Geospatial epidemiology of hepatitis C infection in Egypt 2017 by governorate

Engy Mohamed El-Ghitany, Azza Galal Farghaly, Engy Mohamed El-Ghitany, Azza Galal Farghaly

Abstract

Background: Geographic Information Systems (GIS) and spatial epidemiological methods may provide a basis for disease investigation through which hotspots and disease determinants can be identified. Applying these methods for hepatitis C virus (HCV) in Egypt would support a more effective strategy to control its transmission. Therefore, this study used GIS software to draw one of the first HCV maps in Egypt elucidating and analyzing geographical and epidemiological differences in HCV distribution within the country.

Methods: A cross-sectional survey of 21 governorates (n = 12169, 8080 rural, 3733 urban and 356 slums areas) was completed. All participants were interviewed regarding potential exposures to HCV. Third generation ELISA was used to test serum for HCV antibody. Quantitative real-time RT-PCR was used to test anti-HCV positive subjects for HCV-RNA.

Results: The participants ranged in age from 14-90 years. Overall, anti-HCV sero-prevalence was 14.8%. The prevalence of HCV-RNA, was 9.5%. Proportionally, 65.8% of anti-HCV positives were positive for HCV-RNA. The map of Egyptian governorates highlighted the darkest spot of HCV infection in Menoufeya (37.8%) followed by Beni Suef (29.2%) and Minya (28.6%). Anti-HCV prevalence was higher among males and logistic regression models revealed a strong independent association with increasing age, rural residence and parenteral anti-schistosomal therapy.

Conclusions: Rural residences and HCV hotspots should be prioritized for HCV prevention programs. The unique age distribution first shown in this study shows that the older age groups (≥60 years old) constitutes a considerable reservoir of infection and must not be neglected.

Keywords: Microbiology; Virology.

Figures

Fig. 1
Fig. 1
Prevalence of anti-HCV across 21 Egyptian governorates in 2016/2017.
Fig. 2
Fig. 2
Anti-HCV prevalence by age in the current study and EHIS, 2015.

