Validation of EGCRISC for Chronic Hepatitis C Infection Screening and Risk Assessment in the Egyptian Population

Abstract

Chronic HCV infection, a highly endemic disease in Egypt, is usually asymptomatic for decades after infection. Prediction questionnaire tool was proofed to be a valuable, feasible and efficient instrument for the screening of several diseases. We previously developed an Egyptian HCV risk screening tool (EGCRISC). This study aims to validate/modify EGCRISC. A cross-sectional study testing 4579 individuals by EGCRISC as well as ELISA/PCR was performed. The sample was a stratified cluster sampling from urban and rural areas in Upper and Lower Egypt using a proportional allocation technique. The degree of agreement and positive and negative posttest probabilities were calculated. ROC curve was done and the cutoff points were customized for best performance. The total score was further classified into three levels according to the risk load. The mean age of the participants was 41.1±12.2 in whom HCV prevalence was 8.6%. EGCRISC, particularly after modifying the cutoff points, has a good discriminating ability. The degree of agreement was at least 68.1% and the positive posttest probability ranged from 5% to 37.2% whereas the negative posttest probability was in the range 1% to 17%. We conclude that EGCRISC is a valid tool that can potentially screen for HCV infection risk in Egypt and could diminish the demand for mass serologic screening in those apparently at minimal risk. Extensive use of electronic and self- or interviewer-administered risk-based screening strategy may simplify and promote overall screening and detection of HCV dissimilar communities.

Geospatial epidemiology of hepatitis C infection in Egypt 2017 by governorate

“…An informed written consent was signed by all participants invited after elaborating on the study aim and concerns. They were interviewed using a modified version of EGCRISC that inquires about factors associated with HCV antibody in Egypt [10, 11, 12]. Although the EGCRISC has four versions that are based on age and gender, we combined all questions in one sheet and added questions regarding visiting dentist and HCV status and treatment.…”

Performance and modification of EGCRISC among hepatitis C virus high-risk groups

“…A face-to-face interview was conducted to fill the EGCRISC form with the predetermined cut-off points and zone limits: green, yellow and red zones for low-, intermediate- and high-risk individuals, respectively. Other potential risk factors were also inquired about [8, 11].…”

“…Due to the long asymptomatic phase of HCV infection, early detection is the challenge in HCV control. This can only be achieved through screening [8].…”

“…Accordingly, we have developed a valid, specific and cost-effective EGCRISC screening tool that can be used as a first-level approach to identify persons who have a high probability of being HCV infected and consequently should undergo further serologic testing. EGCRISC scores categorise the general population into low risk (green zone), moderate risk (yellow zone) or high risk (red zone) [8–11].…”

Hepatitis C Virus Infection in Egypt: Current Situation and Future Perspective

“…(57) An effective risk-based HCV screening tool tailored to Egyptians (EGCRISC) has been developed, validated and showed a good performance. (58)(59)(60) The cost analysis of EGCRISC use as a screening tool versus mass screening showed that, applying EGCRISC would save LE 0.44 billion accounting for about 21 646 227 unnecessary tests and would only miss about 69 660 cases. This estimation is based on a minimal cost of 20 L.E./test and the population census in January 2015 and did take into account the population growth.…”