Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan

Malik

et al. 2020

Preprint

Background; Viral hepatitis causes devastating health issues to everyone globally and specifically the most vulnerable groups like pregnant ladies. The aim of this study was to identify risk factors for hepatitis B and C virus infection with univariate association of virus seropositivity among pregnant women and comparison of public with private hospital data.Study Design; An Unmatched Case Control Pilot Study.Place and Duration; Gynaecology wards of Two Public Tertiary Care Hospitals of Peshawar and equal number of Private clinics, from September- 2018 to February- 2019.Methods; This study enrolled 21 cases and controls as 1:1 ratio via consecutive sampling. A validated questionnaire was used. Cases included were HBsAg and ELISA positive HCV females, while anti HBsAg and Anti HCV ELISA negative were the controls. The collected data was entered and analysed in SPSS version- 19. Descriptive statistics were computed by frequency and percentages while inferential statistics through Odd ratio and 95% confidence interval. P value cut of limit was set at <0.05. Results; The mean age was 37±9 for the cases and 28±6 years for controls respectively. The risk factors with increase occurrence of disease were past history of abortion OR=1.23 (95% Cl=0.34-4.35), past hospitalization OR=2.90 (Cl=0.77-10.8), past surgical procedure OR=3.69 (Cl=0.81-16.6), dental extraction OR=1.25 (Cl=0.33-4.63), delivery in hospital OR=4.26 (Cl=1.13-16.05), injection in hospitals OR=1.47 (Cl=0.43-5.04), household contact with jaundice OR=5.66 (Cl=1.41-22.7). Normal vaginal delivery OR=1.96 (Cl=0.51-7.48) and history of sexually transmitted infections OR=2.23 (Cl=0.36-13.7) were independently associated with HBV, HCV.Conclusion; Iatrogenic exposures of injections, blood transfusions, tooth extractions, home deliveries with past history of sexually transmitted infections, abortion, hepatitis infection and hospital admissions were the risk factors among the pregnant women.

Section: Introductionmentioning

confidence: 85%

Association of Risk Factors With Hepatitis B & C Infection Among Pregnant Women Visiting a Private Tertiary Care Hospitals- Peshawar (An Un Matched Pilot Case Control Study)

Malik

et al. 2020

Preprint

“…Also, the present study was only conducted in one city of District Peshawar. 3 A Karachi based hospital study identified injections, surgery and blood transfusions as the common risk factors and high prevalence of the HCV infection among the pregnant women. 4 These results correlate with the present study findings with same methodology for the test however, the present study determined the seroprevalence of Hepatitis-B as well as Hepatitis-C. An Observational study screened all population among five districts of Sind with 3.9% seroprevalence for HBV and 11.8% for HCV infection however, higher prevalence among female groups.…”

Section: Discussionmentioning

confidence: 99%

“…Pakistan had the highest burden of these infections in South East Asian Region. 3 Hepatitis-C prevalence among general population was 8-15 % and among pregnant women as 3.27 % -8.9 %. The risk factors included blood products transfusion, occupational injury, surgery, injections and vertical transmission.…”

mentioning

confidence: 96%

Prevalence and Risk Factors Association With Hepatitis B and C Infected Pregnant Ladies Visiting Tertiary Care Hospitals of Peshawar: An Unmatched Pilot Case-Control Study

2023

JPMI

Objective: To determine the prevalence, risk factors, and their association with Hepatitis B and C infection among pregnant females visiting Tertiary Care Hospitals of Peshawar.Methods: A pilot case-control study was conducted in the Gynecology & Obstetrics units of Tertiary Care Hospitals of Peshawar after being approved by the institutional IRB Committee. A consecutive sampling technique was used to enroll 21 pregnant females in a ratio of 1: 1 among both groups. The included cases were HBsAg positive with ELIZA positive HCV while the negative ones were in the control group. A validated research tool from previous studies was used. The collected data were analyzed through SPSS Version-19. Descriptive and inferential statistics like frequency, percentages, 95% confidence interval, chi-square and odds ratio were applied with cut-off p-value limit set at 0.05. Results:The mean age for cases and controls was 37±9 and 28±6 years. The seroprevalence of HBV was 28.9% and HCV as 61.9%. Abortion history OR=1.23 (95% Cl=0.34-4.35), hospitalization OR=2.90 (Cl=0.77-10.8), past surgical procedure , delivery in hospital OR=4.26 (Cl=1.13-16.05), injection in hospitals OR=1.47 (Cl=0.43-5.04), household contact with jaundice OR=5.66 (Cl=1.41-22.7) were the significant risk factors. Normal vaginal delivery ) and history of sexually transmitted infections OR=2.23 (Cl=0.36-13.7) were independently associated with HBV, and HCV. Conclusion:Hepatitis C prevalence rate was more with blood transfusions, unsafe injections, tooth extractions, home deliveries with past history of sexually transmitted infections, abortion, hepatitis infection, and hospital admissions as the significant risk factors among pregnant women.

“…38 In the Khyber Pakhtunkhwa region, randomly screened hospital-visiting pregnant women had an HCV infection rate of 5.9%, making this province a hotspot of HCV infection in Pakistan. 39 In other countries, a study of 272 pregnant women and their offspring in Southwestern Nigeria tertiary medical centre, revealed that 9.2% of subjects and 1.1% of offspring were positive for anti-HCV antibodies, reflecting a vertical transmission rate of 12.0%. 40 At an antenatal clinic in India, 8,130 pregnant women had an HCV infection rate of 1.03%.…”

Section: Monthmentioning

confidence: 99%

Screening for hepatitis b and c viral infections among pregnant women attending the Bolan Medical Complex Hospital and Sandeman Provincial Civil Hospital Quetta, Pakistan.

Tanveer¹,

Ahmad²,

Javed³

et al. 2020

TPMJ

Infectious diseases caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) are a worldwide burden to health, especially in developing countries. Pakistan has one of the highest levels of HBV and HCV infection, causing a severe health problem with significant challenges and priorities. To prevent vertical transmission of infection, regular screening of pregnant women for HBV and HCV is vital. Objectives: The objective of this study was to evaluate the prevalence of HBV and HCV virus in pregnant women having prenatal care. Study Design: Cross-Sectional study. Setting: Bolan Medical Complex Hospital and Sandeman Provincial Civil Hospital Quetta. Period: August 2017 to July 2018. Material & Methods: Blood serum samples were screened for HBV surface antigen (HBsAg) and for anti-HCV using immunochromatography methods. Results: A total of 12,209 pregnant women were tested over a period of one year (August 2017 to July 2018). The overall HBV infections frequency was 1.3% (95% CI 1.1-1.4%) and for HCV infections it was 0.6% (95% CI 0.6-0.7%). Whilst there was only small month-wise variation in the occurrence of HBV and HCV infections, HBV prevalence was highest in May (1.7%) and HCV prevalence was highest in August and December (0.8%). Conclusions: Screening of all pregnant women for HBV and HCV is essential for reducing and eliminating vertical transmission of infection. Risk factors for infection need to be avoided and managed properly.