References

    1. Elgharably A., Gomaa A.I., Crossey M.M., Norsworthy P.J., Waked I., Taylor-Robinson S.D. Hepatitis C in Egypt–past, present, and future. Int. J. Gen. Med. 2017;10:1.
    1. Kim C.W., Chang K.M. Hepatitis C virus: virology and life cycle. Clin. Mol. Hepatol. 2013;19(1):17–25.
    1. El-Zanaty F., Way A. Ministry of Health and Population; Cairo, Egypt: 2015. Egypt Health Issue Survey.
    1. El-Ghitany E.M., Abdel Wahab M.M., Abd El-Wahab E.W., Hassouna S., Farghaly A.G. A comprehensive hepatitis C virus risk factors meta-analysis (1989-2013): do they differ in Egypt? Liver Int. : Off. J. Int. Assoc. Stud. Liver. 2015;35(2):489–501.
    1. Frank C., Mohamed M.K., Strickland G.T., Lavanchy D., Arthur R.R., Magder L.S. The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet. 2000;355(9207):887–891.
    1. Miller F.D., Abu-Raddad L.J. Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt. Proc. Natl. Acad. Sci. 2010;107(33):14757–14762.
    1. Wedemeyer H., Duberg A.S., Buti M., Rosenberg W.M., Frankova S., Esmat G. Strategies to manage hepatitis C virus (HCV) disease burden. J. Viral Hepat. 2014;21(Suppl 1):60–89.
    1. Cuadros D.F., Branscum A.J., Miller F.D., Abu-Raddad L.J. Spatial epidemiology of hepatitis C virus infection in Egypt: analyses and implications. Hepatology. 2014;60(4):1150–1159.
    1. Stopka T.J., Goulart M.A., Meyers D.J., Hutcheson M., Barton K., Onofrey S. Identifying and characterizing hepatitis C virus hotspots in Massachusetts: a spatial epidemiological approach. BMC Infect. Dis. 2017;17(1):294.
    1. El-Ghitany E., Farghaly A., Farag S. THU-208-Performance of the validated EGCRISC screening tool in chronic hepatitis C infection detection after application in the Egyptian setting. J. Hepatol. 2017;66(1):S279–S280.
    1. El-Ghitany E.M., Farghaly A.G., Farag S., Abd El-Wahab E.W. Validation of EGCRISC for chronic hepatitis C infection screening and risk assessment in the Egyptian population. PLoS One. 2016;11(12)
    1. El-Ghitany E.M., Farghaly A.G., Abdel Wahab M.M., Farag S., Abd El-Wahab E.W. Toward a simple risk assessment screening tool for HCV infection in Egypt. J. Med. Virol. 2016;88(10):1767–1775.
    1. Tulsiani S., Choudhury N., Desai P., Shah R., Mathur A., Harimoorthy V. True positivity of anti-Hepatitis C Virus Enzyme-linked immunosorbent assay reactive blood donors: a prospective study done in western India. Asian J. Transfus. Sci. 2012;6(2):165–168.
    1. WHO . 2016. Technical Considerations and Case Definitions to Improve Surveillance for Viral Hepatitis: Technical Report.
    1. Communicable Disease Control Hepatitis C . 2016. Hepatitis Education Canada. Available from:
    1. Mathei C., Buntinx F., Van Damme P. Is the prevalence of hepatitis C virus (HCV) RNA in anti-HCV-positive injection drug users positively correlated with age? J. Infect. Dis. 2001;184(5):659–660.
    1. Kandeel A., Genedy M., El-Refai S., Funk A.L., Fontanet A., Talaat M. The prevalence of hepatitis C virus infection in Egypt 2015: implications for future policy on prevention and treatment. Liver Int. 2017;37(1):45–53.
    1. Gomaa A., Allam N., Elsharkway A., El Kassas M., Waked I. Hepatitis C infection in Egypt: prevalence, impact and management strategies. Hepatic Med. Evid. Res. 2017;9:17.
    1. Kouyoumjian S.P., Chemaitelly H., Abu-Raddad L.J. Characterizing hepatitis C virus epidemiology in Egypt: systematic reviews, meta-analyses, and meta-regressions. Sci. Rep. 2018;8(1):1661.
    1. Abdo A.A., Sanai F.M., Al-Faleh F.Z. Epidemiology of viral hepatitis in Saudi Arabia: are we off the hook? Saudi J. Gastroenterol. : Off. J. Saudi Gastroenterol. Assoc. 2012;18(6):349–357.
    1. El-Ghitany E., Farghaly A., El-Wahab E. Knowledge of hepatitis C and awareness of infection in the Egyptian community. J. Virol. Antivir. Res. 2016;5:1. 8955.
    1. Foster M., Barker L., Jiles R., Holmberg S., editors. Awareness of Infection and Medical Follow-Up Among Persons Testing Positive for Hepatitis C Virus—National Health and Nutrition Examination Survey, 2001–2014. Open Forum Infectious Diseases. Oxford University Press; 2016.
    1. Denniston M.M., Klevens R.M., McQuillan G.M., Jiles R.B. Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: national Health and Nutrition Examination Survey 2001-2008. Hepatology. 2012;55(6):1652–1661.
    1. Cornberg M., Razavi H.A., Alberti A., Bernasconi E., Buti M., Cooper C. A systematic review of hepatitis C virus epidemiology in Europe, Canada and Israel. Liver Int. : Off. J. Int. Assoc. Stud. Liver. 2011;31(Suppl 2):30–60.
    1. Abdelrahman T., Hughes J., Main J., McLauchlan J., Thursz M., Thomson E. Next-generation sequencing sheds light on the natural history of hepatitis C infection in patients who fail treatment. Hepatology. 2015;61(1):88–97.
    1. Obach D., Yazdanpanah Y., Esmat G., Avihingsanon A., Dewedar S., Durier N. How to optimize hepatitis C virus treatment impact on life years saved in resource-constrained countries. Hepatology. 2015;62(1):31–39.
    1. Trooskin S.B., Hadler J., St Louis T., Navarro V.J. Geospatial analysis of hepatitis C in Connecticut: a novel application of a public health tool. Public Health. 2005;119(11):1042–1047.
    1. Nafeh M.A., Medhat A., Shehata M., Mikhail N.N., Swifee Y., Abdel-Hamid M. Hepatitis C in a community in Upper Egypt: I. Cross-sectional survey. Am. J. Trop. Med. Hyg. 2000;63(5-6):236–241.
    1. Talaat M., El-Sayed N., Kandeel A., Azab M.A., Afifi S., Youssef F.G. Sentinel surveillance for patients with acute hepatitis in Egypt, 2001-04. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit. 2010;16(2):134–140.
    1. Inchauspe G., Honnet G., Bonnefoy J.Y., Nicosia A., Strickland G.T. Hepatitis C vaccine: supply and demand. Lancet Infect. Dis. 2008;8(12):739–740.
    1. Stoszek S.K., Abdel-Hamid M., Narooz S., El Daly M., Saleh D.A., Mikhail N. Prevalence of and risk factors for hepatitis C in rural pregnant Egyptian women. Trans. R. Soc. Trop. Med. Hyg. 2006;100(2):102–107.
    1. Abdel-Aziz F., Habib M., Mohamed M.K., Abdel-Hamid M., Gamil F., Madkour S. Hepatitis C virus (HCV) infection in a community in the Nile Delta: population description and HCV prevalence. Hepatology. 2000;32(1):111–115.
    1. Lavanchy D. Evolving epidemiology of hepatitis C virus. Clin. microbiol. infect.: Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis. 2011;17(2):107–115.
    1. Mohamoud Y.A., Mumtaz G.R., Riome S., Miller D., Abu-Raddad L.J. The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis. BMC Infect. Dis. 2013;13(1):288.
    1. El-Adly A., Wardany A. Seroprevalence of hepatitis C virus among population in luxor governorate, Egypt. J. Hum. Virol. Retrovirol. 2017;5(2)
    1. Ayele A.G., Gebre-Selassie S. Prevalence and risk factors of hepatitis B and hepatitis C virus infections among patients with chronic liver diseases in public hospitals in Addis Ababa, Ethiopia. ISRN Trop. Med. 2013;2013

Source: PubMed

3
Se inscrever