埃塞俄比亚南部沃莱塔地区社区中未诊断出的乙型和丙型肝炎病毒感染血清流行率
Undiagnosed Seroprevalence of Hepatitis B and C Virus Infections in the Community of Wolaita Zone, Southern Ethiopia.
作者信息
Kumalo Abera, Teklu Takele, Demisse Tigistu, Anjulo Abebe
机构信息
School of Medical Laboratory Sciences, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia.
Department of Medical Laboratory, Wolaita Sodo Blood Bank, Sodo, Ethiopia.
出版信息
Hepat Med. 2022 Aug 9;14:111-122. doi: 10.2147/HMER.S374029. eCollection 2022.
BACKGROUND
Despite Ethiopia's hepatitis endemic status with intermediate to hyperendemic level, there is no national strategy for monitoring, preventing, and controlling viral hepatitis. In order to advise community-based intervention programs, studies on the magnitude, determinant factors, and understanding of indigenous social organization are important. Thus, this study examined undiagnosed seroprevalence and associated factors for HBV and HCV infections among community members in Wolaita Zone, Southern Ethiopia.
METHODS
A cross-sectional study was conducted on 320 individuals from randomly selected two woredas in the Wolaita Zone to determine the magnitude of HBV and HCV. Multistage sampling was used to select participants. Relevant clinical and sociodemographic data were collected using a structured questionnaire. One test strip technique was used for the screening of hepatitis B surface antigen and for antibodies against HCV. Both tests were confirmed by ELISA methods. The associated factors were assessed using bivariate and multivariate logistic regression analyses. P-values less than 0.05 were considered statistically significant.
RESULTS
The seroprevalence for HBV infection was 6.6% (95% CI: 4.22%, 8.69%) using a one-step HBsAg test strip and 5.6% (95% CI: 3.47%, 8.58%) using confirmatory test (ELISA). The two tests had a very good agreement (K = 0.918; SE = 0.047; P < 0.001). The overall seroprevalence for HCV infection was 1.9% (95% CI: 0.9%, 3.0%). All four of the one-step HCV test strip positives were also positive by ELISA. One (0.3%) of the participants was co-infected with HBV and HCV. Hospital admission (AOR = 0.22; 95% CI = 0.5-0.95) and needle stick (AOR = 0.15; 95% CI = 0.07-0.72) were independently associated with HBV infections.
CONCLUSION
According to the current study, in Wolaita community, there is endemic to HBV at a higher-intermediate level and to HCV at a low level. It would be imperative to increase awareness of transmission modes and prevention of infection, as well as vaccination, in order to reduce the burden of both HBV and HCV.
背景
尽管埃塞俄比亚处于肝炎地方病流行状态，流行程度为中度至高度，但该国尚无监测、预防和控制病毒性肝炎的国家战略。为了为基于社区的干预项目提供建议，开展关于疾病严重程度、决定因素以及对当地社会组织的了解的研究很重要。因此，本研究调查了埃塞俄比亚南部沃莱塔地区社区成员中未诊断出的乙肝病毒（HBV）和丙肝病毒（HCV）感染的血清流行率及相关因素。
方法
对从沃莱塔地区随机选取的两个 woreda 的 320 名个体进行了一项横断面研究，以确定 HBV 和 HCV 的流行程度。采用多阶段抽样来选择参与者。使用结构化问卷收集相关临床和社会人口学数据。采用一步检测试纸技术筛查乙肝表面抗原和抗 HCV 抗体。两种检测均通过酶联免疫吸附测定（ELISA）方法进行确认。使用二元和多元逻辑回归分析评估相关因素。P 值小于 0.05 被认为具有统计学意义。
结果
使用一步 HBsAg 检测试纸，HBV 感染的血清流行率为 6.6%（95%可信区间：4.22%，8.69%），使用确认检测（ELISA）为 5.6%（95%可信区间：3.47%，8.58%）。两种检测具有非常好的一致性（K = 0.918；标准误 = 0.047；P < 0.001）。HCV 感染的总体血清流行率为 1.9%（95%可信区间：0.9%，3.0%）。一步 HCV 检测试纸呈阳性的所有 4 人经 ELISA 检测也呈阳性。1 名（0.3%）参与者同时感染了 HBV 和 HCV。住院（比值比[AOR]=0.22；95%可信区间 = 0.5 - 0.95）和针刺伤（AOR = 0.15；95%可信区间 = 0.07 - 0.72）与 HBV 感染独立相关。
结论
根据当前研究，在沃莱塔社区，HBV 呈中高水平地方流行，HCV 呈低水平地方流行。为了减轻 HBV 和 HCV 的负担，必须提高对传播方式和感染预防以及疫苗接种的认识。
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