1
|
Geremia N, Giovagnorio F, De Vito A, Martignago L, Fiore V, Rastrelli E, Madeddu G, Parisi SG, Starnini G, Panese S, Babudieri S. HBV in Italian Women's Jail: An Underestimated Problem? J Clin Med 2024; 13:1398. [PMID: 38592679 PMCID: PMC10932425 DOI: 10.3390/jcm13051398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND There is little information regarding the hepatitis B virus (HBV), vaccination status, and hepatitis B exposure in Italian women's jails. We aimed to describe the HBV exposure and HBs antibody (anti-HBs) protection levels in female prisoners. MATERIAL AND METHODS A retrospective multicentric study was performed in Italian prisons from 2021 to 2023. Univariate and multivariate analyses were conducted to identify risk factors for HBc antibody (anti-HBc) seropositivity and non-protective anti-HBs titer. RESULTS We included 156 patients. The median age was 41.0 (IQR 34.0-48.0). Of the studied subjects, 31 (19.9%) had anti-HBc positive titer. Two women were HBsAg positive. In the multivariate analysis, older age [OR 1.06 (CI 1.01-1.11), p = 0.011], North-Eastern European [OR 11.67 (3.29-41.30), p < 0.001] and African origin [OR 6.92 (CI 1.51-31.60), p = 0.013], and drug use [OR 6.55 (CI 1.96-21.9), p = 0.002] were risk factors for HBV exposure. Thirty-seven (32%) women had no history of HBV vaccination. Forty-four (38%) had an anti-HBs non-protective titer. In the multivariate analysis, North-Eastern European origin [OR 4.55 (CI 1.19-17.50), p = 0.027] was associated with unprotective anti-HBs titer. CONCLUSION Our results show both the low prevalence of HBV and protection in female prisoners. Age, North-Eastern European and African origin, and drug use have a role in exposure risk to HBV.
Collapse
Affiliation(s)
- Nicholas Geremia
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Dell'Angelo, 30174 Venice, Italy
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile "S.S. Giovanni e Paolo", 30122 Venice, Italy
| | | | - Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- School in Biomedical Science, Biomedical Science Department, University of Sassari, 07100 Sassari, Italy
| | - Luca Martignago
- Department of Molecular Medicine, University of Padua, 35121 Padua, Italy
| | - Vito Fiore
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Elena Rastrelli
- Medicina Protetta-Unit of Infectious Diseases, Belcolle Hospital, 01100 Viterbo, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | | | - Giulio Starnini
- Medicina Protetta-Unit of Infectious Diseases, Belcolle Hospital, 01100 Viterbo, Italy
| | - Sandro Panese
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Dell'Angelo, 30174 Venice, Italy
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile "S.S. Giovanni e Paolo", 30122 Venice, Italy
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| |
Collapse
|
2
|
Sagoe KWC, Atuahene K, Ayiku ANA, Pappoe-Ashong PJ, Boamah I, Till H, Hagbe FS, Egyire IK, Nyampong M, Addo SA, Manu A, Noora CL, Tetteh M, Ankomah A, Adanu R. Hepatitis B and human immunodeficiency virus infections within correctional facilities in Ghana. PLoS One 2023; 18:e0293009. [PMID: 37922278 PMCID: PMC10624276 DOI: 10.1371/journal.pone.0293009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 10/03/2023] [Indexed: 11/05/2023] Open
Abstract
Previous studies have suggested high Immunodeficiency Virus (HIV) and hepatitis B virus (HBV) prevalence in prisons in Ghana. However, this study was part of a nationally representative bio-behavioural survey and determined the prevalence of HIV and HBV among prison inmates and identified factors associated with these infections. Both biomedical and behavioural data were collected from a total of 2,443 prison inmates from 19 prison stations during 2013 in Ghana; 12 male prisons and 7 female prisons selected across the country. The national HIV screening algorithm was used for HIV testing while two rapid detection tests were used to confirm HBV infections. HIV and HBV prevalence among prisoners in Ghana were approximately 2.34% and 12.38% respectively. Only 5 inmates, had co-infection with both viruses. The prevalence of HIV was significantly lower among male inmates (1.5%) compared to the female inmates (11.8%). Age, sex, and marital status, were significantly associated with both HIV and HBV infections. However, BMI category, IDU, and time spent in prison were associated with HIV infections. The educational level was significantly associated with HBV infections. After binary logistic regression, being female (AOR: 0.18, 95% CI: 0.07-0.45, p<0.001) and having a stay of 5 years or more (AOR: 0.07, 95% CI: 0.01-0.60, p = 0.016), increased the risk of having HIV infection. While, those with no formal education (AOR: 0.65, 95% CI: 0.45-0.95, p = 0.024) and are underweight (AOR: 0.51, 95% CI: 0.27-0.99, p = 0.046), were more likely to have HBV infection. Forced penetrative sex may be a problem in the prisons. The need to have and strengthen an integrated screening, treatment and vaccination plan for the prison is emphasized. The prison does not serve as an exceptionally high risk to the general population. The findings support a critical look at the issue of forced penetrative sex in the prisons.
