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Tariq M, Shoukat AB, Akbar S, Hameed S, Naqvi MZ, Azher A, Saad M, Rizwan M, Nadeem M, Javed A, Ali A, Aziz S. Epidemiology, risk factors, and pathogenesis associated with a superbug: A comprehensive literature review on hepatitis C virus infection. SAGE Open Med 2022; 10:20503121221105957. [PMID: 35795865 PMCID: PMC9252020 DOI: 10.1177/20503121221105957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/20/2022] [Indexed: 12/20/2022] Open
Abstract
Viral hepatitis is a major public health concern. It is associated with life threatening conditions including liver cirrhosis and hepatocellular carcinoma. Hepatitis C virus infects around 71 million people annually, resultantly 700,000 deaths worldwide. Extrahepatic associated chronic hepatitis C virus accounts for one fourth of total healthcare load. This review included a total of 150 studies that revealed almost 19 million people are infected with hepatitis C virus and 240,000 new cases are being reported each year. This trend is continually rising in developing countries like Pakistan where intravenous drug abuse, street barbers, unsafe blood transfusions, use of unsterilized surgical instruments and recycled syringes plays a major role in virus transmission. Almost 123–180 million people are found to be hepatitis C virus infected or carrier that accounts for 2%–3% of world’s population. The general symptoms of hepatitis C virus infection include fatigue, jaundice, dark urine, anorexia, fever malaise, nausea and constipation varying on severity and chronicity of infection. More than 90% of hepatitis C virus infected patients are treated with direct-acting antiviral agents that prevent progression of liver disease, decreasing the elevation of hepatocellular carcinoma. Standardizing the healthcare techniques, minimizing the street practices, and screening for viral hepatitis on mass levels for early diagnosis and prompt treatment may help in decreasing the burden on already fragmented healthcare system. However, more advanced studies on larger populations focusing on mode of transmission and treatment protocols are warranted to understand and minimize the overall infection and death stigma among masses.
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Affiliation(s)
- Mehlayl Tariq
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Abu Bakar Shoukat
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sedrah Akbar
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Samaia Hameed
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muniba Zainab Naqvi
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Ayesha Azher
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Saad
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.,BreathMAT Lab, IAD, Pakistan Institute of Nuclear Science and Technology (PINSTECH), Islamabad, Pakistan
| | - Muhammad Rizwan
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Nadeem
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Anum Javed
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Asad Ali
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Punjab, Pakistan
| | - Shahid Aziz
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.,BreathMAT Lab, IAD, Pakistan Institute of Nuclear Science and Technology (PINSTECH), Islamabad, Pakistan
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Umutesi J, Klett-Tammen C, Nsanzimana S, Krause G, Ott JJ. Cross-sectional study of chronic hepatitis B virus infection in Rwandan high-risk groups: unexpected findings on prevalence and its determinants. BMJ Open 2021. [PMCID: PMC8719204 DOI: 10.1136/bmjopen-2021-054039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
ObjectivesUsing secondary data from 208 079 Rwandans, we determined the prevalence of chronic hepatitis B virus (HBV) infection among high-risk groups and its demographic, geographical and health-related determinants.DesignIn this cross-sectional study, we obtained and analysed data from a national hepatitis B vaccination and screening campaign conducted in Rwanda in 2017. We performed logistic regression to examine associations between chronic HBV infection and related factors such as risk status and geographical characteristics.SettingIndividuals were sampled nationally in all 30 districts across 4 provinces and the city of Kigali and all prisons in Rwanda.ParticipantsThe study involves 208 079 individuals at high risk including prisoners and other high-risk groups (oHRG).Main outcomeThe primary outcome for our study was hepatitis B surface antigens (HBsAg) prevalence.FindingsFrom 208 079 adults participants, 206 517 (99.2%) had valid HBsAg results, 4.3% of 64 944 prisoners and 4.0% of 140 985 oHRG were HBV positive. The prevalence was higher in Northern Province 5.1%, (95% CI 4.8 to 5.4). In multivariate analysis, the odds of infection decreased with increasing age, and hepatitis C antibody positivity reduced the odds for chronic HBV (OR 0.58, 95% CI 0.52 to 0.66 and OR 0.74, 95% CI 0.62 to 0.89 among oHRG and prisoners, respectively). In addition, being female was associated with lower odds of HBV (OR 0.70, 95% CI 0.66 to 0.74 and OR 0.80, 95% CI 0.65 to 0.98 among oHRG and prisoners, respectively).ConclusionWe found that individuals below 55 years of age and individuals who belong to high-risk groups (ie, sex workers, injection drug users, men who have sex with men, etc) have a higher probability of chronic HBV infection. Infection with chronic hepatitis C virus was not correlated with chronic HBV infection in our study population. Potential explanations include differential routes of transmission, specific immunological and pathophysiological factors or different effects of health prevention and control programmes.
