BackgroundIt is well documented that Egypt has the highest prevalence of hepatitis C virus (HCV) infection in the world. The recent development of highly effective direct acting antiviral drugs (DAAs), has opened the possibility of treating and curing HCV infection in the Egyptian population on a large scale.MethodsA screening demonstration project was implemented in southern Egypt in and around the city of Luxor. Free screening and if indicated, treatment, was offered to those 16 years or older for anti-HCV antibodies (anti-HCV) and hepatitis B surface antigen (HBsAg) using third generation enzyme immunoassays (Enzygnost® Anti-HCV and HbsAg). Statistical methods included estimation of odds ratios (OR) and 95% confidence intervals (95% CI).ResultsThere was a large turnout of 67,042 persons who were screened in a 12-month period starting in June 2016. Thirty-one thousand nine hundred sixty-four males (47.7%) and 35,074 females (52.3%) were screened with a mean age of 43.6 ± 14.3 years. Nine thousand seven hundred one patients (14.5%) were positive for anti-HCV and 2950 (4.4%) for HBsAg. Prevalence of anti-HCV was significantly higher in males than females (19.67% vs.9.73% OR = 2.27; CI 2.2 to 2.4; p < 0.001) and the same for HBsAg (6.2% vs. 2.8% OR = 2.3; CI 2.2 to 2.5; p < 0.001). The prevalence of anti-HCV was significantly associated with age (p < 0.001), ranging from between 1 and 4% in individuals below the age of 40 years, then increased steadily to 42% at age 60 followed by a precipitous decline in age specific prevalence.ConclusionsThe results showed unanticipated patterns in the Luxor area of anti-HCV and HBsAg by age and gender in contrast to previous reports on this unique HCV epidemic in Egypt. Moreover, the level and rate of turnout, cost, and other logistical issues, provided essential information for effective planning, design, and evaluation methods for larger national mass screening and treatment programs.
Background : It is well documented that Egypt has the highest prevalence of hepatitis C virus (HCV) in the world. The recent development of fast acting, highly effective direct acting antiviral drugs (DAAs), has opened the possibility of treating and curing HCV infection in the Egyptian population on large scale. Methods : A screening demonstration project was implemented in southern Egypt in and around the city of Luxor. Free screening and if indicated, treatment, was offered to those 16 years or older for anti-HCV antibody (anti-HCV) and hepatitis B virus surface antigen (HBsAg) using third generation enzyme immunoassays (Enzygnost® Anti-HCV and HbsAg). Statistical methods included estimation of odds ratios (OR) and 95% confidence intervals (95% CI). Results: There was a large turnout of 67,042 persons who were screened in a 12-month period starting in June 2106. 31,965 males (47.7%) and 35,077 females (52.3%) were screened with a mean age of 43.6±14.3 years. 9,701 patients (14.5%) were positive for anti-HCV and 2,950 (4.4%) for HBsAg. Prevalence of anti-HCV was significantly higher in males than females (19.67% vs.9.73% OR=2.27; CI 2.2 to 2.4; p<0.001) and the same for HBsAg (6.2% vs. 2.8% OR=2.3; CI 2.2 to 2.5; p<0.001). The prevalence of anti-HCV was significantly associated with age (p<0.001), ranging from between 1-4% in individuals below the age of 40 years, then increased steadily to 42% at age 60 followed by a precipitous decline in age specific prevalence. Conclusions: The results showed unanticipated patterns of anti-HCV and HBsAg by age and gender in contrast to previous reports on this unique HCV epidemic in Egypt. Moreover, the results provide essential information for effective planning, design, and evaluation for future Egyptian national mass screen and treatment programs.
Background: Increased speed and resolution of ultrasound have made it a first-line modality for the abdominal examination. During the last 5 years trans-abdominal ultrasonography has been used increasingly, for assessment of patients with small bowel (SB) diseases. Around 350 such examinations are performed annually in the diagnostic imaging department at Azhar University Hospital. Hence, the aim is to determine if the ultrafast three-dimensional ultrasound (U3D US) is potent for optimal examination of SB diseases. Patients and methods: Tap-water intake has been used to distend the SB. All patients have been examined in supine position. The U3D US data of 198 patients with SB diseases were assessed. The proximal and distal SB image quality along with the evaluation of bowel distention, motility and lesions were reported. Results: Image quality was good in all examinations. Adequate demonstration of the proximal and distal SB was obtained in all of U3D US examinations. The inclusive diagnostic accuracy of U3D US was precise in 92.3%. Proximal SB was, however, less frequently involved, particularly in patients below the age of 30 years (P = 0.050). Conclusion: The diagnostic accuracy of U3D US enterography is valuable for detecting SB lesions. This modality is widely available, inexpensive and easy technique, can be used as an initial investigation in the evaluation of patients with SB disorders. Keywords: small bowel disease-ultrafast threedimensional Ultrasonography-Diagnostic performance elwagdy et al 46 Clinical Medicine Insights: Gastroenterology 2011:4
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