Collapse
Affiliation(s)
- Kwamena W. C. Sagoe
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Angela N. A. Ayiku
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prince J. Pappoe-Ashong
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Isaac Boamah
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Holger Till
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH, Accra, Ghana
| | | | | | | | | | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Charles L. Noora
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Millicent Tetteh
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH, Accra, Ghana
| | - Augustine Ankomah
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Richard Adanu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
3
|
Tsegay B, Gebrecherkos T, Kahsay AG, Abdulkader M. Seroprevalence and Associated Factors of Hepatitis B and Hepatitis C Viral Infections Among Prisoners in Tigrai, Northern Ethiopia. Infect Drug Resist 2023; 16:3743-3750. [PMID: 37333685 PMCID: PMC10276587 DOI: 10.2147/idr.s410017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/07/2023] [Indexed: 06/20/2023] Open
Abstract
Background Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigrai, Ethiopia. Methods A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20 and p<0.05 was considered statistically significant. Results The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18-25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15-13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17-7.74, p=0.022) were significantly associated with HBV infections. Conclusion The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.
Collapse
Affiliation(s)
- Belaynesh Tsegay
- Ayder Comprehensive Specialized Hospital Laboratory Department, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| | - Teklay Gebrecherkos
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| | - Atsebaha Gebrekidan Kahsay
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| | - Mahmud Abdulkader
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Northern Ethiopia
| |
Collapse
|
4
|
Prevalence of overt and occult hepatitis B virus infection among an incarcerated population of Central-Western Brazil. Acta Trop 2023; 241:106886. [PMID: 36871619 DOI: 10.1016/j.actatropica.2023.106886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/03/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
Brazilian prison complexes are characterized by overcrowded cells and precarious conditions, leading to chronically low vacancy. Brazilian studies involving overt and occult infection (OBI) in this population are still scarce despite the vulnerability of people deprived of liberty to hepatitis B. Therefore, this study estimated the prevalence of HBV infection (overall and OBI) in individuals deprived of liberty in prisons in Central-Western Brazil. In addition, factors associated with HBV infection were evaluated. This cross-sectional study was conducted with a total of 1083 prisoners who were tested for serological hepatitis B markers and HBV DNA from 2017 to 2020. Factors associated with lifetime HBV infection were investigated using logistic regression. An overall prevalence of HBV infection of 10.1% (95% CI: 8.42-12.11) was detected. Only 32.8% (95% CI: 30.08-35.76) had isolated anti-HBs positivity (serological evidence of HBV vaccination). Indeed, more than half of the population was susceptible to HBV infection (57.1%; 95% CI: 54.15-60.13). HBV DNA was detected in one HBsAg-positive sample (n=1/9; 11%). Also, HBV DNA was detected in five HBsAg-negative samples (n=5/1074), resulting in a prevalence of 0.5% (95% CI: 0.15-1.08) for occult infection. After the multivariate analysis, sexual intercourse with a partner living with HIV was a predictor independently associated with HBV exposure (OR: 4.3; 95% CI: 1.26-14.55; p<0.020). These data demonstrate the need for preventive measures, mainly aimed at health education and better strategies for hepatitis B screening to control this infection in prisons more effectively.