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Affiliation(s)
- Justine Umutesi
- Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- IHDPC, Rwanda Biomedical Center, Kigali, Rwanda
| | | | - Sabin Nsanzimana
- Office of the Director General, Rwanda Biomedical Center, Kigali, Rwanda
| | - G Krause
- Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Epidemiology, DZIF, Braunschweig, Niedersachsen, Germany
| | - J J Ott
- Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- MHH, Hannover, Niedersachsen, Germany
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Younas A, Riaz J, Chughtai T, Maqsood H, Saim M, Qazi S, Younus S, Ghaffar U, Khaliq M. Hyponatremia and Its Correlation With Hepatic Encephalopathy and Severity of Liver Disease. Cureus 2021; 13:e13175. [PMID: 33717720 PMCID: PMC7939097 DOI: 10.7759/cureus.13175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and objective Hepatic cirrhosis is one of the leading causes of morbidity and mortality worldwide. Patients with cirrhosis frequently develop complications such as ascites, variceal bleeding, and hepatic encephalopathy (HE). The clinical manifestations of HE range from the mildly altered level of sensorium to severely altered consciousness levels, difficulty in judgment, the day-night reversal of sleep, flapping tremor of hands, and irrelevant talking or speech. Patients with hyponatremia are at a higher risk of developing HE and electroencephalographic abnormalities. The severity of hyponatremia is directly related to the deterioration in terms of grades of HE. Our study sought to determine the frequency of hyponatremia in cirrhotic patients and its correlation with the frequency and severity of HE. Methodology This study was carried out at the inpatient department of medicine in a tertiary care hospital in Pakistan. A total of 260 patients of both genders with hepatic cirrhosis were approached. After taking relevant history and physical examination, the venous blood sample of each patient was drawn and sent to the institutional laboratory for estimation of serum electrolytes, liver function tests (LFTs), renal parameters (RPMs), prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR). We classified the HE according to the West Haven classification system. Mild to moderate encephalopathy was classified under grades I-II, while severe encephalopathy was classified under grades III-IV. We documented the severity of liver disease according to the Child-Pugh score criteria. All data were analyzed by using SPSS Statistics version 25.0 (IBM, Armonk, NY). We reported the data as means along with the standard error. Results Overall, the serum sodium levels of the subjects ranged from 115 to 142 meq/L with a mean of 129.11 ±6.53 meq/L. In patients with hyponatremia, it ranged from 115 to 127 meq/L (mean 121.41 ±5.17 meq/L). Hyponatremia was present in 96 (36.9%) patients. Among these, 51 (53.12%) were male and 45 (46.8%) were female; 24 (9.2%) patients had mild hyponatremia, 56 (21.5%) had moderate, and 16 (6.2%) had severe hyponatremia. HE was present in 176 (67.7%) patients. HE grade I was present in 54 (20.8%), grade II in 62 (23.8%), grade III in 32 (12.3%), and grade IV in 28 (10.8%) patients. In 96 patients with hyponatremia, 84 were found to have HE (p-value: <0.001). Conclusion Based on our findings, cirrhotic patients with chronic hepatitis infections have a variable presence of low sodium levels. Sodium levels of <130 meq/L were associated with higher morbidity and mortality rate. Moreover, patients with lower levels of sodium had higher grades of HE.
