Mohamed M K, Hussein M H, Massoud A A, Rakhaa M M, Shoeir S, Aoun A A, Aboul Naser M
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
J Egypt Public Health Assoc. 1996;71(1-2):113-47.
The aim of this study was to identify the risk factors for viral hepatitis C infection among Egyptians. A cross-sectional study with case-control analysis was conducted including 5071 Egyptians applying to the Ministry of Health Laboratories for certification of freedom from viral hepatitis (B and C) to work abroad. A questionnaire designed to cover the most important known and suspected risk factors was filled out by physicians interviewers before blood drawing and after proper orientation of the purpose of the study. The overall seropositivity among the whole sample for HCV was 31.5% and was significantly lower among females (13.2%) than among males (34%). A consistent increase of seropositivity for HCV antibodies with age (in males and females and in urban and rural areas) was observed with a peak level of 54.9% in all individuals for the age group 45-49 years (significant trend p < 0.0001). A significant increase of seropositivity (p < 0.005) above 25 years of age (35.7%) than below this age 12.8%) was observed on examination of HCV distribution in 5-year age group. Married individuals have a significant higher seropositivity for HCV than non-married (38.2% and 20.9% respectively OR = 2.3, 95% CL 2.1-2.7). Individuals living in rural areas had significantly more HCV seropositivity than those living in urban areas (OR = 1.7, 95% CL 1.5-2.0). Also, individuals living in Cairo and seashore governorates had significantly lower seropositivity (14.7% and 12.7% respectively) than those living in governorates in upper or lower Egypt (29.4% and 36.3% respectively). Medical procedures risk factors identified to be associated with significant higher HCV seropositivity included: past history of injections for bilharziasis, use of common syringes, dental extraction, injections for urography, blood transfusions and previous hospitalizations. Multivariate logistic analysis revealed that only age, male sex, marriage, rural residence, living in upper and lower Egypt, injections for bilharziasis and urography were significant in the final equation for the whole group. Blood transfusion was significant in the final regression analysis among females in urban living and hospitalization was significant among males in urban living and females in rural living. Further research is needed to elucidate those factors prevailing in rural areas and in upper and lower Egypt associated with increased risk for HCV infection.
本研究的目的是确定埃及人群中丙型病毒性肝炎感染的风险因素。开展了一项采用病例对照分析的横断面研究，纳入了5071名向卫生部实验室申请无病毒性肝炎（乙、丙型）证明以出国工作的埃及人。在采血前，由医生访谈员在对研究目的进行适当说明后，填写一份旨在涵盖最重要的已知和疑似风险因素的问卷。整个样本中HCV的总体血清阳性率为31.5%，女性（13.2%）显著低于男性（34%）。观察到HCV抗体血清阳性率随年龄（男性和女性、城市和农村地区）持续上升，45 - 49岁年龄组所有人的峰值水平为54.9%（显著趋势p < 0.0001）。在按5岁年龄组检查HCV分布时，观察到25岁以上（35.7%）的血清阳性率显著高于该年龄以下（12.8%）（p < 0.005）。已婚个体的HCV血清阳性率显著高于未婚个体（分别为38.2%和20.9%，OR = 2.3，95% CL 2.1 - 2.7）。生活在农村地区的个体HCV血清阳性率显著高于生活在城市地区的个体（OR = 1.7，95% CL 1.5 - 2.0）。此外，生活在开罗和沿海省份的个体血清阳性率显著低于生活在上埃及或下埃及省份的个体（分别为14.7%和12.7%，而分别为29.4%和36.3%）。确定与显著较高的HCV血清阳性率相关的医疗程序风险因素包括：既往血吸虫病注射史、共用注射器、拔牙、尿路造影注射、输血和既往住院史。多因素逻辑分析显示，在整个组的最终方程中，只有年龄、男性性别、婚姻状况、农村居住、生活在上埃及和下埃及、血吸虫病注射和尿路造影注射是显著的。输血在城市生活女性的最终回归分析中显著，住院在城市生活男性和农村生活女性中显著。需要进一步研究以阐明在上埃及、下埃及和农村地区存在的那些与HCV感染风险增加相关的因素。