Collapse
|
5
|
Seroprevalence and factors associated with hepatitis B virus exposure in the incarcerated population from southern Brazil. PLoS One 2022; 17:e0278029. [PMID: 36413542 PMCID: PMC9681091 DOI: 10.1371/journal.pone.0278029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022] Open
Abstract
Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9-12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32-9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58-9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03-2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12-2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48-4.64). The findings indicate that public policies-including vaccination, early diagnosis, harm reduction strategies, and adequate treatment-should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.
Collapse
|
6
|
Mawuli G, Dzudzor B, Tachi K, Kuma AABA, Odame-Aboagye J, Obeng BM, Boateng AT, Edu-Quansah EP, Attiku KO, Agbosu E, Arjarquah A, Bonney JHK. Hepatitis C virus (HCV) infection among patients with sickle cell disease at the Korle-Bu teaching hospital. Virol J 2022; 19:73. [PMID: 35459145 PMCID: PMC9026067 DOI: 10.1186/s12985-022-01797-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/11/2022] [Indexed: 11/12/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection is a blood borne infection that remains potentially transmissible through blood transfusions. Sickle cell disease (SCD) is a common inheritable haemoglobinopathy in Ghana that requires multiple blood transfusions as part of its management. The SCD patient is therefore at a high risk of HCV infection; however, data on the occurrence of HCV in SCD patients has not been documented in Ghana. This study sought to determine the prevalence and genotypes of HCV infection in SCD patients. Materials and methods This was a cross-sectional study which enrolled 141 sickle-cell disease patients from the Ghana Institute for Clinical Genetics, Korle-Bu Teaching Hospital (KBTH). Patient information was obtained through a structured questionnaire. Aliquots of the plasma obtained was used for both serology with Advanced Quality Rapid Anti-HCV Test Strip and molecular testing by RT-PCR with primers targeting the HCV core gene. The amplified DNA were purified and subjected to phylogenetic analysis to characterize HCV genotypes. Results Twelve (9%) out of the 141 patients were sero-positive for HCV total antibodies. HCV RNA was amplified from 8 (6%) out of the total number of patients’ samples. One of the 12 sero-positives was HCV RNA positive. Five (63%) out of the 8 HCV RNA positive samples were successfully sequenced. The phylogenetic tree constructed with the study and GenBank reference sequences, clustered all five study sequences into HCV genotype 1. Conclusion The HCV seroprevalence of 9% among sickle cell disease patients is higher than reported for the general Ghanaian population which is 3%. Genotype 1 is the common HCV genotype infecting SCD patients. Sickle cell disease is likely to be a high-risk group for HCV inapparent infections in Ghana as seroprevalence does not correlate with viremia. However, even with higher seroprevalence, the group must be given priority in resource allocation for preventive, diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Gifty Mawuli
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana.,Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Kenneth Tachi
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | | | - James Odame-Aboagye
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | | | - Anthony Twumasi Boateng
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | | | - Keren Okyerebea Attiku
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | - Esinam Agbosu
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | - Augustina Arjarquah
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | - Joseph Humphrey Kofi Bonney
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana.
| |
Collapse
|
7
|
Global prevalence of hepatitis C in prisoners: a comprehensive systematic review and meta-analysis. Arch Virol 2022; 167:1025-1039. [PMID: 35165781 DOI: 10.1007/s00705-022-05382-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/21/2021] [Indexed: 12/11/2022]
Abstract
Hepatitis C virus (HCV), one of the most significant causes of liver inflammation, has a high annual mortality rate. The unfavorable hygiene conditions and inadequate health monitoring in many prisons increase the risk of blood-borne infections such as hepatitis C. The growing incidence of this disease among prisoners results in overspill transmission to the general population from undiagnosed prisoners that have been released. Therefore, the aim of this study was to investigate the prevalence of hepatitis C among the world's prison population. A systematic review and meta-analysis of studies on the prevalence of hepatitis C was carried out using the keywords "Prevalence", "Hepatitis C", and "Prisoner" in the Iranian and international databases SID, MagIran, Iran Doc, Science Direct, Scopus, PubMed, and Web of Science (WoS) from January 1990 to September 2020. After transferring the articles to the information management software EndNote and eliminating duplicate studies, the remaining studies were reviewed based on inclusion and exclusion criteria, three stages of primary and secondary evaluation, and qualitative evaluation. Comprehensive meta-analysis software and Begg and Mazumdar and I2 tests were used for data analysis and assessment of dissemination bias, and heterogeneity, respectively. Out of 93 studies (22 from Asia, 26 from Europe, seven from Africa, 29 from America, and nine from Australia) with a total sample size of 145,823 subjects, the prevalence of hepatitis C in prisoners worldwide was estimated to be 17.7% (95% confidence interval, 15-20.7%). The highest prevalence of hepatitis C on the continents included in this study was reported in prisoners incarcerated in Australia and Oceania, with 28.4% (95% CI: 21.6-36.4) in nine studies, and Europe, with 25.1% (95% CI: 19.4-31.8) in 26 studies. All studies used an ELISA test for the detection of HCV antibodies. The results showed a prevalence of HCV of 17.7% in prisoners worldwide, ranging between 10 and 30% over five continents (Asia, Europe, America, Africa, and Australia and Oceania). The highest prevalence was reported in Australia and Oceania (28.4%), indicating the need to pay more attention to this issue on the continent. It is necessary to reduce the incidence of the disease in prisons by appropriate policy-making and the development of accurate and practical programs, including the distribution of free syringes and examination, testing, and screening of prisoners.
