Abstract
The serological status of hepatitis viruses and other infectious diseases in the 66 dialysed patients of one haemodialysis unit in Kosovo were studied, comparing the data with a large group of blood donors and out-patients. All dialysed patients were hepatitis A virus (HAV) positive. Prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (anti-HBs), and hepatitis B core antibodies (anti-HBc) was 14 of 66, 21% (95% confidence interval (CI): 12-33%), 5 of 66, 8% (95%CI: 5-22%), and 50 of 66, 76% (95%CI: 64-85%), respectively. Antibodies to hepatitis C virus (anti-HCV) prevalence was 57 of 66, 86% (95%CI: 76-94%). No human immunodeficiency virus (HIV) positive case was found. Prevalence of past herpes simplex virus type 2 (HSV-2) infection was 29% (95%CI: 18-41%). Two patients (3%, 95%CI: 0-10%) were positive for Treponema pallidum and 18% (95%CI: 10-30%) were human herpesvirus 8 (HHV-8) antibody positive. Four hundred and fifty-two subjects were recruited for comparison. Markers of past HAV infection was associated with haemodialysis (Fisher s exact test p-value=0.037). Dialysed patients were at a higher risk of being HBsAg positive than others: the sex- and age-adjusted odds ratio (OR) was 5.18 (95%CI: 1.87-14.32). Anti-HBc positivity was strongly associated with haemodialysis: the sex- and age-adjusted OR was 6.43 (95%CI: 3.22-12-85). Anti-HCV positivity was 86% and 1% in presence and absence of haemodialysis, respectively. The Fisher s exact test for association proved a strong association between haemodialysis and HCV (p-value<0.0001). The OR for association between haemodialysis and HSV-2 positivity was 3.20 (95%CI: 1.46-7.00). Significant associations were also observed between haemodialysis status and antibodies to Treponema pallidum (Fisher s exact test p-value=0.044). In Kosovo, the prevalence of viral hepatitis infection and other viral infections and Treponema pallidum among dialysed patients is high, indicating major ongoing nosocomial transmission.
Highlights
The population of Kosovo has suffered substantially after the break-up of the former Yugoslavia in the early 1990ies and the consequent armed conflict in 1999
At the time of our study, patients were treated in six different dialysis centres (DC), with standard twice or three times a week five hour dialysis sessions (10% and 90%, respectively).We examined patients at the DC in Peja hospital which had no special areas dedicated to patients with positive history of hepatitis
The association between the prevalence of viral hepatitis and other infections and the haemodialysis status was assessed by comparing the end-stage renal disease (ESRD) patients with a group of blood donors and subjects who had been examined for routine laboratory testing
Summary
The population of Kosovo has suffered substantially after the break-up of the former Yugoslavia in the early 1990ies and the consequent armed conflict in 1999. In 2006, the population was estimated at 1.9 million and was one of the youngest in Europe. About 37% lived in poverty; unemployment was estimated at around 40%, with a gross domestic product per capita of 834 EUR in 2006 (468 EUR in 2000) [2]. Health indicators remained among the most unfavourable in the Balkan region. The annual per capita government expenditure on health care was 35 EUR, the lowest in Europe. Kosovo had one of the highest perinatal mortality rates (23 per 1,000 live births) in Europe and the number of physicians per 1,000 inhabitants was 0.94 [3]. The transition to more modern concepts of health care management presented a challenge to health personnel and the population after the war. The healthcare system consists of primary centers located in each municipality, secondary health care facilities at the regional level (five hospitals), and tertiary health care centers (University of Pristine and a few other specialised institutions)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
