Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh

Abstract

BackgroundViral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Bangladesh due to the lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. Also there is lack of information on their prevalence among the general population. So, a population-based serological survey was conducted in Dhaka to determine the prevalence and risk factors of HBV and HCV infections.MethodsHealthy individuals were selected for demographic and behavioural characteristics by stratified cluster sampling and blood tested for hepatitis B surface antigen (HBsAg), antibody to HBV core antigen (anti-HBc), and anti-HCV antibodies (anti-HCV).ResultsFrom June 2005-November 2006, 1997 participants were screened for HBsAg, anti-HBc and anti-HCV, 738 (37%) were males with mean (SD) age of 24 (14) years. HBV-seropositivity was documented in 582 (29%) participants: 14 (0.7%) were positive for HBsAg, 452 (22.6%) for anti-HBc and 116 (5.8%) for both HBsAg and anti-HBc. Four (0.2%) participants were positive for anti-HCV, and another five (0.3%) for both anti-HBc and anti-HCV. Ninety-six/246 (39%) family members residing at same households with HBsAg positive participants were also HBV-seropositive [74 (30.1%) for anti-HBc and 22 (8.9%) for both HBsAg and anti-HBc], which was significantly higher among family members (39%) than that of study participants (29%) (OR 1.56; p < 0.001). In bivariate analysis, HBV-seropositivity was significantly associated with married status (OR 2.27; p < 0.001), history of jaundice (OR 1.35; p = 0.009), surgical operations (OR 1.26; p = 0.04), needle-stick injuries (OR 2.09; p = 0.002), visiting unregistered health-care providers (OR 1.40; p = 0.008), receiving treatment for sexually transmitted diseases (STD) (OR 1.79; p = 0.001), animal bites (OR 1.73; p < 0.001); ear-nose-body piercing in females (OR 4.97; p < 0.001); circumcision (OR 3.21; p < 0.001), and visiting community barber for shaving in males (OR 3.77; p < 0.001). In logistic regression analysis, married status (OR 1.32; p = 0.04), surgical operations (OR 1.39; p = 0.02), animal bites (OR 1.43; p = 0.02), visiting unregistered health-care providers (OR 1.40; p = 0.01); and ear-nose-body piercing in females (OR 4.97; p < 0.001) were significantly associated with HBV-seropositivity.ConclusionsThe results indicate intermediate level of endemicity of HBV infection in Dhaka community, with much higher prevalence among family members of HBsAg positive individuals but low prevalence of HCV infections, clearly indicating need for universal hepatitis B vaccination. The use of disposable needles for ear-nose-body piercing need to be promoted through public awareness programmes as a preventive strategy.

Seroprevalence of Anti-HCV Antibody in Patients with Chronic Kidney Disease before Starting Dialysis Therapy

“…[27][28][29] A very few studies a r e available regarding HCV prevalence in general population in our country. According to a study 30 conducted by ICDDRB at Kamlapur, Dhaka, 1997 participants ( general population) were screened for anti-HCV. Four (0.2%) participants were positive for anti-HCV.…”

Management of Chronic Hepatitis B in Childhood: A Comprehensive Guideline

“…3 Although there is a paucity of information about a nation-wide survey regarding HBV prevalence in Bangladesh, published data show that about 5%-6% of apparently healthy individuals are HBV carriers in Bangladesh. [4][5][6] In another study the prevalence of HBV infection among the students of a Girls' School of Dhaka city was found to be 2.3%, 7 it was 7% in multi-transfused thalassemic patients 8 and 3.6% in pregnant women of Dhaka city. 9 About 350 million people are chronically infected globally.…”

Anti-HBc Screening of Blood Donors in Bangladesh: Relevance to Containment of HBV Propagation

“…However, these scientific developments have not influenced the ongoing blood transfusion program of Bangladesh, even though high prevalence of anti-HBc (22.6%) has been reported among healthy subjects of Bangladesh. 10 Additionally, anti-HBc-positivity is extremely high even among children below the age of 5 years (16.3%) and increased to 30% among family members. 10 In this dangerous situation, almost nothing is known about the real extent of problem with anti-HBc positivity in this country.…”

“…10 Additionally, anti-HBc-positivity is extremely high even among children below the age of 5 years (16.3%) and increased to 30% among family members. 10 In this dangerous situation, almost nothing is known about the real extent of problem with anti-HBc positivity in this country. These facts have also indirectly induced the policy making authority of Bangladesh to adopt 'nothing to do' approaches about occult HBV infection in the context of blood transfusion.…”