The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan

To determine the prevalence and routes of transmission of hepatitis C virus (HCV) infection in Hafizabad, Pakistan, we collected sera in 1993 from a geographically based random sample of residents, and in 1994 identified 15 HCV-infected individuals (cases) and 67 age and sex matched uninfected individuals (controls). Initially we approached 504 households, and collected serum from a randomly selected household member in 309 (64%). Twenty persons (6·5%) had anti-HCV antibody; 31% percent had hepatitis B core antibodies, and 4·3% had hepatitis B surface antigen. In the case-control study, persons who received more therapeutic injections (categorized as averaging 1, 2–4, 5–9 or >10 injections per year in the previous 10 years) were more likely to be infected with HCV (odds ratio 0, 1·5, 2·5 and 6·9 respectively, P=0·008) compared to persons averaging 0 injections per year. Efforts to limit therapeutic injections to only those that are medically indicated and that use sterile equipment are essential in order to prevent transmission of HCV.

[1]  N. Beeching,et al.  The occurrence of hepatitis B and C viruses in Pakistani patients with chronic liver disease and hepatocellula carcinoma , 1996, Epidemiology and Infection.

[2]  L. Hutwagner,et al.  Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice , 1995, BMJ.

[3]  C. Ponticelli,et al.  Comparison of Three Different Tests for Assessment of Hepatitis C Virus in Dialysis Patients , 1995 .

[4]  C. Ponticelli,et al.  Comparison of Three Different Tests for Assessment of Hepatitis C Virus in Dialysis Patients , 1995, Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis.

[5]  S. Kashiwagi,et al.  Transmission of hepatitis C virus by health care workers in a rural area of Japan. , 1995, The American journal of gastroenterology.

[6]  A. Hoes.  Case-control studies. , 1995, The Netherlands journal of medicine.

[7]  K. Neal,et al.  Risk factors for hepatitis C virus infection. A case-control study of blood donors in the Trent Region (UK) , 1994, Epidemiology and Infection.

[8]  M. Sakamoto,et al.  Hepatitis C Virus Infection in Spouses of Patients with Type C Chronic Liver Disease , 1994, Annals of Internal Medicine.

[9]  H. Gayle,et al.  Risk factors for HIV infection among abandoned Romanian children , 1993, AIDS.

[10]  E. Delaporte,et al.  High level of hepatitis C endemicity in Gabon, equatorial Africa. , 1993, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[11]  J. Oldenburg,et al.  Search for intrafamilial transmission of hepatitis C virus in hemophilia patients. , 1993, Blood.

[12]  H. Sheppard,et al.  Risk factors for hepatitis C virus seropositivity in heterosexual couples. , 1993, JAMA.

[13]  K. Inokuchi,et al.  Epidemiology and long term prognosis of hepatitis C virus infection in Japan. , 1993, Gut.

[14]  H. Alter,et al.  Failure To Detect Vertical Transmission of Hepatitis C Virus , 1992, Annals of Internal Medicine.

[15]  S. Y. Lin,et al.  High prevalence of hepatitis C virus infection in aborigines in Taiwan. , 1992, Japanese journal of medical science & biology.

[16]  M. Rapicetta,et al.  Seroprevalence of anti-HCV in an urban child population: a pilot survey in a developing area, Cameroon. , 1992, The Journal of tropical medicine and hygiene.

[17]  M. Nasser,et al.  Intrafamilial transmission of hepatitis C virus (HCV): a major mode of spread in the Saudi Arabia population , 1992 .

[18]  M. A. al Nasser.  Intrafamilial transmission of hepatitis C virus (HCV): a major mode of spread in the Saudi Arabia population. , 1992, Annals of tropical paediatrics.

[19]  J. Olson,et al.  The epidemiology of hepatitis C virus antibody in Yemen. , 1992, The American journal of tropical medicine and hygiene.

[20]  K. Ishak,et al.  Long‐term clinical and histopathological follow‐up of chronic posttransfusion hepatitis , 1991, Hepatology.

[21]  R. Purcell,et al.  Hepatitis C in hospital employees with needlestick injuries. , 1991, Annals of internal medicine.

[22]  K. Tokunaga,et al.  Hepatitis C and hepatitis B in the etiology of hepatocellular carcinoma in the Japanese population. , 1991, Cancer research.

[23]  Y. Ko,et al.  Horizontal transmission of hepatitis B virus from siblings and intramuscular injection among preschool children in a familial cohort. , 1991, American journal of epidemiology.

[24]  H. Margolis,et al.  Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. , 1990, JAMA.

[25]  A. Reeler.  Injections: a fatal attraction? , 1990, Social science & medicine.

[26]  J. Bruix,et al.  PREVALENCE OF ANTIBODIES TO HEPATITIS C VIRUS IN SPANISH PATIENTS WITH HEPATOCELLULAR CARCINOMA AND HEPATIC CIRRHOSIS , 1989, The Lancet.

[27]  J. McCormick,et al.  Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread. , 1983, Bulletin of the World Health Organization.