; 95% CI: 1.1, 9.6), more than 5 injections (adjusted OR = 1.4; 95% CI: 1.4, 12.7) during the last five years or have received injection through a glass syringe (adjusted OR = 9.4; 95% CI: 2.6, 34.3). Injury resulted in bleeding during shaving from barbers (adjusted OR = 2.3; 95% CI: 1.1, 4.8) was also significant predictor of HBsAg positivity.
Conclusion
Prevalence of HBsAg positivity in the male volunteer blood donors in Karachi was 2%. Infection control measures in health-care settings including safe injection practices and proper sterilization techniques of medical instruments and education of barbers about the significance of sterilization of their instruments may reduce the burden of HBV infection in this and similar settings. There is also an urgent need of developing locally relevant guidelines for counseling and management of HBsAg positive blood donors.
【 授权许可】
2005 Akhtar et al; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150610022320163.pdf | 282KB |
【 参考文献 】
- [1]Torbenson M, Thomas DL: Occult hepatitis B. Lancet Infec Dis 2002, 2:479-486.
- [2]World Health Organization: Hepatitis B. Fact sheet 2000. WHO/204
- [3]Yassin K, Awad R, Tebi AJ, Queder A, Laaser U: Prevalence and risk factors of HBsAg in Gaza: implications for prevention and control. J Infect 2002, 44:252-256.
- [4]Arboleda M, Castilho MC, Fonseca JC, Albuquerque BC, Saboia RC, Yoshida CF: Epidemiological aspects of hepatitis B and D virus infection in thenorthern region of Amazonas, Brazil. Trans Roy Soc Trop Med Hyg 1995, 89:481-483.
- [5]Passos AD, Gomes UA, Figueiredo JF, do Nascimento MM, de Oliveira JM, Gaspar AM, Yoshida CF: Influence of migration on the prevalence of serologic hepatitis B markers in a rural community. 1. Analysis of prevalence by birthplace. Revista De Saude Publica 1993, 27:30-35.
- [6]el-Sayed HF, Abaza SM, Mehanna S, Winch PJ: The prevalence of hepatitis B and C infections among immigrants to a newly reclaimed area endemic for Schistosoma mansoni in Sinai, Egypt. Acta Tropica 1997, 68:229-237.
- [7]Chowdhury A, Santra A, Chaudhuri S, Ghosh A, Banerjee P, Mazumder DN: Prevalence of hepatitis B infection in the general population: a rural community based study. Trop Gastroenterol 1999, 20:75-77.
- [8]Custer B, Sullivan SD, Hazlet TK, Iloeje U, Veenstra DL, Kowdley KV: Global epidemiology of hepatitis B virus. J Clin Gastroenterol 38(10 Suppl):S158-S168.
- [9]Aylward B, Lloyd J, Zaffran M, McNair-Scott R, Evans P: Reducing the risk of unsafe injections in immunization programmes: financial and operational implications of various injection technologies. Bull World Health Organ 1995, 73:531-540.
- [10]Usman HR, Akhtar S, Rahbar MH, Hamid S, Moattar T, Luby SP: Injections in health care settings: a risk factor for acute hepatitis B virus infection in Karachi, Pakistan. Epidemiol Infect 2003, 130:293-300.
- [11]Khan AJ, Luby SP, Fikree F, Karim A, Obaid S, Dellawala S, Mirza S, Malik T, Fisher-Hoch S, McCormick JB: Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakistan. Bull World Health Organ 2000, 78:956-963.
- [12]Doganci T, Uysal G, Kir T, Bakirtas A, Kuyucu N, Doganci L: Horizontal transmission of hepatitis B virus in children with chronic hepatitis B. World J Gastroenterol 2005, 11:418-420.
- [13]Shaikh MH: Prevalence of HBV markers in health care personals and control. J Coll Physicians Surg Pak 1995, 5:19-21.
- [14]Chaudhry NT, Khan SJ, Khan TA, Saeed M, Syed M, Iqbal J, Ahmed S, Saleem M, Yaqub : Prevalence of hepatitis B carriers and blood group frequency in voluntary blood donors. J Ayub Med Coll Abbottabad 1996, 8:29-32.
- [15]Rehman K, Khan AA, Haider Z, Shahzad A, Iqbal J, Khan RU, Ahmad S, Siddiqui A, Syed SH: Prevalence of seromarkers of HBV and HCV in health care personnel and apparently healthy blood donors. J Pak Med Assoc 1996, 46:152-154.
- [16]Kakepoto GN, Bhally HS, Khaliq G, Kayani N, Burney IA, Siddiqui T, Khurshid M: Epidemiology of blood-borne viruses: a study of healthy blood donors in Southern Pakistan. Southeast Asian J Trop Med Public Health 1996, 27:703-706.
- [17]Tareen S, Eslick GD, Kam EP, Byles JE, Durrani AB, Maree SM: High prevalence of hepatitis B virus (HBV) among male blood donors in a developing country: urgent need for systematic screening. Scand J Infect Dis 2002, 34:712-713.
- [18]Khokhar N, Gill ML, Malik GJ: General seroprevalence of hepatitis C and hepatitis B virus infections in population. J Coll Physicians Surg Pak 2004, 14:534-536.
- [19]Tong CY, Khan R, Beeching NJ, Tariq WU, Hart CA, Ahmad N, Malik IA: The occurance of hepatitis B virus and HCV in Pakistani patients with chronic liver disease and hepatocellular carcinoma. Epidemiol Infect 1996, 117:327-332.
