Cent Eur J Public Health 2009, 17(1):31-35 | DOI: 10.21101/cejph.a3489

Reassessment of Selected Healthcare Associated Risk Factors for HBV and HCV Infections among Volunteer Blood Donors, Karachi, Pakistan

Muhammad Younus1, Azfar-e-Alam Siddiqi1, Saeed Akhtar2
1 Dept. of Epidemiology, College of Human Medicine, Michigan State University, USA
2 Dept. of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait and Dept. of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

Epidemiologic studies conducted in the 1990s identified several independent healthcare associated risk factors for HBV and HCV infections in Pakistan. In 2002, we re-examined healthcare associated HBV and/or HCV infection risk factors in volunteer blood donors.
In this case-control study, we collected data using a structured questionnaire on socioeconomic attributes, putative healthcare related risk factors, and other known factors for HBV and HCV infections in Karachi, Pakistan.
The multivariable logistic-regression model (166 cases, 394 controls) after adjusting for socio-demographic attributes and other known HBV and HCV risk factors revealed that more cases than controls had multiple lifetime hospitalization, adjusted odds ratio (AOR)=2.48; 95% confidence interval (CI) 1.04,5.94, and had received dental treatment from an unqualified provider (AOR=5.90, CI, 1.66,21.02). More cases than controls had received a large number of therapeutic injections during the last 5 years (1-5 injections vs. 0, AOR=2.64, 95% CI 1.06,6.60; 6-19 injections vs. 0, AOR=4.09, 95% CI 1.59,10.51; ≥20 injections vs. 0,AOR=4.34, 95% CI 1.70,11.07), and had their last injection given using a re-usable glass syringe (AOR=3.41 CI 1.13,10.29).
Our data suggest that risk factors for HBV and HCV infections identified in the last decade have remained unchanged in healthcare facilities in Karachi. Additional multi-disciplinary efforts are needed to control healthcare associated HBV and HCV transmission in Pakistan.

Klíčová slova: healthcare, hepatitis B virus, hepatitis C virus, risk factors, blood donors, developing countries, Pakistan

Vloženo: 25. březen 2008; Revidováno: 24. červen 2008; Přijato: 24. červen 2008; Zveřejněno: 1. březen 2009  Zobrazit citaci

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Younus M, Siddiqi A, Akhtar S. Reassessment of Selected Healthcare Associated Risk Factors for HBV and HCV Infections among Volunteer Blood Donors, Karachi, Pakistan. Cent Eur J Public Health. 2009;17(1):31-35. doi: 10.21101/cejph.a3489. PubMed PMID: 19418717.
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Reference