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Affiliation(s)
- Amna Younas
- Medicine, Russells Hall Hospital, Dudley, GBR
| | - Junaid Riaz
- Medicine, Nishtar Medical University, Multan, PAK
| | | | | | | | - Shaheryar Qazi
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Shifa Younus
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Umar Ghaffar
- Internal Medicine, Nishtar Medical University, Multan, PAK
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Mahmud S, Mumtaz GR, Chemaitelly H, Al Kanaani Z, Kouyoumjian SP, Hermez JG, Abu‐Raddad LJ. The status of hepatitis C virus infection among people who inject drugs in the Middle East and North Africa. Addiction 2020; 115:1244-1262. [PMID: 32009283 PMCID: PMC7318323 DOI: 10.1111/add.14944] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/14/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS People who inject drugs (PWID) are a key population at high risk of hepatitis C virus (HCV) infection. The aim of this study was to delineate the epidemiology of HCV in PWID in the Middle East and North Africa (MENA). METHODS Syntheses of data were conducted on the standardized and systematically assembled databases of the MENA HCV Epidemiology Synthesis Project, 1989-2018. Random-effects meta-analyses and meta-regressions were performed. Meta-regression variables included country, study site, year of data collection and year of publication [to assess trends in HCV antibody prevalence over time], sample size and sampling methodology. Numbers of chronically infected PWID across MENA were estimated. The Shannon Diversity Index was calculated to assess genotype diversity. RESULTS Based on 118 HCV antibody prevalence measures, the pooled mean prevalence in PWID for all MENA was 49.3% [95% confidence interval (CI) = 44.4-54.1%]. The country-specific pooled mean ranged from 21.7% (95% CI = 4.9-38.6%) in Tunisia to 94.2% (95% CI = 90.8-96.7%) in Libya. An estimated 221 704 PWID were chronically infected, with the largest numbers found in Iran at 68 526 and in Pakistan at 46 554. There was no statistically significant evidence for a decline in HCV antibody prevalence over time. Genotype diversity was moderate (Shannon Diversity Index of 1.01 out of 1.95; 52.1%). The pooled mean percentage for each HCV genotype was highest in genotype 3 (42.7%) and in genotype 1 (35.9%). CONCLUSION Half of people who inject drugs in the Middle East and North Africa appear to have ever been infected with hepatitis C virus, but there are large variations in antibody prevalence among countries. In addition to > 200 000 chronically infected current people who inject drugs, there is an unknown number of people who no longer inject drugs who may have acquired hepatitis C virus during past injecting drug use. Harm reduction services must be expanded, and innovative strategies need to be employed to ensure accessibility to hepatitis C virus testing and treatment.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Ghina R. Mumtaz
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar,Department of Epidemiology and Population Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Joumana G. Hermez
- Department of Communicable Diseases, HIV/Hepatitis/STIs Unit, World Health Organization,Regional Office for the Eastern MediterraneanCairoEgypt
| | - Laith J. Abu‐Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar,Department of Healthcare Policy and Research, Weill Cornell MedicineCornell UniversityNew YorkNY, USA,College of Health and Life SciencesHamad bin Khalifa UniversityDohaQatar
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Tufon KA, Meriki HD, Kwenti TE, Tony NJ, Malika E, Bolimo AF, Kouanou YS, Nkuo-Akenji T, Anong DN. HBV Transmission Risk Assessment in Healthcare Workers, Household and Sexual Contacts of HBV Infected Patients in the Southwest Region of Cameroon. Oman Med J 2019; 34:313-321. [PMID: 31360320 PMCID: PMC6642709 DOI: 10.5001/omj.2019.62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives Hepatitis B virus (HBV) is known to be highly transmissible via the body fluids of an infected person. We investigated the transmission risks, awareness, and prevalence among healthcare workers (HCWs), household contacts (HHCs), and sexual partners (SPs) of HBV infected individuals. Methods We conducted a cross-sectional study of HCWs, HBV infected individuals as well as their corresponding HHCs and SPs. Data related to some transmission risks and HBV awareness was obtained from each participant using a questionnaire. Blood samples were collected from each participant and tested for hepatitis B surface antigen (HBsAg), hepatitis B e-antigen, and anti-hepatitis B core (anti-HBc). HBV viral load