Incidence and risk factors for community-acquired hepatitis C infection from birth to 5 years of age in rural Egyptian children

Saleh, Doa’a A.; Shebl, Fatma M.; El-Kamary, Samer S.; Magder, Laurence S.; Allam, Alif; Abdel‐Hamid, Mohamed; Mikhail, Nabiel; Hashem, Mohamed; Sharaf, Soraya; Stoszek, Sonia K.; Strickland, G. Thomas

doi:10.1016/j.trstmh.2010.01.009

Cited by 37 publications

(24 citation statements)

References 26 publications

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“…Saleh et al reported a greater risk for incident infection among women whose babies were delivered by a physician rather than by a nurse or a traditional birth attendant, in a health facility rather than at their home, and in women having complicated vaginal deliveries [15]. Among children, incident infection was associated with hospitalization and low birth weight [17]. Community and informal health provider related exposures such as circumcision, cautery, and injections were also associated with HCV infection [62,82,120].…”

Section: Resultsmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

et al. 2013

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BackgroundEgypt has the highest prevalence of hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. Our study’s objective was to delineate the evidence on the epidemiology of HCV infection among the different population groups in Egypt, and to draw analytical inferences about the nature of HCV transmission in this country.MethodsWe conducted a systematic review of all data on HCV prevalence and incidence in Egypt following PRISMA guidelines. The main sources of data included PubMed and Embase databases. We also used a multivariate regression model to infer the temporal trend of HCV prevalence among the general population and high risk population in Egypt.ResultsWe identified 150 relevant records, four of which were incidence studies. HCV incidence ranged from 0.8 to 6.8 per 1,000 person-years. Overall, HCV prevalence among pregnant women ranged between 5-15%, among blood donors between 5-25%, and among other general population groups between 0-40%. HCV prevalence among multi-transfused patients ranged between 10-55%, among dialysis patients between 50-90%, and among other high risk populations between 10% and 85%. HCV prevalence varied widely among other clinical populations and populations at intermediate risk. Risk factors appear to be parenteral anti-schistosomal therapy, injections, transfusions, and surgical procedures, among others. Results of our time trend analysis suggest that there is no evidence of a statistically significant decline in HCV prevalence over time in both the general population (p-value: 0.215) and high risk population (p-value: 0.426).ConclusionsEgypt is confronted with an HCV disease burden of historical proportions that distinguishes this nation from others. A massive HCV epidemic at the national level must have occurred with substantial transmission still ongoing today. HCV prevention in Egypt must become a national priority. Policymakers, and public health and medical care stakeholders need to introduce and implement further prevention measures targeting the routes of HCV transmission.

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Section: Resultsmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

et al. 2013

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“…It was shown that prolonged hospitalization and low birth weight increased the risk of infection, whereas maternal HCV was the source of infection in only two older children. By the end of the followup period, six children (40%) had natural clearance [39] . A fouryear populationbased cohort study was conducted on seronegative villagers to calculate the incidence of new HCV cases.…”

Section: Incidencementioning

confidence: 99%

Hepatitis C genotype 4: The past, present, and future

Abdel-Ghaffar

Sira

Naghi

2015

WJH

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Hepatitis C virus (HCV) genotype (GT) 4 represents 12%-15% (15-18 million) of total global HCV infection. It is prevalent in Northern and Equatorial Africa and the Middle East, and is also present in some countries in Europe. GT-4 (and subtype 4a in particular) dominates the HCV epidemic in Egypt. In underdeveloped countries, risk factors associated with HCV infection may be due to unsafe medical practices or other factors such as familial transmission, mother's HCV status, or illiteracy. HCV prevention and control programs should include health education, increased community awareness towards the disease, controlling infection distribution in healthcare centers, proper sterilization of medical and dental instruments, and ensuring safe supply of blood and blood-products. Response rates to a 48-wk combined pegylated-interferon (PEG-IFN) and ribavirin (RBV) treatment range from 40%-69%, and HCV-GT-4 has been considered better than GT-1 but worse than GT-2 and GT-3 in treatment with PEG-IFN/RBV. However, with the introduction of the HCV-GT-1 effective protease inhibitors boceprevir and telaprevir in 2011, HCV-GT-4 became the "most difficult (GT) to treat". Recently, the direct-acting antivirals (DAAs) with pan-genotypic activities simeprevir, sofosbuvir, and daclatasvir have been recommended in triple regimens with PEG-IFN/RBV for the treatment of HCV-GT-4. An IFN-free regimen will be available for treatment of all genotypes of HCV in the near future. To date, several DAAs have been developed and are currently being evaluated in various combinations in clinical trials. As new regimens and new agents are being approved by the Food and Drug Administration, we can expect the guidelines for HCV treatment to be changed. The availability of shorter, simpler, and more tolerable treatment regimens can reduce the morbidity and mortality associated with HCV infection. With such a large number of therapeutic agents available, we can end up with a range of choices that we can select from to treat patients.

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“…However, most studies have found that blood transfusion is no longer a risk factor for HCV in pregnancy [50,104], and the same is generally true in Arab countries [24], although some Arab countries have found it to be a risk factor [50]. In contrast, blood transfusion might well be a risk factor among African countries, such as Ghana and Kenya, and probably a number of others, because of budget shortfalls [105,106,107].…”

Section: Factors Associated With Transmission Of Hcv Among Pregnant Wmentioning

confidence: 99%

“…Another sociodemographic factor of concern is educational level. It has been found that women who have received less than secondary school level education are at higher risk [24], and an Egyptian group has found that a low level of maternal education is a risk factor for HCV infection of children [106]. Being the long-term steady sex partner of an HCVinfected individual is not a risk factor [108], as the role of sexual transmission itself in HCV infection needs validation [109].…”

Section: Sociodemographic Factorsmentioning

confidence: 99%

Hepatitis B and C virus infections among pregnant women in Arab and African countries

Gasim

Murad

Adam

2013

J Infect Dev Ctries

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Introduction: The epidemiology of viral hepatitis during pregnancy is of paramount importance for health planners and program managers. Data on viral hepatitis during pregnancy are not readily available in many African and Arab countries. Both regions have their own unique geography, and comprise over 59 states with crossover and interaction of different cultures. Methodology: A systematic electronic search of the published literature was conducted and data on epidemiology and risk factors of maternal hepatitis B virus (HBV) infection and hepatitis C (HCV) infection in Arab and African countries were extracted from relevant studies. Results: The serology of hepatitis viruses varies greatly among these countries, with different viral genotype patterns. Such a variation in prevalence could be explained by the different risk factors involved. Sexual contact, perinatal infection, blood and its derivatives, hemodialysis, intravenous and percutaneous drug use, and occupational, habitual, and social behavior have been identified as risk factors for hepatitis transmission in various settings in these countries. Conclusions: Infection from hepatitis B and C viruses imposes major socioeconomic and even political burdens on such young and dynamic societies. Thus strategies and clear policies of intervention are required to combat the consequences of hepatitis B and C at both the regional and national levels.

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Incidence and risk factors for community-acquired hepatitis C infection from birth to 5 years of age in rural Egyptian children

Cited by 37 publications

References 26 publications

The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

Hepatitis C genotype 4: The past, present, and future

Hepatitis B and C virus infections among pregnant women in Arab and African countries

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