Health care risk factors among women and personal behaviours among men explain the high prevalence of hepatitis C virus infection in Karachi, Pakistan

Abstract

To estimate the prevalence and identify factors associated with hepatitis C virus (HCV) infection among men and women in Karachi, Pakistan. We conducted a cross-sectional study of adult men and women in a peri-urban community of Karachi (Jam Kandah). Households were selected through systematic sampling from within all villages in the study area. All available adults within each household were interviewed about potential HCV risk factors. A blood specimen was collected to test for anti-HCV antibodies by enzyme immunoassay. We used generalized estimating equations while accounting for correlation of responses within villages to identify the factors associated with HCV infection. Of 1997 participants, 476 (23.8%) were anti-HCV positive. Overall, HCV infection was significantly associated with increasing age, ethnicity, and having received > or =2 blood transfusions, > or =3 hospitalizations, dental treatment and >5 injections among women. Among women, > or =2 blood transfusions [adjusted odds ratio (aOR) = 2.32], >5 injections during the past 6 months (aORs = 1.47), dental treatment (aOR = 1.31) and increasing age(aOR = 1.49), while among men, extramarital sexual intercourse (aOR = 2.77), at least once a week shave from barber (aOR = 5.04), > or =3 hospitalizations (aOR = 2.50) and increasing age (aOR = 1.28) were associated with HCV infection. A very high prevalence of HCV was found in the study population. Among women, unsafe health care practices, while among men extramarital sex, shaving from a barber and hospitalizations were associated with HCV infection. Efforts are needed to improve the safety of medical procedures to reduce the transmission of HCV in Pakistan [Corrections made in Summary after initial online publication.].

Seroprevalence of hepatitis B and C among barbers and their clients in the Rabat region of Morocco

“…This seroprevalence is significantly lower than that found by ZahraouiMahadji et al in Casablanca (5%) [2] and among barbers elsewhere [11,17]. Individuals giving or receiving traditional barber services have been shown to be at higher risk of HCV in most, but not all, settings [6,7,10,12,19]. In spite of the poor hygiene conditions in many barbershops in this study, we observed a near-universal practice of changing of blades between clients.…”

“…However, adults are still at risk for both HBV and HCV. In particular, acquisition and transmission of bloodborne pathogens has been shown to be an occupational risk among traditional barbers in many countries [6][7][8][9][10][11][12]. In Morocco, barbers are commonly exposed inadvertently to the blood and body fluids of their customers [13,14].…”

Health belief model to predict sharps injuries among health care workers at first level care facilities in rural Pakistan

“…High rate of medical injection use (13 injections/person/year) and frequent reuse of injection equipment (20-60%) that involves equipment manipulation increases the risk of SIs [Janjua et al, 2005]. Sharps are more likely to be contaminated with BBPs given the high prevalence of HBV and HCV among general population (range 0.3-31.9%) [Ali et al, 2009;Janjua et al, 2010a]. Thus, the risk of a SI is high and likelihood of acquiring a BBP after a SI is also high among FLCF workers in Pakistan.…”

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

“…Moreover, 82 % of administered injections in Asia were considered unnecessary [107]. Reuse of needles and reuse of syringes remain a common practice in Bangladesh and Pakistan [108,109]. Unsafe injections have been estimated to transmit 2.3-4.7 million HCV infections every year [110].…”