measurement was done for the HBV infected participants. Results A total of 596 participants were enrolled (127 HCWs, 128 HHCs, 138 SPs, and 203 HBV infected participants). HHCs (odds ratio (OR): 3.85, confidence interval (CI): 1.89–7.81), and SPs (OR: 3.04, CI: 1.51–6.17) were more associated with HBsAg/anti-HBc positivity compared to HCWs. Age, years spent with HBV infected partner, unprotected sex, and marriage were not identified as risk factors for HBV sexual transmission but cohabiting with an HBV infected SP was significantly (p = 0.005) associated with transmission (OR: 3.56, CI: 1.46–8.72). Female HHCs (OR: 2.48, CI: 1.06–5.80) and SPs (OR: 2.64, CI: 0.95–7.30) were more associated with HBsAg/anti-HBc positivity. The mean viral load (log IU) of HBV infected individuals (3.9±2.0) with HBsAg positive SPs was significantly higher than that of HBV infected individuals (2.8±1.0) with HBsAg negative SPs (p < 0.001). Conclusions HHCs and SPs of HBV infected patients are more associated with HBV infection compared to HCWs. Horizontal transmission can as well be implicated among SPs since unprotected sex was not identified as a risk factor for transmission, but cohabitation was. Prompt management and preventive measures could be implemented if HHCs and SPs of HBV infected patients are identified, sensitized, and screened.
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Affiliation(s)
- Kukwah Anthony Tufon
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon
| | - Henry Dilonga Meriki
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon.,Department of Public Health and Hygiene, Faculty of Health Science, University of Buea, Buea, Cameroon
| | - Tebit Emmanuel Kwenti
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon.,Department of Public Health and Hygiene, Faculty of Health Science, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Science, Faculty of Health Science, University of Buea, Buea, Cameroon
| | - Nyeke James Tony
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon
| | - Ekeme Malika
- Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon.,Department of Public Health and Hygiene, Faculty of Health Science, University of Buea, Buea, Cameroon
| | - Ayah Flora Bolimo
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon
| | | | - Theresa Nkuo-Akenji
- Department of Biological Science, Faculty of Science, University of Bamenda, Bamenda, Cameroon
| | - Damian Nota Anong
- Department of Biological Science, Faculty of Science, University of Bamenda, Bamenda, Cameroon
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National prevalence rate of hepatitis B and C in Pakistan and its risk factors. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-019-01081-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Jafari S, Moradi G, Gouya MM, Azimian Zavareh F, Ghaderi E. Predictors of Drug Injection in High-Risk Populations of Prisoners with a History of Tattooing: A Cross-Sectional Study. J Res Health Sci 2019; 19:e00435. [PMID: 31133625 PMCID: PMC6941624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/19/2018] [Accepted: 12/25/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Transmitting blood-borne diseases is alarming in places with high prevalence of people who inject drugs. This study aimed to determine the prevalence of drug injection and its related predictors among prisoners with a history of tattooing in Iran. STUDY DESIGN Cross-sectional study. METHODS By using a census sampling, 5493 prisoners with a history of tattooing of 11988 prisoners participated for hepatitis B and C bio-behavioral surveillance surveys (BSS) in prisons of Iran, during 2015-2016 from 55 prisons in 19 provinces were assessed. The data for the BSS were collected using face-to-face checklist-based interviews. Weighted prevalence and the association between variables and history of drug injection were determined using Chi-square test and adjusted odds ratio (AOR) was estimated through multivariate logistic regression test using survey package. RESULTS The mean age of participants was 33.9 ±8.3 yr. Most of them were male (96.4%) and had a history of drug use (85.4%). The prevalence of drug injection among drug users was 20.2%, of which 33.9% had a history of shared injection. The prevalence of drug injection among prisoners with a history of tattooing is associated with male gender (P=0.047), age ≥35 yr (P<0.001), being single (P=0.002), being divorced/widow (P=0.039), and a history of imprisonment (P<0.001). CONCLUSION The prevalence of drug injection increases in the presence of other high-risk behaviors. It is necessary to initiate harm reduction programs and preventive interventions in groups with multiple high-risk behaviors.
