IDENTIFICATION OF EPIDEMIOLOGICAL RISK FACTORS FOR HEPATITIS C IN PUNJAB, PAKISTAN
AbstractBackground & Objectives: Hepatitis C virus (HCV) is one of the major health issues in Punjab,Pakistan. About 3% of the world population have been infected by hepatitis C virus. The objective ofthis study was to find out significantly associated factors with Hepatitis C in the region. Demographic,socio-economic and clinical factors were taken in consideration to determine the predictive strength ofthese associated factors by the logistic regression model approach. Methods: This was a hospital basedcase-control study of 400 patients; out of which 119 were controlled patients (HCV negative) while 281were cases (HCV positive). Patients admitted in gastroenterology wards of Jinnah, Shaikh Zayed, andMayo hospitals in Lahore city were interviewed to gather risk factors information. Data was collectedin six months starting from April 2006 to September 2006. Results: results from multiple linear logisticregression model for overall data showed that age (OR=1.035, p=0.001), history of blood transfusion(OR=9.204, p=0.004), history of hospitalization (OR=2.979, p=0.043), Tattooing (OR=27.484,p=0.013), family history of hepatitis (OR=4.069, p=0.000), surgical operation (OR=4.290, p=0.030)were found to have significant and positively association with Hepatitis C. Conclusion: Hence ourestimated logit model can be used to predict the chance of hepatitis C under the presence or absence ofcertain significant factors.Keywords: Hepatitis C, Risk factors, Logistic regression, Odds Ratio, Pakistan
World Health Organization. Hepatitis C - global prevalence.
Weekly Epidemiol Rec 1997;72:341–4.
Marcellin P. Hepatitis C: The clinical spectrum of the
disease. J Hepatol 1999;31:9–16.
Hamid S, Umar M, Alam A, Siddiqui A, Qureshi H, Butt J et
al. PSG Consensus Statement on management of hepatitis c
virus infection-2003. J Pak Med Assoc 2004;54(3):146–50.
J Ayub Med Coll Abbottabad 2009;21(2)
Luby SP, Qamruddin K, Shah AA, Omair A, Pahsa O, Khan
AJ, et al. The relationship between therapeutic injections and
high prevalence of hepatitis C infection in Hafizabad,
Pakistan. Epidemiol Infect 1997;119:349–56.
Noor A, Gulfraz, and Aslam B. Assessment of HBsAg and
AntiHCV in some area of Pakistan, Online J Biol Sci
Viral Hepatitis Prevention Board. Hepatitis A, B & C:
defining workers at risk. Viral Hepatitis 1995;3:25–35.
Mast EE, Hwang LY, Seto DS, Nolte FS, Nainan
OV, Wurtzel H, et al. Risk factors for prenatal transmission
of hepatitis C virus (HCV) and the natural history of HCV
infection acquired in infancy”, J Infect Dis 2005;192:1880–9.
World Health Organization. Global surveillance and control
of hepatitis C: Report of a WHO Consultation organized in
Collaboration with the Viral Hepatitis Prevention Board,
Antwerp, Belgium. J Viral Hematol 2000;6:35–47.
Chen SL, , Morgan TR. The natural history of hepatitis C
virus (HCV) infection”, Int J Med. Sci 2006;3(2):47–52.
Tong CYW, Khan R, Beeching NJ, Tariq WUZ, Hart CA,
Ahmad N, et al. The occurrence of hepatitis B virus and HCV
in Pakistan patients with chronic liver disease and
Hepatocellular carcinoma. Epidemiol Infect 1996;117:327–32.
Pasha O, Luby SP, Khan AJ, Shah SA, McCormick JB, FisherHoch SP. Household members of hepatitis C virus-infected
people in Hafizabad, Pakistan: infection by injections from
health care providers. Epidemiol Infect 1999; 123:515–8.
Sandhu J, Preiksaitis JK, Campbell PM, Carriere KC, Hessel
PA. Prevalence and Risk Factors in the Northern Alberta
Dialysis Population”, Am J Epidemiol 1999;150:58–66.
Bari A, Akhtar S, Rahbar MH, Luby SP. Risk factors for
hepatitis C virus infection in male adults in RawalpindiIslamabad, Pakistan. Trop Med Int Health 2001;6:732–8.
Shah FU, Salih M, Malik IA, sHussain I. Increasing
prevalence of chronic hepatitis and associated risk factors.
Pakistan J Med Res 2002; 41(2): 46-50.
Rehman FU, Haq NU, Humayun M, Afridi J. Risk of
Hepatitis in Surgical Practice. J Postgrad Med Inst
Yee LJ, Weiss HL, Langner RG, Herrera J, Kaslow RA, van
Leeuwen DJ. Risk factors for acquisition of hepatitis C virus
infection: a case-series and potential implications for disease
surveillance. BMC Infect Dis 2001;1(8):doi:10.1186/1471-
Akhtar S, Younus M, Adil S, Jafri SH., Hassan F. Hepatitis C
virus infection in asymptomatic male volunteer blood donors
in Karachi”, Pakistan. J Viral Hepat 2004;11(6):527–35.
Mendes-Correa MC, Barone AA, Gianini RJ. Risk factors
associated with hepatitis C among patients co-infected with
human immunodeficiency virus: A Case-Control Study, Am
J Trop Med Hyg 2005;72:762–7.
Lock G, Dircherl M, Obermeier F, Gelbmann M, Hellerbrand
C, Knöll A et al. Hepatitis C - Contamination of Toothbrushes:
Myth or Reality?”, J Viral Hepat 2006;13:571–3.
Hanif M, Ahmed M. (eds). Biostatistics for Health Students
with Manual on Software Application. Lahore Pakistan: Taya
David C. (ed). Modeling for binary data. USA: Chapman &
Hosmer DW, Lemeshow S. (eds) Applied Logistic
Regression Analysis. New York: John Wiley & Sons;1989.
Tariq WU, Hussain AB, Karamat KA, Ghani E, Hussain
T, Hussain S.. Demographic aspects of Hepatitis C in
Northern Pakistan. J Pak Med Assoc 1999;49:198–201.
Umer M, Busbra HT, Shuaib A, Anwar A, Nisar HS.
Spectrum of Chronic .liver disease due to hepatitis C virus
infection. J Coll Physicians Surg Pak 2000;10:380–3.
Akhtar A, Talib W, Shami N, Anwar S. Frequency of
Hepatitis C in admitted patients of Deptt. Of Obstetrics &
Gynaecology, Ghurki Trust Teaching Hospital, Lahore.
Lubna S, Zaigham A. Comparison of risk factors for hepatitis
B and C patients visiting a Gastroenterology clinic. J Coll
Physicians Surg Pak 2006;16(2):104–7.
Wake DJ, Cutting WA. Blood transfusion in developing
countries Problems, priorities and practicalities. Trop Doct
Shafi F, Akram S, Kausar S, Banna H. To Study the Risk
Factors for Hepatitis C in Cirrhotic Patients. Ann King
Edward Med Coll 2000;2(6):203–4.
Rodger AJ, Roberts S, Lanigan A, Bowden S, Brown T and
Crofts N. 2000. Assessment of long term outcomes of
community-acquired hepatitis C infection in a cohort with
sera stored from 1971–1975. Hepatology 32:582–7.