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埃及丙型肝炎感染与血吸虫病肠外治疗关联的进一步证据。

Further evidence for association of hepatitis C infection with parenteral schistosomiasis treatment in Egypt.

作者信息

Rao Malla R, Naficy Abdollah B, Darwish Medhat A, Darwish Nebal M, Schisterman Enrique, Clemens John D, Edelman Robert

机构信息

Epidemiology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, USA.

出版信息

BMC Infect Dis. 2002 Dec 4;2:29. doi: 10.1186/1471-2334-2-29.

Abstract

BACKGROUND

Hepatitis C virus (HCV) infection and schistosomiasis are major public health problems in the Nile Delta of Egypt. To control schistosomiasis, mass treatment campaigns using tartar emetic injections were conducted in the 1960s through 1980s. Evidence suggests that inadequately sterilized needles used in these campaigns contributed to the transmission of HCV in the region. To corroborate this evidence, this study evaluates whether HCV infections clustered within houses in which household members had received parenteral treatment for schistosomiasis.

METHODS

A serosurvey was conducted in a village in the Nile Delta and residents were questioned about prior treatment for schistosomiasis. Sera were evaluated for the presence of antibodies to HCV. The GEE2 approach was used to test for clustering of HCV infections, where correlation of HCV infections within household members who had been treated for schistosomiasis was the parameter of interest.

RESULTS

A history of parenteral treatment for schistosomiasis was observed to cluster within households, OR for clustering: 2.44 (95% CI: 1.47-4.06). Overall, HCV seropositivity was 40% (321/796) and was observed to cluster within households that had members who had received parenteral treatment for schistosomiasis, OR for clustering: 1.76 (95% CI: 1.05-2.95). No such evidence for clustering was found in the remaining households.

CONCLUSION

Clustering of HCV infections and receipt of parenteral treatment for schistosomiasis within the same households provides further evidence of an association between the schistosomiasis treatment campaigns and the high HCV seroprevalence rates currently observed in the Nile delta of Egypt.

摘要

背景

丙型肝炎病毒(HCV)感染和血吸虫病是埃及尼罗河三角洲地区的主要公共卫生问题。为控制血吸虫病,20世纪60年代至80年代开展了使用吐酒石注射剂的大规模治疗运动。有证据表明,这些运动中使用的未充分消毒的针头促成了该地区HCV的传播。为证实这一证据,本研究评估HCV感染是否聚集在其家庭成员接受过血吸虫病注射治疗的家庭中。

方法

在尼罗河三角洲的一个村庄进行了血清学调查,并询问居民既往血吸虫病治疗情况。检测血清中HCV抗体的存在情况。采用广义估计方程2(GEE2)方法检测HCV感染的聚集性,其中接受过血吸虫病治疗的家庭成员中HCV感染的相关性是感兴趣的参数。

结果

观察到血吸虫病注射治疗史在家庭中呈聚集性,聚集比值比(OR):2.44(95%置信区间:1.47 - 4.06)。总体而言,HCV血清阳性率为40%(321/796),且在有家庭成员接受过血吸虫病注射治疗的家庭中呈聚集性,聚集OR:1.76(95%置信区间:1.05 - 2.95)。在其余家庭中未发现此类聚集证据。

结论

HCV感染与血吸虫病注射治疗在同一家庭中的聚集性,为血吸虫病治疗运动与目前在埃及尼罗河三角洲观察到的高HCV血清流行率之间的关联提供了进一步证据。

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