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Affiliation(s)
- Saeede Jafari
- 1 Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- 2 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Mehdi Gouya
- 3 Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Fatemeh Azimian Zavareh
- 3 Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Ebrahim Ghaderi
- 2 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
,Correspondence: Ebrahim Ghaderi (PhD) Tel: +98 9183732644 Fax: +87 33664643-6 E-mail:
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Moazen B, Saeedi Moghaddam S, Silbernagl MA, Lotfizadeh M, Bosworth RJ, Alammehrjerdi Z, Kinner SA, Wirtz AL, Bärnighausen TW, Stöver HJ, Dolan KA. Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates. Epidemiol Rev 2018; 40:58-69. [PMID: 29860343 DOI: 10.1093/epirev/mxy002] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
Prisoners engage in a range of risk behaviors that can lead to the transmission of viral infections, such as HIV, hepatitis B and hepatitis C. In this review, we summarize the epidemiologic literature from 2007 to 2017 on 4 key risk behaviors for human immunodeficiency virus and hepatitis C virus among prisoners globally: drug injection, sexual activity, tattooing, and piercing. Of 9,303 peer-reviewed and 4,150 gray literature publications, 140 and 14, respectively, met inclusion criteria covering 53 countries (28%). Regions with high levels of injection drug use were Asia Pacific (20.2%), Eastern Europe and Central Asia (17.3%), and Latin America and the Caribbean (11.3%), although the confidence interval for Latin America was high. Low levels of injection drug use in prison were found in African regions. The highest levels of sexual activity in prison were in Europe and North America (12.1%) and West and Central Africa (13.6%); low levels were reported from the Middle East and North African regions (1.5%). High levels of tattooing were reported from Europe and North America (14.7%), Asia Pacific (21.4%), and Latin America (45.4%). Prisons are burdened with a high prevalence of infectious diseases and risk behaviors for transmission of these diseases, and, commonly, a striking lack of evidence-based infection control measures, even when such measures are available in the surrounding community. Given that most prisoners return to these communities, failure to implement effective responses has repercussions not only prisoner health but also for public health.
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Affiliation(s)
- Babak Moazen
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.,Department of Community Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rebecca J Bosworth
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Zahra Alammehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Till W Bärnighausen
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Heino J Stöver
- Department of Health and Social Work, Institute of Addiction Research
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9
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Mundt AP, Baranyi G, Gabrysch C, Fazel S. Substance Use During Imprisonment in Low- and Middle-Income Countries. Epidemiol Rev 2018; 40:70-81. [PMID: 29584860 PMCID: PMC5982797 DOI: 10.1093/epirev/mxx016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/07/2017] [Indexed: 12/29/2022] Open
Abstract
Substance use disorders are among the most common health problems of people involved with the criminal justice system. Scaling up addiction services in prisons is a global public health and human rights challenge, especially in poorly resourced countries. We systematically reviewed the prevalence of substance use in prison populations in low- and middle-income countries. We searched for studies reporting prevalence rates of nicotine, alcohol, illicit drug, and injection drug use during imprisonment in unselected samples of imprisoned people in low- and middle-income countries. Data meta-analysis was conducted and sources of heterogeneity were examined by meta-regression. Prevalence of nicotine use during imprisonment ranged from 5% to 87%, with a random-effects pooled estimate of 56% (95% confidence interval (CI): 45, 66) with significant geographical heterogeneity. Alcohol use varied from 1% to 76% (pooled prevalence, 16%, 95% CI: 9, 25). Approximately one-quarter of people (25%; 95% CI: 17, 33; range, 0–78) used illicit drugs during imprisonment. The prevalence of injection drug use varied from 0% to 26% (pooled estimate, 1.6%, 95% CI: 0.8, 3.0). Lifetime substance use was investigated in secondary analyses. The high prevalence of smoking in prison suggests that policies regarding smoking need careful review. Furthermore, the findings underscore the importance of timely, scalable, and available treatments for alcohol and illegal drug use by people involved with the criminal justice system.
