Abstract
BackgroundThe epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; however, this information is crucial to shaping the country’s public health approach to hepatitis C control.MethodsA HCV screening campaign was conducted in the general population in 24 districts previously identified to have a high HCV disease burden. At the time of sample collection, sociodemographic information and self-reported risk factors were collected. Bivariate and multivariate logistic regressions were conducted to assess risk factors independently associated with hepatitis C antibodies (HCVAb) seroprevalence.ResultsOut of a total of 326,263 individuals screened for HCVAb, 22,183 (6.8%) were positive. In multivariate analysis, risk factors identified as statistically associated with HCVAb Seroprevalence include history of traditional operation or scarification (OR = 1.09, 95% CI: 1.05–1.14), presence of viral hepatitis in the family (OR = 1.27, 95% CI: 1.15–1.40), widowed or separated/divorced (OR = 1.36, 95% CI: 1.26–1.47), Southern province (OR = 1.98, 95% CI: 1.88–2.08) and aged 65 years and older (OR = 4.86, 95% CI: 4.62–5.11). Ubudehe category 3 (OR = 0.97, 95% CI: 0.93–1.01) and participants using RAMA (Health insurances for employees of public and private sectors) insurance (OR = 0.76, 95% CI: 0.70–0.85) had lower odds of HCV seroprevalence.ConclusionsOur findings provide important information for Rwanda’s strategy on prevention and case-finding. Future prevention interventions should aim to reduce transmission through targeted messaging around traditional healing practices and case-finding targeting individuals with a history of exposure or advanced age.
Highlights
The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; this information is crucial to shaping the country’s public health approach to hepatitis C control
Viral hepatitis contributed to 1.34 million deaths in 2015, a number comparable to annual deaths caused by tuberculosis and exceeding annual deaths caused by HIV
While increasing resources have been dedicated to address the burden of HCV in some high-income countries, to date, there remains a lack of strategic planning for prevention and management of HCV in Sub-Saharan African (SSA) despite accumulating evidence of a Makuza et al BMC Infectious Diseases (2019) 19:688 significant disease burden [5]
Summary
The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; this information is crucial to shaping the country’s public health approach to hepatitis C control. An estimated 71 million people are infected with chronic hepatitis C virus (HCV) infection [1]. While HCV is increasingly highlighted as an important contributor to disease burden in high-income countries such as Europe, Canada and the United States [4], the burden in the African region is less known and thought to be highly variable across geographic area [5]. Few studies in SSA have quantified the prevalence of past-exposures to known risk factors. The association between such risk factors and HCV infection and those studies were conducted only on specific groups, such as people living with HIV and MSM [7, 8] rather than the general population
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