埃塞俄比亚南部病毒性肝炎的负担及传播风险：预防与控制措施所需证据
Burden and Transmission Risks of Viral Hepatitis in Southern Ethiopia: Evidence Needed for Prevention and Control Measures.
作者信息
Beykaso Gizachew, Mulu Andargachew, Giday Mirutse, Berhe Nega, Selamu Markos, Mihret Adane, Teklehaymanot Tilahun
机构信息
Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
出版信息
Risk Manag Healthc Policy. 2021 Dec 1;14:4843-4852. doi: 10.2147/RMHP.S336776. eCollection 2021.
BACKGROUND
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver-associated morbidity and mortality for millions of people globally. Ethiopia is one of the viral hepatitis-endemic countries with no national strategy for surveillance and limited data. As such, this study aimed to investigated the extent and associated risk factors of HBV and HCV among community members in southern Ethiopia.
METHODS
A community-based cross-sectional study was conducted from January 2020 to August 2020. A structured questionnaire was used to collect behavioral and sociodemographic data. Serum samples were collected and assayed for seromarkers of HBV (HBsAg, anti-HBc, and anti-HBs) and HCV (anti-HCV) using ELISAs. In HBsAg-positive samples, HBV DNA was further quantified using RT-PCR. Data were entered into EpiData 3.1 and analyzed using SPSS 21.0. Descriptive statistics and logistic regression analysis were employed.
RESULTS
The study included 693 participants. Seromarkers for HBsAg, anti-HCV, anti-HBc, and anti-HBs were found to be 9.5%, 1.4%, 31.1%, and 14.3%, respectively. In 66 HBsAg positives, 57 (86.4%) had quantifiable HBV DNA. Prevalence of current HBV infection (HBsAg, anti-HBc, anti-HBs) and lifetime exposure (positive for either HBsAg or anti-HBc) to HBV were 8.7% and 31.9%, respectively, and 63.1% of participants were vulnerable or had no evidence of prior HBV infection (HBsAg, anti-HBc, anti-HBs). On multivariate logistic regression analysis, multiple sexual contacts, family history of hepatitis infection, alcohol consumption, and khat chewing were significantly associated with HBV. The seroprevalence of HBV was relatively high in this study area.
CONCLUSION
This study showed high prevalence of HBV infection, but low prevalence of HCV. This indicates that HBV is a major health problem in this community. Population-based surveillance, care, and treatment, as well as behavioral change and education programs, should be enhanced to minimize risk exposure.
背景
乙肝病毒（HBV）和丙肝病毒（HCV）是全球数百万人肝脏相关发病和死亡的重要原因。埃塞俄比亚是病毒性肝炎流行国家之一，没有国家监测战略且数据有限。因此，本研究旨在调查埃塞俄比亚南部社区成员中HBV和HCV的感染程度及相关危险因素。
方法
于2020年1月至2020年8月开展了一项基于社区的横断面研究。使用结构化问卷收集行为和社会人口学数据。采集血清样本，采用酶联免疫吸附测定法（ELISA）检测HBV（乙肝表面抗原、乙肝核心抗体和乙肝表面抗体）和HCV（丙肝抗体）的血清标志物。对于乙肝表面抗原阳性样本，使用逆转录聚合酶链反应（RT-PCR）进一步定量HBV DNA。数据录入EpiData 3.1并使用SPSS 21.0进行分析。采用描述性统计和逻辑回归分析。
结果
该研究纳入了693名参与者。乙肝表面抗原、丙肝抗体、乙肝核心抗体和乙肝表面抗体的血清标志物检出率分别为9.5%、1.4%、31.1%和14.3%。在66例乙肝表面抗原阳性者中，57例（86.4%）有可定量的HBV DNA。当前HBV感染（乙肝表面抗原、乙肝核心抗体、乙肝表面抗体）的患病率和HBV的终身暴露率（乙肝表面抗原或乙肝核心抗体阳性）分别为8.7%和31.9%，63.1%的参与者易感染或无既往HBV感染证据（乙肝表面抗原、乙肝核心抗体、乙肝表面抗体）。多因素逻辑回归分析显示，多个性伴侣、肝炎感染家族史、饮酒和咀嚼恰特草与HBV感染显著相关。该研究地区HBV的血清流行率相对较高。
结论
本研究显示HBV感染患病率高，但HCV患病率低。这表明HBV是该社区的一个主要健康问题。应加强基于人群的监测、护理和治疗，以及行为改变和教育项目，以尽量减少风险暴露。
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