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Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile.,Medical School, Universidad San Sebastián, Puerto Montt, Chile
| | - Gergo Baranyi
- Center for Research on Environment Society and Health, School of Geosciences, University of Edinburgh, Edinburgh, United Kingdom.,Institute and Polyclinic for Occupational and Social Medicine, Technische Universität Dresden, Germany
| | - Caroline Gabrysch
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Seena Fazel
- Department of Psychiatry, Oxford University, Oxford, United Kingdom
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10
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Nejo Y, Faneye AO, Olusola B, Bakarey S, Olayinka A, Motayo B. Hepatitis B virus infection among sexually active individuals in Nigeria: a cross-sectional study. Pan Afr Med J 2018; 30:155. [PMID: 30455784 PMCID: PMC6235487 DOI: 10.11604/pamj.2018.30.155.14886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/07/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction Hepatitis B virus (HBV) infection is a major health challenge in sub-Saharan African countries. Chronic HBV infection is a risk factor for severe disease progression. Perinatal and sexual transmissions of Hepatitis B virus are the main routes of infection in HBV endemic countries like Nigeria. However, there is paucity of data as regards the major contributory route of transmission to chronic HBV infection in this region. Also, in Nigeria, not everyone at high risk of the infection has been identified. Therefore our study investigated the prevalence of HBV infection among sexually active individuals in Nigeria. Methods Blood samples collected from 463 participants (360 sexually active individuals and 103 teenagers) recruited from health institutions across the country were tested for the presence of HBsAg, and HBV nucleic acid related antigen (HBVNRAg) by ELISA. Positive samples were further tested for the presence of HBeAg and antiHBe by ELISA. Data were analyzed using Chi-square and binary logistic regression at p = 0.05. Results HBsAg and HBVNRAg were detected in 10.4% and 7.6% of the participants respectively. STI clinic attendees had the highest prevalence for HBsAg (17%; p = 0.002). Teenagers had the lowest HBsAg (1.9; p = 0.002) and HBVNRAg (2.9%; p = 0.0001) prevalence rates. Male gender (p = 0.01) and reproductive age group (p=0.009) were the major predictors of chronic HBV infection. Conclusion Sexual transmission was identified as the major contributor to chronic HBV infection. Sexually active individuals especially those with STIs are high risk groups for chronic HBV infection. Interventions targeted at this group is therefore recommended.
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Affiliation(s)
- Yewande Nejo
- Department of Biological Sciences, Bowen University Iwo, Nigeria.,Department of Virology, College of Medicine University of Ibadan, Nigeria
| | | | - Babatunde Olusola
- Department of Virology, College of Medicine University of Ibadan, Nigeria
| | - Solomon Bakarey
- Department of Virology, College of Medicine University of Ibadan, Nigeria
| | - Adebowale Olayinka
- Department of Virology, College of Medicine University of Ibadan, Nigeria
| | - Babatunde Motayo
- Department of Virology, College of Medicine University of Ibadan, Nigeria
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11
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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: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [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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Mahmud S, Kouyoumjian SP, Al Kanaani Z, Chemaitelly H, Abu-Raddad LJ. Individual-level key associations and modes of exposure for hepatitis C virus infection in the Middle East and North Africa: a systematic synthesis. Ann Epidemiol 2018; 28:452-461. [PMID: 29661680 DOI: 10.1016/j.annepidem.2018.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/01/2018] [Accepted: 03/16/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. METHODS Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. RESULTS In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2%), followed by other infections/diseases (n = 20; 17.5%), and incarceration (n = 17; 14.9%). Among modes of exposure, health care-related exposures were most frequently reported (n = 127; 59.5%), followed by injecting drug use exposures (n = 45; 20.9%), community-related exposures (n = 34; 15.8%), and sexual-related exposures (n = 8; 3.7%). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care-related exposures. CONCLUSIONS Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Silva P Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar; Department of Healthcare Policy & Research, Weill Cornell Medicine, Cornell University, New York.
