The prevalence of HBV infection in the cohort of IDPs of war against terrorism in Malakand Division of Northern Pakistan

Abstract

BackgroundHepatitis B is an important public health problem in the Pakistani population and is the major cause of chronic hepatitis, cirrhosis, fibrosis and hepatocellular carcinoma. High prevalence of HBV infections has been observed especially in areas of low economic status. In spite of effective immunization programs, no significant change has been observed in the epidemiology of HBV in the rural areas of Pakistan (~67.5% of the total population) mainly due to lack of interest from government authorities and poor hygienic measures. The current study was aimed at estimating the prevalence and risk factors associated with HBV infection within internally displaced persons (IDPs) due to war against terrorism in the Malakand Division of Northern Pakistan.MethodsBlood samples from 950 IDPs suspected with HBV infection (including both males and females) were collected and processed with commercial ELISA kits for HBsAg, Anti HBs, HBeAg, Anti HBe antibodies. The samples positive by ELISA were confirmed for HBV DNA by real-time PCR analysis.ResultsThe overall prevalence of HBV observed was 21.05% of which 78.5% were males and 21.5% were females. Most confirmed HBV patients belong to the Malakand and Dir (lower) district. High-risk of infection was found in the older subjects 29.13% (46-60 years), while a lower incidence (11.97%) was observed in children aged <15 years. Lack of awareness, socioecomic conditions, sexual activities and sharing of razor blades, syringes and tattooing needles were the most common risk factors of HBV infection observed during the cohort of patients.ConclusionThe present study, revealed for the first time a high degree of prevalence of HBV infection in rural areas of Northern Pakistan. The noticed prevalence is gender- and age-dependent that might be due to their high exposures to the common risk factors. To avoid the transmission of HBV infection proper awareness about the possible risk factors and extension of immunization to the rural areas are recommended.

Prevalence of HBV infection in suspected population of conflict-affected area of war against terrorism in North Waziristan FATA Pakistan

“…Nearly similar results have been reported earlier from other parts of Pakistan as high prevalence of HBV was observed in male gender (78.04%) as compared to female gender (21.95%) (Khan et al, 2011;Shazi and Abbas, 2006). Likewise in the neighboring countries the prevalence rate of HBV infection is significantly high in males as compared to female (Zhang et al, 2011;Zali et al, 1996).…”

“…We do not have any data on sharing of personal items, on house hold contact, on dental medical and medical surgeries. Recently Khan et al (2011) noted that the aforementioned risk factors that were strongly correlated with HBV infection in general populace of Pakistan (Khan et al, 2011). The findings of this study suggest an alarming high rate of HBV infection among the conflict-affected people.…”

Prevalence of hepatitis B virus in the Kurram Agency, Pakistan: A 5-year observational study in a war-affected region

“…This study also indicated the potential risk factors for HBV infection in the people from war-affected areas [8]. Moreover, genotype C of HBV was found to be the dominant genotype that was prevalent at 38.8% in the Pashtun population [9].…”

Molecular characterization of hepatitis B virus (HBV) strains circulating in the northern coast of the Persian Gulf and its comparison with worldwide distribution of HBV subgenotype D1

“…In addition, war has led to the restriction of access to basic health services, such as vaccination, safe injections, and obstetric health care. Also, a high prevalence of HBV among people displaced by war has been reported [Khan et al, ]. Temporary immigration out of war‐affected could also have a significant impact on the epidemiological profile of infectious agents like HBV.…”