Predicting acute viral hepatitis serum markers (A and E) in jaundiced patients attending primary health care centers in Baghdad: A one year cross-sectional study.

Abstract

Background:Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study was to evaluate the role of some risk factors in predicting a positive acute viral hepatitis marker among patients with suspected acute viral hepatitis in a primary health care setting in Baghdad. Besides, finding out the occurrence of jaundice, contribution of viruses A and E to the cases that have occurred in Baghdad province was also searched for.Methods:Over a period of 1 year a descriptive cross sectional study was carried out at the primary health care centers in Baghdad. A questionnaire form was used to collect data about demographic factors and the results of the investigations. Total serum bilirubin and bilirubin in urine were done at the primary health care center laboratory. The rest of the sera samples were sent to Hepatitis referral Lab at Central Public Health Laboratory (CPHL) to be tested for anti HAV IgM and anti HEV IgM using ELISA technique.Results:A total of 7,576,372 consultations to primary health care centers were recorded in Baghdad. Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations). More than two fifths (44.8%) of cases were positive for anti-HAV antibodies and another 1.6% had positive anti-HEV antibodies.Conclusion:During 1 year period, the rate of occurrence of suspected acute viral hepatitis cases was 35.5 per 100000 of consultations to the primary health care centers in Baghdad. Of the total suspected cases, only 17.6 per 100000 of the consultations were positive for one of the viral hepatitis markers. Those who tested positive for one of the viral hepatitis markers represent 49.5% of the suspected cases. Proportion of anti HAV IgM positive tests among suspected cases was 44.8%. Factors that were able to predict positive Anti HAV IgM were (younger age group, negative history of cupping or tattooing, negative past history of jaundice). Male gender was the least important predictor of a positive case for anti HAV IgM. Proportion of Anti HEV IgM positive tests among suspected cases was 1.6%. Of the factors studied, only age was able to predict a positive Anti HEV IgM in those more than 15 years. Further studies are recommended.

Seasonality of hepatitis: A review update

“…Key data from these studies are summarized in [ Table 1 ]. [ 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ] Three studies were included in this review does not contain information about the number of participants and the duration of studies were not available in three selected studies. Form a total of studies included in this review, 18 articles included results from patients with acute hepatitis A, eight studies reported on acute hepatitis B, 12 studies on acute hepatitis E (AHE) and five studies on acute hepatitis C (AHC).…”

“…These findings have been explained by some authors as due to summer travel to an endemic area, swimming habits of the population in hot months, increase sexual contact, tattoo, poor hygiene and environmental sanitation, and food habits (feco-oral transmission of viral hepatitis). [ 5 20 ] HAV and HEV are communicable by way of the fecal-oral. On the other hand, HBV, HCV are contagious by blood and blood products, also may be transmitted by sexual intercourse and household exposure to an infected contact, exposure to multiple partners and perinatal exposure, particularly for hepatitis C, but the efficiency of transmission in these settings appears to be low.…”

Prevalence of HBsAg and anti HCV Ab among patients with suspected acute viral hepatitis in baghdad, Iraq in 2010

“…Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as suspected acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations) (table not presented), [10]. Only (3.3%) of suspected cases with positive viral markers had HBs Ag and another 0.7% had positive anti-HCV antibodies in their tested sera, ( Table 1).…”

Co-infection of Hepatitis A and Hepatitis E Viruses among the Acute Viral Hepatitis Cases in Tertiary Care Hospital –A Four Years Retrospective Study

“…Our study results of single virus infectivity with either HAV or HEV are in concordance with different investigations from various locality in the nation, prevalence ranging from 12.6% to 78.6%. [11][12][13] Arvindkumar et al 10 (2006) reported high rate of co-infection 24.4 % ,Monika et al 4 reported low rate of co-infection 5.2% in 2016. Few studies are done in rural health setup, one of them was Gitanjali Sarangi et al 15 (2019) reported confection rate 2.2% in Odisha Eeastrn India.…”