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Mokhtari M, Basirkazeruni H, Rostami M. The Correlation between Different Risk Factors of Hepatitis C and Different Genotypes. Adv Biomed Res 2017; 6:45. [PMID: 28503500 PMCID: PMC5414405 DOI: 10.4103/2277-9175.204588] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hepatitis C infection is one of the health problems in the world. Several known risk factors are responsible in transmission of this infection. We are going to study the prevalence of these risk factors for different genotypes of hepatitis C and if possible, specify probable relations between each risk factor and transmission of each genotype. MATERIALS AND METHODS This is a cross-sectional study done on 270 people who had positive anti-hepatitis C virus (HCV) antibody and HCV RNA. Demographic specificity and possible risk factors were collected using a questionnaire, and statistical analysis was done by SPSS software (version 20). Chi-square test used to estimate the prevalence and relation between each qualitative risk factor and HCV genotype transmitted. Analysis of variance was used for studying the prevalence and relation between quantitative risk factors and HCV genotypes. RESULTS The sample size was 270 persons. Of these, 217 (80.4%) were men and 185 (68.5%) were infected with genotype Type III. Most people were in age range of 31-40 years old 92 (34%). Single people were 126 (46.7%) and 169 (62.6%) were high school and university graduated. Tattooing as a risk factor had a meaningful relation with hepatitis C genotype (P < 0.001). CONCLUSIONS According to the findings, most people in central provinces of Iran with hepatitis C are carrying genotype III, with most prevalent risk factors such as intravenous drug use and unsafe sexual activity. Besides, tattooing had a significant association with hepatitis C genotype, so that in these groups of people, genotype I was more frequent isolated virus.
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Affiliation(s)
- Mozhgan Mokhtari
- Department of Pathology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hanieh Basirkazeruni
- Department of Pathology, Isfahan Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Rostami
- Department of Infectious Disease, Isfahan Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Younis BB, Arshad R, Khurhsid S, Masood J, Nazir F, Tahira M. Fulminant hepatic failure (FHF) due to acute hepatitis C. Pak J Med Sci 2015; 31:1009-11. [PMID: 26430449 PMCID: PMC4590397 DOI: 10.12669/pjms.314.7618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Acute hepatitis C (HCV) infection has been identified as an important cause of fulminant hepatic failure (FHF), characterized by rapid deterioration of liver function from massive hepatic necrosis leading to encephalopathy and multi-organ failure. We admitted a female patient at Shalamar Hospital with jaundice, fever, encephalopathy and coagulopathy of short duration with no history of any comorbidity. Her hepatitis viral screen revealed positive anti HCV. Her viral loads were also high. A diagnosis of FHF due to acute HCV infection was made. Patient was treated conservatively and improved gradually. In summary, acute HCV can cause FHF and should be ruled out in patients with FHF of unknown cause in an endemic country for HCV like Pakistan.