- [20]Khan TS, Rizvi FJ: Hepatitis B seropositivity among chronic liver disease patients in Hazara division Pakistan. J Ayub Med Coll Abbottabad 2003, 15:54-55.
- [21]Pillonel J, Saura C, Courouce AM: Prevalence of HIV, HTLV, and hepatitis B and C viruses in blood donors in France, 1992–1996. Transfus Clin Biol 1998, 5:305-312.
- [22]Akhtar S, Younus M, Adil S, Jafri SH, Hassan F: Hepatitis C virus infection in asymptomatic male volunteer blood donors in Karachi, Pakistan. J Viral Hepat 2004, 11:527-535.
- [23]Hosmer DW Jr, Lemeshow S: Applied Logistic Regression. New York: John Wiley & Sons; 1989:307.
- [24]Butsashvili M, Tsertsvadze T, McNutt LA, Kamkamidze G, Gvetadze R, Badridze N: Prevalence of hepatitis B, hepatitis C, syphilis and HIV in Georgian blood donors. Eur J Epidemiol 2001, 17:693-695.
- [25]Tsai SJ, Chen CJ, Hsieh YS, Yang CS: Seroprevalence of anti-HCV among voluntary blood donors in Taiwan. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1991, 4:61-70.
- [26]Budihusodo U, Sulaiman HA, Akbar HN, Lesmana LA, Waspodo AS, Noer HM, Akahane Y, Suzuki H: Seroepidemiology of HBV and HCV infection in Jakarta, Indonesia. Gastroenterol Jpn 1991, 26(Suppl 3):196-201.
- [27]Correll PK, Law MG, Seed CR, Gust A, Buring M, Dax EM, Keller AJ, Kaldor JM: Variant Creutzfeldt-Jakob disease in Australian blood donors: estimation of risk and the impact of deferral strategies. Vox Sang 2001, 81:6-11.
- [28]Christensen PB, Titlestad IL, Homburg KM, Georgsen J, Kristensen T: Hepatitis B core antibodies in Danish blood donors: a surrogate marker of risk behaviour. Vox Sang 2001, 81:222-227.
- [29]Akbar N, Basuki B, Mulyanto M, Garabrant DH, Sulaiman A, Noer HM: Ethnicity, socioeconomic status, transfusions and risk of hepatitis B and hepatitis C infection. J Gastroenterol Hepatol 1997, 12:752-757.
- [30]Cisneros-Castolo M, Hernandez-Ruiz L, Ibarra-Robles IE, Fernandez-Garate IH, La Pena JE: Prevalence of hepatitis B virus infection and related risk factors in a rural community of Mexico. Am J Trop Med Hyg 2001, 65:759-763.
- [31]Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M: Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates. Bull World Health Organ 1999, 77:801-807.
- [32]Simonsen L, Kane A, Lloyd J, Zaffran M, Kane M: Unsafe injections in the developing world and transmission of blood-borne pathogens: a review. Bull World Health Organ 1999, 77:789-800.
- [33]Thaver IH: Prescribing patterns of primary care providers in squatter areas of Karachi. J Pak Med Assoc 1995, 45:301-302.
- [34]Janjua NZ, Akhtar S, Hutin YJF: Injection use in two districts of Pakistan: implications for disease prevention. Int J Qual Health Care 2005, in press.
- [35]Reeler AV: Anthropological perspectives on injections: a review. Bull Wrld Hlth Org 2000, 78:135-143.
- [36]Ko YC, Li SC, Yen YY, Yeh SM, Hsieh CC: Horizontal transmission of hepatitis B virus from siblings and intramuscular injection among preschool children in a familial cohort. Am J Epidemiol 1991, 133:1015-1023.
- [37]Singh J, Bhatia R, Gandhi JC, Kaswekar AP, Khare S, Patel SB, Oza VB, Jain DC, Sokhey J: Outbreak of viral hepatitis B in a rural community in India linked to inadequately sterilized needles and syringes. Bull World Health Organ 1998, 76:93-98.
- [38]Voelker R: Eradication efforts need needle-free delivery. JAMA 1999, 281:1879-1881.
- [39]Mele A, Corona R, Tosti ME, Palumbo F, Moiraghi A, Novaco F, Galanti C, Bernacchia R, Ferraro P: Beauty treatments and risk of parenterally transmitted hepatitis: results from the hepatitis surveillance system in Italy. Scand J Infect Dis 1995, 27:441-444.
- [40]Yee LJ, Weiss HL, Langner RG, Herrera J, Kaslow RA, Leeuwen DJV: Risk factors for acquisition of hepatitis C virus infection: a case series and potential implications for disease surveillance. BMC Infect Dis 2001, 1:8. BioMed Central Full Text
- [41]Bari A, Akhtar S, Rahbar MH, Luby SP: Risk factors for hepatitis C virus infection in male adults in Rawalpindi-Islamabad, Pakistan. Trop Med Int Health 2001, 6:732-738.
- [42]Crook PD, Jones ME, Hall AJ: Mortality of hepatitis B surface antigen-positive blood donors in England and Wales. Int J Epidemiol 2003, 32:118-124.
- [43]Schlesselman JJ, Stolley PD: Case-control studies: Design, Conduct, Analysis. New York: Oxford University Press; 1982.
- [44]Robinson WS: Hepatitis B virus and Hepatitis D virus. In Principles and Practice of Infectious Diseases. Edited by Mandell GL, Nemmett JE, Dolin R. New York: Churchill Livingstone; 1995:1406-1439.
PDF