Collapse
|
8
|
Kowo MP, Andoulo FA, Sizimboue DT, Ndam AWN, Ngek LT, Kouanfack C, Leundji H, Djanteng R, Ondo BE, Torimiro JN, Ndam ECN, Njoya O. Seroprevalence of hepatitis B and associated factors among inmates: a cross sectional study in the Douala New Bell Prison, Cameroon. Pan Afr Med J 2021; 38:355. [PMID: 34367434 PMCID: PMC8309011 DOI: 10.11604/pamj.2021.38.355.20386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/08/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction in Cameroon, data on viral hepatitis B infection in prison environments is limited. We determined the prevalence of hepatitis B infection (HBV) and correlates among prisoners incarcerated at the Douala New Bell Central Prison in Cameroon. Methods this was a cross-sectional study carried out in July 2018 and included 940 randomly selected prisoners. Data were collected using pre-tested questionnaire while blood screening for HBV surface antigen (HBs Ag) used rapid test, with confirmation via Elisa test. Sociodemographic characteristics and risk factors were compared among the three age groups with respect to the prison's partitioning. Factors associated with positive HBs Ag were identified using logistic regression adjusted to age and gender. Confounders were then excluded by logistic multivariate analysis. All p values less than 0.05 were considered statistically significant. Results of the 940 prisoners selected, 94% were male. The mean age of the study population was 33.81 ± 10.35 years. The median duration of incarceration and median number of incarcerations were 12 months (IQR: 5-36) and 1 (IQR: 1-2) respectively. HBV prevalence was 12.9% (95% CI: 10.7-15%). The use of non-injectable illicit drugs (OR: 3.5; 95% CI: 1.9-6.2; P<0.001), sharing of needle or razors (aOR: 24.1; 95% CI: 12.9-45.0; P<0.001), sharing of tooth brushes(aOR: 2.7; 95% CI: 0.9-7.4) (P=0.053), having tattoos or piercings (aOR: 1.9; 95% CI: 1.1-3.1; P=0.01) were significantly associated with HBs Ag seropositivity. Conclusion prisoners in this setting had a high prevalence of HBV and related risk factors. These findings highlight an urgent need to implement control strategies and programs that reach people in detention centers in Cameroon.