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Affiliation(s)
- Bilal Bin Younis
- Bilal Bin Younis, Sakina Institute of Diabetes and Endocrine Research, Shamalar Medical & Dental College Hospital, Lahore, Pakistan
| | - Rozina Arshad
- Rozina Arshad, Sakina Institute of Diabetes and Endocrine Research, Shamalar Medical & Dental College Hospital, Lahore, Pakistan
| | - Saima Khurhsid
- Saima Khurhsid, Sakina Institute of Diabetes and Endocrine Research, Shamalar Medical & Dental College Hospital, Lahore, Pakistan
| | - Junaid Masood
- Junaid Masood, Sakina Institute of Diabetes and Endocrine Research, Shamalar Medical & Dental College Hospital, Lahore, Pakistan
| | - Farhan Nazir
- Farhan Nazir, Sakina Institute of Diabetes and Endocrine Research, Shamalar Medical & Dental College Hospital, Lahore, Pakistan
| | - Maham Tahira
- Maham Tahira, Sakina Institute of Diabetes and Endocrine Research, Shamalar Medical & Dental College Hospital, Lahore, Pakistan
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Janjua NZ, Mahmood B, Imran Khan M. Does knowledge about bloodborne pathogens influence the reuse of medical injection syringes among women in Pakistan? J Infect Public Health 2014; 7:345-55. [PMID: 24861642 DOI: 10.1016/j.jiph.2014.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 04/08/2014] [Accepted: 04/09/2014] [Indexed: 12/12/2022] Open
Abstract
Injections with re-used syringes have been identified as a major risk factor for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Pakistan. We analyzed data from the 2006-2007 Pakistan Demographic Health Survey (PDHS) to describe the distribution of injections administered with newly opened syringes and assessed the association of knowledge about bloodborne pathogens with syringe reuse in Pakistan. In the PDHS, women aged 12-49 years were enrolled through a multistage stratified cluster-sampling strategy across Pakistan. Approximately 10,000 women were interviewed to collect information regarding receiving injections, the use of syringes taken out of new unopened packages for their last injections, and knowledge regarding the transmission of Human Immunodeficiency Virus (HIV), HBV and HCV through the re-use of syringes and transfusion of unscreened blood. Of the 5126/10,023 women who provided information concerning their last injection, 4342 (86%) received this injection with a new syringe taken out of an unopened package. The proportion of injections received with a new syringe increased with the education level, wealth, HIV knowledge and knowledge about HCV/HBV transmission through the re-use of syringes. In the multivariable model, respondents in the 4th (adjusted odds ratio (AOR): 2.1, 95%CI: 1.4-3.0) and 5th (AOR: 2.4, 95%CI: 1.6-3.5) wealth quintiles, with some education (AOR: 1.4, 95%CI: 1.1-1.9), those in the 4th quartile of the HIV knowledge score (AOR: 1.5, 95%CI: 1.1-2.0), and those with the knowledge that a new syringe protects against HCV/HBV and HIV (AOR: 2.3, 95%CI: 1.5-3.5) were more likely to receive injections with a newly opened syringe. The patients' knowledge regarding the transmission of bloodborne pathogens is an important factor in receiving injections with a new syringe.
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Affiliation(s)
- Naveed Z Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada; Schools of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
| | | | - M Imran Khan
- Department of International Health, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, United States
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Samreen B, Khaliq S, Ashfaq UA, Khan M, Afzal N, Shahzad MA, Riaz S, Jahan S. Hepatitis C virus entry: role of host and viral factors. INFECTION GENETICS AND EVOLUTION 2012; 12:1699-709. [PMID: 22878095 DOI: 10.1016/j.meegid.2012.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 07/13/2012] [Accepted: 07/16/2012] [Indexed: 12/24/2022]
Abstract
Hepatitis C virus (HCV) has been considered to be a significant risk factor in developing liver associated diseases including hepatocellular carcinoma all over the world. HCV is an enveloped positive strand virus comprising a complex between genomic RNA and viral envelope glycoproteins (E1 and E2), which are anchored within host derived double-layered lipid membrane surrounding the nucleocapsid composed of several copies of core protein. HCV cell entry is the first step in infection and viral replication into host cells mainly hepatocytes. HCV cell entry is a complex process involving both the viral (envelope glycoproteins E1/E2) and host factors (cellular receptors and associated factors i.e. CD81, SR-BI, LDL-R, CLDN1, Occludin, DC-SIGN, L-SIGN and Glycosaminoglycans). Besides these the expression of certain other conditions such as polarization and EWI-2 expression inhibits the viral cell entry. Exploring the mechanism of HCV entry will help to better understand the viral life cycle and possible therapeutic targets against HCV infection including viral and host factors involved in this process. New strategies such as RNAi represents a new option for targeting the host or viral factors for prevention and therapeutic against HCV infection. In the current review we try to summarize the current knowledge about mechanism and interaction of cellular and viral factors involved in HCV cell entry and its implication as therapeutic target to inhibit HCV infection.
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Affiliation(s)
- Baila Samreen
- National Center of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
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