  1. Simonsen L, Kane A, Lloyd J, Zaffran M, Kane M. Unsafe injections in the developing world and transmission of bloodborne pathogens: a review. Bull World Health Organ. 1999;77(10):789-800. Přejít na PubMed...
  2. World Health Organization. Fact Sheet 2000. Hepatitis C. WHO/164. Geneva: WHO; 2000.
  3. World Health Organization. Fact Sheet 2000. Hepatitis B. WHO/204. Geneva: WHO; 2000.
  4. CentersforDiseaseControl(CDC).Guidelinesforpreventionoftransmissionof human immunodeficiency virus and hepatitis B virus to health-care and publicsafetyworkers.MMWRMorbMortalWklyRep.1989Jun23;38Suppl6:1-37. Erratum in: MMWR Morb Mortal Wkly Rep 1989 Nov 3;38(43):746.
  5. Kermode M. Unsafe injections in low-income country health settings: need for injection safety promotion to prevent the spread of blood-borne viruses. Health Promot Int. 2004 Mar;19(1):95-103. Přejít k původnímu zdroji... Přejít na PubMed...
  6. Allegranzi B, Pittet D. Healthcare-associated infection in developing countries: simple solutions to meet complex challenges. Infect Control Hosp Epidemiol. 2007 Dec;28(12):1323-7. Přejít k původnímu zdroji... Přejít na PubMed...
  7. Luby SP, Qamruddin K, Shah AA, Omair A, Pahsa O, Khan AJ, et al. The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan. Epidemiol Infect. 1997 Dec;119(3):349-56. Přejít k původnímu zdroji... Přejít na PubMed...
  8. Khan AJ, Luby SP, Fikree F, Karim A, Obaid S, Dellawala S, et al. Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakistan. Bull World Health Organ. 2000;78(8):956-63. Přejít na PubMed...
  9. Pasha O, Luby SP, Khan AJ, Shah SA, McCormick JB, Fisher-Hoch SP. Household members of hepatitis C virus-infected people in Hafizabad, Pakistan: infection by injections from health care providers. Epidemiol Infect. 1999 Dec;123(3):515-8. Přejít k původnímu zdroji... Přejít na PubMed...
  10. Raza MW, Kazi BM, Mustafa M, Gould FK. Developing countries have their own characteristic problems with infection control. J Hosp Infect. 2004 Aug;57(4):294-9. Přejít k původnímu zdroji... Přejít na PubMed...
  11. Akhtar S, Younus M, Adil S, Jafri SH, Hassan F. Hepatitis C virus infection in asymptomatic male volunteer blood donors in Karachi, Pakistan. J Viral Hepat. 2004 Nov;11(6):527-35. Přejít k původnímu zdroji... Přejít na PubMed...
  12. Chlabicz S, Grzeszczuk A, Pytel B, Prokopowicz D. Is acute hepatitis B still a nosocomially-acquired infection in Poland? A case-controlled study of transmission routes in a hospital sample. Scand J Infect Dis. 2002;34(11):808-10. Přejít k původnímu zdroji...
  13. Chlabicz S, Grzeszczuk A, Prokopowicz D. Medical procedures and the risk of iatrogenic hepatitis C infection: case-controlled study in northeastern Poland. J Hosp Infect. 2004 Nov;58(3):204-9. Přejít k původnímu zdroji... Přejít na PubMed...
  14. Janjua NZ, Hutin YJ, Akhtar S, Ahmad K. Population beliefs about the efficacy of injections in Pakistan's Sindh province. Public Health. 2006 Sep;120(9):824-33. Přejít k původnímu zdroji... Přejít na PubMed...
  15. HutinYJ, Chen RT. Injection safety: a global challenge. BullWorld Health Organ. 1999;77(10):787-8.
  16. Altaf A, Fatmi Z, Ajmal A, Hussain T, Qahir H, Agboatwalla M. Determinants of therapeutic injection overuse among communities in Sindh, Pakistan. J Ayub Med Coll Abbottabad. 2004 Jul-Sep;16(3):35-8.
  17. Reeler AV. Anthropological perspectives on injections: a review. Bull World Health Organ. 2000;78(1):135-43. Přejít na PubMed...
  18. Singh J, Gupta S, Khare S, Bhatia R, Jain DC, Sokhey J. A severe and explosive outbreak of hepatitis B in a rural population in Sirsa district, Haryana, India: unnecessary therapeutic injections were a major risk factor. Epidemiol Infect. 2000 Dec;125(3):693-9. Přejít k původnímu zdroji... Přejít na PubMed...
  19. Butt AK, Khan AA, Khan SY, Sharea I. Dentistry as a possible route of hepatitis C transmission in Pakistan. Int Dent J. 2003 Jun;53(3):141-4. Přejít k původnímu zdroji...
  20. Fazli Z,Asghar H, Baig NU, FahmiA, DilAS, Zaidi SS, et al. Prevalence of hepatitis B Virus in dental clinics in Rawalpindi/Islamabad. J Pak Med Assoc. 1998 Aug;48(8):259. Přejít na PubMed...
  21. Schlesselman JJ, Stolley P. Case-control studies: design, conduct, analysis. New York: Oxford University Press; 1982.