INSERM UMR_S 707, and UPMC, Univ Paris 06, F-75012 Paris, France.
BMC Public Health. 2010 Dec 20;10:773. doi: 10.1186/1471-2458-10-773.
Hepatitis C virus (HCV) recently emerged as a major public health hazard in Egypt. However, dramatic healthcare budget constraints limit access to the costly treatment. We assessed risk perception and priority setting for intervention among HCV, unsafe water, and outdoor air pollution in Cairo city.
A survey was conducted in the homes of a representative sample of household heads in Cairo city. Risk perception was assessed using the "psychometric paradigm" where health hazards are evaluated according to several attributes and then summarized by principal component analysis. Priority setting was assessed by individual ranking of interventions reducing health hazards by 50% over five years. The Condorcet method was used to aggregate individual rankings of the three interventions (main study) or two of three interventions (validation study). Explanatory factors of priority setting were explored in multivariate generalized logistic models.
HCV was perceived as having the most severe consequences in terms of illness and out-of-pocket costs, while outdoor air pollution was perceived as the most uncontrollable risk. In the main study (n = 2,603), improved water supply received higher priority than both improved outdoor air quality (60.1%, P < .0001) and screening and treatment of chronic hepatitis C (66.3%, P < .0001), as confirmed in the validation study (n = 1,019). Higher education, report of HCV-related diseases in the household, and perception of HCV as the most severe risk were significantly associated to setting HCV treatment as the first priority.
The Cairo community prefers to further improving water supply as compared to improved outdoor air quality and screening and treatment of chronic hepatitis C.
丙型肝炎病毒（HCV）最近在埃及成为一个主要的公共卫生危害。然而，急剧的医疗保健预算限制了获得昂贵治疗的机会。我们评估了 HCV、不安全水和户外空气污染在开罗市的风险认知和干预优先级。
在开罗市的家庭户长的代表性样本家中进行了一项调查。使用“心理测量范式”评估风险认知，根据几个属性评估健康危害，然后通过主成分分析进行总结。通过个人对五年内降低 50%健康危害的干预措施进行排名来评估干预优先级。使用 Condorcet 方法对三种干预措施的个人排名（主要研究）或三种干预措施中的两种进行汇总（验证研究）。使用多变量广义逻辑模型探索了干预优先级的解释因素。
HCV 在疾病和自付费用方面被认为具有最严重的后果，而户外空气污染被认为是最不可控的风险。在主要研究（n = 2,603）中，改善供水的优先级高于改善户外空气质量（60.1%，P <.0001）和慢性丙型肝炎的筛查和治疗（66.3%，P <.0001），在验证研究（n = 1,019）中也得到了证实。更高的教育程度、家庭报告的 HCV 相关疾病以及将 HCV 视为最严重风险与将 HCV 治疗作为第一优先事项显著相关。
与改善户外空气质量和慢性丙型肝炎的筛查和治疗相比，开罗社区更愿意进一步改善供水。