Collapse
Affiliation(s)
- Mathurin Pierre Kowo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | | | - Larry Tangie Ngek
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Charles Kouanfack
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | | | | | | | | | | | - Oudou Njoya
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| |
Collapse
|
9
|
Dan-Nwafor CC, Adeoye I, Aderemi K, Onuoha M, Adedire E, Bashorun A, Osunkwo D, Gidado S, Balogun M, Idris S, Ade-Yusuf I, Udom E, Nguku P. Serological markers and risk factors associated with Hepatitis B virus infection among Federal Capital Territory prison inmates, Nigeria: Should we be concerned? PLoS One 2021; 16:e0248045. [PMID: 33705419 PMCID: PMC7951833 DOI: 10.1371/journal.pone.0248045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 02/18/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Hepatitis B virus (HBV) infection is hyper-endemic in Nigeria. Prisons are high-risk environments for the spread of infectious diseases. Worldwide, seroprevalence of HBV infection is substantially higher among individuals in correctional facilities when compared to general population. We determined the seroprevalence and risk factors associated with HBV infection among Kuje prison inmates, Nigeria. Material and methods We conducted a prison facility based cross-sectional study. Interviewer administered questionnaires were used to obtain information on participants socio-demographic characteristics, HBV risk factors, previous HBV test and vaccination history. Blood samples collected from participants were analysed for HBsAg, HBsAb, HBcAb, HBeAg and HBeAb markers using rapid lateral chromatographic immunoassay kit. Univariate, bivariate, and multivariate analysis were performed. Results A total of 271 inmates (63 convicts and 208 awaiting trial inmates) were recruited into the study as participants. The mean age of the participants was 32.7 SD±9 years. HBV seroprevalence (HBsAg) of 13.7% (95% CI: 9.8–18.3) was found. 55.4% (95% CI: 49.2–61.4) of inmates were susceptible to HBV infection, 20.7% (95%CI; 16.0–26.0) had past HBV infection while 10.3% (95% CI: 7.0–14.6) had acquired natural or artificial HBV immunity. Factors found to be associated with current HBV infection (HBsAg) include age-group ≤25years (aOR = 8.0,95% CI: 2.9–22.3), being ever married (aOR = 4.2, 95% CI: 1.7–10.4) and history of alcohol consumption (aOR = 3.4, 95% CI: 1.3–8.4). Conclusion This study reveals a high seroprevalence of HBV infection among Kuje Prison inmates, hence the need to introduce prison-focused health intervention initiatives such as HBV screening, vaccination and care to reduce the transmission of HBV infection among inmates and ultimately the general population.
Collapse
Affiliation(s)
- Chioma Cindy Dan-Nwafor
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
- * E-mail:
| | - Ikeola Adeoye
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Kehinde Aderemi
- Department of Medical Microbiology and Parasitology, College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Martins Onuoha
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
- Nigerian Prisons Service Headquarters, Abuja, Nigeria
| | - Elizabeth Adedire
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
| | - Adebobola Bashorun
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
| | - Damaris Osunkwo
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
| | - Saheed Gidado
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
| | - Muhammad Balogun
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
| | - Suleiman Idris
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Ekpedeme Udom
- Nigerian Prisons Service Headquarters, Abuja, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Decatur, Georgia, United States of America
| |
Collapse
|
10
|
Okafor IM, Ugwu SO, Okoroiwu HU. Hepatitis C virus infection and its associated factors among prisoners in a Nigerian prison. BMC Gastroenterol 2020; 20:360. [PMID: 33126856 PMCID: PMC7602341 DOI: 10.1186/s12876-020-01504-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background The prison population is considered at high risk of acquiring infectious diseases due to confined conditions, behavioral factors, injection drug use, unprotected sexual activity, non-professional tattooing and scarification, and needle sharing. Hepatitis C virus (HCV) is a blood borne pathogen mostly transmitted via percutaneous exposure that results in inflammation of the liver. It is one of the public health problem worldwide and is the principal cause of parenterally transmitted non-A, non-B hepatitis. The study was aimed at evaluating the prevalence of HCV among prison inmates in Calabar, Cross River State, Nigeria and the associated factors. Methods The study took a descriptive cross sectional approach using multi-stage sampling technique. One hundred and forty-two (142) prison inmates within the age range of 18–50 years and above were recruited for this study. Result Forty two (42); [29.6%] of the participating prison inmates were seropositive for HCV. Gender stratification showed that 31.0% of the males were seropositive for HCV while 15.4% of the females were seropositive for HCV. Fisher exact test showed that gender, age, marital status, occupation and level of education had no association in distribution of seroprevalence of HCV (p > 0.05) but the duration in prison was significantly associated with distribution of seropositivity of HCV in the studied population (p < 0.05). Bivariate logistic regression showed that tattoo/scarification, injection drug use, history of blood transfusion, sexual experience, shaving equipment sharing and multiple sexual partners were not risk factor for distribution of HCV prevalence in the studied population (p > 0.05). However, 23.5% who had tattoo/scarification, 29.6% who used injection drug, 33.3% who had history of blood transfusion, 29.8% who had sexual experience, 21.2% who shared shaving equipment, and 28.3% who had multiple sex partners were seropositive for HCV. Conclusion Approximately 29.6% prevalence of Hepatitis C virus infection observed among inmates studied is high and calls for concern. Attitude and behaviors by inmates such as tattooing/scarification, injection drugs use, sharing of shaving equipment, multiple sexual partners should be discouraged.
