Medhat Ahmed, Shehata Magda, Magder Laurence S, Mikhail Nabiel, Abdel-Baki Laila, Nafeh Mohamed, Abdel-Hamid Mohamed, Strickland G Thomas, Fix Alan D
Hepatitis C Prevention Project, Assiut University Faculty of Medicine, Egypt.
Am J Trop Med Hyg. 2002 May;66(5):633-8. doi: 10.4269/ajtmh.2002.66.633.
This investigation's objective was to identify risk factors for hepatitis C virus (HCV) in a village in Upper Egypt with a moderately high prevalence (8.7%) of antibodies to HCV (anti-HCV). A representative sample of 6,012 (63%) of the 9,581 village inhabitants was included in the study. A questionnaire solicited information regarding risk factors for infection, and blood samples were tested for anti-HCV. Parenteral risks identified in age-adjusted analysis included blood transfusions, dental procedures, hospital admission, surgery, complicated deliveries, history of injection therapy for schistosomiasis, and history of frequent injections. Circumcision was pervasive and was not associated per se with ant-HCV; however, circumcision by an informal, rather than formal, health care provider was associated with anti-HCV among young men and boys. The results did not reveal any unique community-acquired exposures that caused HCV infections: inhabitants who had tattoos, who smoked goza, who were shaved by a community barber, or who had their ears pierced were not at greater risk for anti-HCV than those who did not. Risks identified in multivariate analysis for both those older and younger than 30 years included prior parenteral therapy for schistosomiasis and blood transfusion; for those 30 or younger, circumcision by an informal rather than formal health care provider, and frequent injections; and for those older than 30, never attending college, invasive medical procedures, and complicated deliveries. Selecting for those with blood transfusion, prior parenteral therapy for schistosomiasis, and invasive medical procedures would identify less than half of those infected. Inclusion of frequent injections would identify 80% of those infected with HCV, but as a result of the pervasive use of injections, it would not discriminate from those uninfected. Nonetheless, general reduction of these exposures and assuring sterile practices are logical goals for intervention.
本调查的目的是在埃及上埃及一个丙型肝炎病毒（HCV）抗体患病率中等偏高（8.7%）的村庄中确定HCV的风险因素。该研究纳入了9581名村庄居民中的6012名（63%）具有代表性的样本。通过问卷调查收集有关感染风险因素的信息，并对血样进行抗HCV检测。年龄调整分析中确定的非肠道风险因素包括输血、牙科手术、住院、手术、难产、血吸虫病注射治疗史以及频繁注射史。包皮环切术很普遍，其本身与抗HCV无关；然而，由非正规而非正规医疗服务提供者进行的包皮环切术与年轻男性和男孩的抗HCV有关。结果未发现任何导致HCV感染的独特社区获得性暴露因素：有纹身、吸goza、由社区理发师剃须或穿耳洞的居民感染抗HCV的风险并不高于未进行这些行为的居民。多变量分析确定的30岁及以上和30岁以下人群的风险因素包括既往血吸虫病非肠道治疗和输血；30岁及以下人群为非正规而非正规医疗服务提供者进行的包皮环切术以及频繁注射；30岁以上人群为从未上过大学、侵入性医疗程序和难产。选择有输血史、既往血吸虫病非肠道治疗史和侵入性医疗程序的人群，只能识别不到一半的感染者。纳入频繁注射可识别80%的HCV感染者，但由于注射的广泛使用，无法将其与未感染者区分开来。尽管如此，普遍减少这些暴露并确保无菌操作仍是合理的干预目标。
