Prevalence of and factors associated with Hepatitis C virus infection among male volunteer blood donors Peshawar, Pakistan

Date of Award

2003

Document Type

Thesis

Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)

Department

Community Health Sciences

Abstract

Hepatitis C virus (HCV) infection is a major public health problem in developing countries- In more than 70o/o of cases acute HCV infections persist as chronic infection and about more than 20Yo of these develop cirrhosis. Some may develop even hepatocellular carcinoma. In the absence of availability of vaccine against HCV infection, prevention seems to be the only available strategy. The knowledge of prevalence of HCV infection in the volunteer blood donors and the associated factors will help in devising strategies to curtail its spread. The objectives of this cross sectional study were to estimate the prevalence of and evaluate the factors associated with HCV seropositivity among volunteer blood donors in three tertiary care hospitals of Peshawar, Pakistan. We enrolled ll31 volunteer blood donors of age 18 to 64 years, having no history of intravenous drug use, from the blood banks of the three tertiary care hospitals of Peshawar during July through September 2002. After taking informed written consent from the study participants, pretested structured questionnaire was administered to them. Of the ll3l total blood donors sampled, 46 (4.1% ± l.l5) were positive for anti-HCV antibodies (anti-HCV) status as tested on Enzyme Immunoassay (EIA). Mean (SD) age (years) of the blood donors was 29 years (SD 8.4). Final multivariate logistic regression analysis revealed that after adjusting for the effect of the enrollment hospital, the anti- HCV positive blood donors compared to anti-HCV negative blood donors were more likely to be 27-32 years old (adjusted OR: 3.6; 95% CI: 1.4 - 9.1) or >32 years old (adjusted OR: 5.r; 95% CI: 2.1 – 12.1), taking rg-26 years age group as reference category. Anti-HCV positive blood donors were more likely to have had l-2 injections (adjusted OR: 4.7; 95% CI: 1.5 - 14.6) or >2 injections (adjusted OR: 5.3; 95% Cr: 1.9 - 14.7) compared to anti-HCV negative blood donors, in the past one year when those receiving no injection is taken as a reference category. Similarly taking blood donors who received no I/V drip as reference category, anti-HCV positive blood donors were more likely to have had l-5 w drips (adjusted OR: 4.4; 95% CI: 1.7 - tl.4)or >5 I/V drips (adjusted OR : 11.7; 95% CI: 4.0 - 34.2) compared to anti-HCV negative blood donors, in the past five years. Furthermore, anti-HCV positive blood donors compared to anti- HCV negative blood donors were more likely to have lived with a jaundiced patient in the household (adjusted OR :2.1;95% CI: 1.1 - 4.3). Anti-HCV positive blood donors compared to anti-HCV negative blood donors were more likely to have had facial shave from barber (adjusted OR: 5.5; 95% CI: 2.6 - 11.7) or armpit shave from barber (adjusted OR: 2.4; 95% CI: 1.2 - 4.7). The study results suggest that preventive measures like routine blood screening for anti- HCV, safe injection policy, mass education on possible routes of HCV transmission at house hold level, dissemination of information to male population on risk involved in having facial and armpit shave from barbers need to be undertaken. Further research is needed to estimate the proportion of unnecessary injections and I/V drips, and the economic burden these impart on the health system, and to identify risk factors of HCV transmission at household level

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