医院探访孕妇表明巴基斯坦开伯尔-普赫图赫瓦省丙型肝炎感染的传播有所增加。

Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan.

机构信息

Department of Microbiology and Biotechnology, Abasyn University Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.

Centre for Biotechnology and Microbiology, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.

出版信息

Virol J. 2017 Oct 10;14(1):195. doi: 10.1186/s12985-017-0861-y.

DOI:10.1186/s12985-017-0861-y

PMID:29017555

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5635535/

Abstract

BACKGROUND

Seroprevalence of hepatitis C in Khyber Pakhtunkhwa province of Pakistan was determined by screening blood samples of expectant mothers seeking antenatal care in gynecological units of district hospitals. The rationale behind this cohort study was that the availability of free-of-cost antenatal care in district hospitals brings expectant mothers from a broader geographical range in each district and thus provides a large sample-size of healthy pregnant women of known medical history for Hepatitis C Virus (HCV) surveillance. The study was carried out along a south west to north east transact of five districts, Kohat-Peshawar-Nowshera-Charsadda-Mardan, with the central district Peshawar and outer districts Kohat and Mardan bordering northern mountainous ranges of the Khyber Pakhtunkhwa province. This distribution of districts along the transact allowed the study to gauge the impact of proximity to remote highland communities on the HCV burden of visiting pregnant women tested for HCV infection.

METHODS

The cohort study randomly selected 150 pregnant women visiting each hospital for serological screening for Anti-HCV carried out by ELISA assay. The feasibility of ICT and RT-PCR assays for HCV prevalence was also examined in the present study.

RESULTS

With a total of 750 blood specimen screened, the results of ELISA tests revealed a staggering 5.9% frequency of Anti-HCV in the five districts with the frequency of ELISA positive cases ranging from 3.3% in Nowshera, 4.7% in Charsadda, 6.0% in Peshawar, 6.7% in Kohat, and 8.7% in Mardan. The relatively higher frequencies of Anti-HCV cases among hospital visiting pregnant women in Peshawar, Kohat and Mardan were consistent with the proximity of these hospitals to the highland communities in the bordering mountain ranges. Compared to 44 Anti-HCV positive serologic specimens detected by ELISA, only 26 and 10 blood specimens were tested positive by ICT and PCR methods, respectively. Our study validates ELISA as a reliable diagnostic technique for both acute and chronic HCV infection.

CONCLUSION

The HCV infection rate of 5.9% in Khyber Pakhtunkhwa province clearly exceeds the HCV prevalence rates reported for other regions in Pakistan, making this province a hotspot of HCV infection in the country.

摘要

背景

在巴基斯坦开伯尔-普赫图赫瓦省，通过筛查寻求在地区医院妇科单位进行产前护理的孕妇的血液样本，确定了丙型肝炎的血清流行率。本队列研究的基本原理是，地区医院提供免费的产前护理，吸引了来自每个地区更广泛地理范围的孕妇，因此为丙型肝炎病毒（HCV）监测提供了大量具有已知病史的健康孕妇的大样本量。该研究沿着五个区的西南到东北方向进行，包括科哈特-白沙瓦-瑙谢拉-恰尔萨达-马尔丹，其中中心区白沙瓦和外区科哈特和马尔丹与开伯尔-普赫图赫瓦省的北部山区接壤。这种沿着方向的分区分布使研究能够评估接近偏远高地社区对接受 HCV 感染检测的孕妇 HCV 负担的影响。

方法

该队列研究随机选择了每个医院的 150 名孕妇进行 ELISA 检测的血清学筛查，以检测 HCV 感染。本研究还检查了 ICT 和 RT-PCR 检测 HCV 流行率的可行性。

结果

在总共筛查了 750 个血液样本中，ELISA 检测结果显示，在这五个区中，抗 HCV 的频率惊人地达到 5.9%，ELISA 阳性病例的频率范围从瑙谢拉的 3.3%、恰尔萨达的 4.7%、白沙瓦的 6.0%、科哈特的 6.7%到马尔丹的 8.7%。白沙瓦、科哈特和马尔丹的医院就诊孕妇中抗 HCV 病例的相对较高频率与这些医院靠近边境山脉的高地社区有关。与通过 ELISA 检测到的 44 个抗 HCV 阳性血清标本相比，ICT 和 PCR 方法仅分别检测到 26 个和 10 个血液标本为阳性。我们的研究证实了 ELISA 是一种可靠的急性和慢性 HCV 感染的诊断技术。