Abstract
BackgroundHepatitis B and C is common in Pakistan and various risk factors are attributable to its spread.One thousand and fifty consecutive male cases suffering from chronic liver disease (327 HBV and 723 HCV) were selected from the OPD of public sector hospital and a private clinic dealing exclusively with the liver patients. To compare the results 723 age and gender matched controls were selected from the blood transfusion services of the public sector hospital. A standard questionnaire was filled for all patients and controls which included the information on possible risk factors.FindingsFamily history of liver disease was significantly higher (43% and 34%) in HBV and HCV positive cases as compared to 5% in controls [odds ratio 15.6; 95% Confidence Interval CI: 10.1 -- 24.1, 10.9; 95% Confidence Interval CI: 7.3 -- 16.4] and same trend was seen for death due to liver disease in the family. Majority 74% hepatitis B positive cases had their shaves done at communal barbers but this practice was equally prevalent amongst controls (68%), thus negating it as a possible risk factor, but there is a significant risk with p < 0.05 associated with HCV in male that get their shave in barber. Very strong association of the disease was found with history of dental treatment (38% HCV 36% HBV and 21% controls) [Odd ratio 2.3; 95% CI: 1.8-3.0, Odd ratio 2.1; 95% CI: 1.5-2.8], surgery (23% HCV cases,14% HBV cases and 12% controls), history of blood transfusion was significantly higher in HCV (6%) as compared to controls (2.1%) [Odd ratio 2.9; 95% CI: 1.5-5.5]. History of taking injections for various ailments by the general practitioners (over 90% patients in both hepatitis B and C cases) was significantly higher as compared to 75% in controls [Odds ratio 3.8, 6.9; 95% CI: 2.4-6.1, 4.5-10.4] but hospitalization was not significant in HBV and HCV cases.ConclusionInjections, surgery and dental treatment appear as major risk factors for the transmission of hepatitis B and C in the community. Massive health care awareness drives need to be done for both health care providers and the public to reduce this menace.
Highlights
Hepatitis B and C is common in Pakistan and various risk factors are attributable to its spread.One thousand and fifty consecutive male cases suffering from chronic liver disease (327 HBV and 723 HCV) were selected from the OPD of public sector hospital and a private clinic dealing exclusively with the liver patients
Injections, surgery and dental treatment appear as major risk factors for the transmission of hepatitis B and C in the community
Massive health care awareness drives need to be done for both health care providers and the public to reduce this menace
Summary
Hepatitis B and C are the major causes of chronic liver diseases in Pakistan. Some parts of the country show higher figures for both these viruses. Both viruses spread though blood and its products and body secretions. For the prevention of HBV a potent vaccine is available which has over 95% protection rates. Improper sterilization of medical devices and reuse of syringes has been reported to be the major factor for this high increase in uncontrolled studies [3,4,5,6]. The present study was done to see if various risk factors mentioned above show a direct or indirect association with the HBV or HCV disease and to compare it with controls
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