Further evidence for association of hepatitis C infection with parenteral schistosomiasis treatment in Egypt

Abstract

BackgroundHepatitis C virus (HCV) infection and schistosomiasis are major public health problems in the Nile Delta of Egypt. To control schistosomiasis, mass treatment campaigns using tartar emetic injections were conducted in the 1960s through 1980s. Evidence suggests that inadequately sterilized needles used in these campaigns contributed to the transmission of HCV in the region. To corroborate this evidence, this study evaluates whether HCV infections clustered within houses in which household members had received parenteral treatment for schistosomiasis.MethodsA serosurvey was conducted in a village in the Nile Delta and residents were questioned about prior treatment for schistosomiasis. Sera were evaluated for the presence of antibodies to HCV. The GEE2 approach was used to test for clustering of HCV infections, where correlation of HCV infections within household members who had been treated for schistosomiasis was the parameter of interest.ResultsA history of parenteral treatment for schistosomiasis was observed to cluster within households, OR for clustering: 2.44 (95% CI: 1.47–4.06). Overall, HCV seropositivity was 40% (321/796) and was observed to cluster within households that had members who had received parenteral treatment for schistosomiasis, OR for clustering: 1.76 (95% CI: 1.05–2.95). No such evidence for clustering was found in the remaining households.ConclusionClustering of HCV infections and receipt of parenteral treatment for schistosomiasis within the same households provides further evidence of an association between the schistosomiasis treatment campaigns and the high HCV seroprevalence rates currently observed in the Nile delta of Egypt.

High prevalence of hepatitis C associated with familial history of hepatitis in a small town of south Brazil: efficiency of the rapid test for epidemiological survey

“…As hypothesized by Rao et al, many infections in the past were probably acquired from external sources in which more than one family member was contaminated at the same time. 26 Nevertheless, the lower prevalence in younger age groups in Tamboara suggests that the unknown exposure may no longer play a role in HCV transmission.…”

Healthcare Experiences of Zabbaleen Women in Cairo, Egypt

“…Wariness of government health programs also arise from the high rates of HCV that are attributed in part to a national campaign to treat schistosomiasis, or bilharzia, a helminthic infection transmitted from snails that flourish in the canals and tributaries of the Nile in the Delta regions (Rao et al, 2002). The campaign, called Parenteral Antischistosomal Therapy (PAT), lasted 15 years, from 1965 to 1980 focusing on the rural Delta regions and southern regions in Egypt where bilharzia was most prevalent and where a large portion of Copts lived (Roberts and Levitt, 2000;Frank et al, 2000;Hyams et al, 1987).…”

“…Studies indicate that contaminated reusable needles and syringes used in this government campaign resulted in transmission of both Hepatitis B and C (MacKeen, 2003;Roberts and Levitt, 2000;Hyams et al, 1987;Rao et al, 2002). Sixty eight percent of patients with Hepatitis C received schistosomiasis treatment during the PAT campaign (Rao et al, 2002). Even though women were not given the treatment as often as men in the PAT campaign, the prevalence of HCV among Egyptian women is estimated at 7 to 23% (Abdel-Aziz et al, 2000;Nafeh et al, 2000;Deuffic-Burban et al, 2006;Michael Atef, personal communication, March 17, 2008).…”

“…The campaign, called Parenteral Antischistosomal Therapy (PAT), lasted 15 years, from 1965 to 1980 focusing on the rural Delta regions and southern regions in Egypt where bilharzia was most prevalent and where a large portion of Copts lived (Roberts and Levitt, 2000;Frank et al, 2000;Hyams et al, 1987). Studies indicate that contaminated reusable needles and syringes used in this government campaign resulted in transmission of both Hepatitis B and C (MacKeen, 2003;Roberts and Levitt, 2000;Hyams et al, 1987;Rao et al, 2002). Sixty eight percent of patients with Hepatitis C received schistosomiasis treatment during the PAT campaign (Rao et al, 2002).…”

Zabbaleen Women’s Perspectives on Suffering

“…Additionally, HCV mortality in Egypt is expected to double in the next 20 years (Elgharably, Gomaa, Crossey, Norsworthy, Waked & Taylor-Robinson, 2017). Theseelevated rates of HCV are attributed in part to a national campaign to treat schistosomiasis, or bilharzia, a helminthic infection transmitted from snails that flourish in the canals and tributaries of the Nile in the Delta regions (Rao et al, 2002). The campaign, called Parenteral Antischistosomal Therapy (PAT), lasted 15 years, from 1965 to 1980,and focused on the rural Delta regions and southern regions in Egypt where bilharzia was most prevalent and where a large portion of Copts lived (Roberts & Levitt, 2000;Hymas, Mansour, Maasoud & Dunn, 1987).…”