Collapse
Affiliation(s)
- Ifeyinwa M Okafor
- Haematology Unit, Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Solomon O Ugwu
- Haematology Unit, Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Henshaw U Okoroiwu
- Haematology Unit, Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| |
Collapse
|
11
|
Owusu DO, Phillips R, Owusu M, Sarfo FS, Frempong M. Increased levels of circulating IL-10 in persons recovered from hepatitis C virus (HCV) infection compared with persons with active HCV infection. BMC Res Notes 2020; 13:472. [PMID: 33028385 PMCID: PMC7542684 DOI: 10.1186/s13104-020-05313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Approximately 70% of all hepatitis C (HCV) infections develop chronic disease. Active or exacerbated chronic hepatitis C infection subsequently progress to liver disease. The role of T-cells secretions in achieving viral clearance is still not well understood. Thus, the current study was set to determine the relationship between the T cell cytokine profiles, biochemical parameters and persistent HCV infection or spontaneous recovery. RESULTS Twenty-five percent (41/163) of the anti-HCV positive participants had recovered from HCV and had significantly higher concentration of IL-10 compared to those with active HCV infection (P < 0.012). Other circulating cytokines measured; IL-2, IFN gamma, TNF alpha, IL-5 and IL-17 were similar in both groups. Participants with active HCV infection had significantly higher aspartate transaminase (AST) (35 units) and alanine transaminase (46 units) compared to those in the recovered state (P < 0.001). Thus, serum levels of IL10 could be explored in larger prospective cohort study as a predictive marker of recovering from an active HCV infection.
Collapse
Affiliation(s)
- Dorcas Ohui Owusu
- Department of Medical Laboratory Technology, Garden City University College (GCUC), P.O. Box 12775, Kumasi, Ghana.
| | - Richard Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), PMB, KNUST, Kumasi, Ghana
| | - Michael Owusu
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology (KNUST), University Post Office, Kumasi, Ghana
| | - Fred Stephen Sarfo
- Department of Medicine, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana
| | - Margaret Frempong
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
12
|
Kose S, Adar P, Gozaydin A, Kuzucu L, Akkoclu G. Hepatitis B and Hepatitis C in prisons: a prevalence study. Int J Prison Health 2019; 15:162-167. [PMID: 31172859 DOI: 10.1108/ijph-01-2018-0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Prisons, which are hazardous places for various contagious diseases, carry additional risks for HBV and HCV because of the communal lifestyle (common use of tools like razor blades, tattoo applications, intravenous drug use and homosexual intercourse). The purpose of this paper is to determine the prevalence of HBV and HCV, and also provide information for prisoners in this respect. DESIGN/METHODOLOGY/APPROACH This study included 180 prisoners from the Buca F-Type Closed Prison, and 180 prisoners from the Foça Open Prison in Turkey. After the training seminars, serum levels of HBsAg, anti HBs, anti HBc total and anti HCV in the prisoners were assessed using the MICROELISA method. FINDINGS All the prisoners were male. The mean age was 40(21-73) years. According to the results of 360 prisoners from both prisons, 17 (4.7 percent) prisoners were HBsAg positive and were diagnosed as HBV. Isolated anti HBs was positive in 33 (9.1 percent) prisoners who had been previously vaccinated. In 25 (6.9 percent) prisoners isolated Anti HBc total was positive, and in 61 (16.9 percent) prisoners both Anti HBs and Anti HBc total was positive in those who were considered to be recovered from the HBV. Anti HCV was positive in 2 (0.5 percent) prisoners; the process was repeated twice, and found to be repeatedly positive. Coinfection of HBV and HCV was not detected. RESEARCH LIMITATIONS/IMPLICATIONS In this study, the prevalence of HBV and HCV was determined to be similar to those in the normal population. However, it is not expedient to generalize this result and apply it to all prisons. For the sake of public health, prisons should be scanned for infectious diseases, and vaccinations must be applied as necessary, in order to provide protection. ORIGINALITY/VALUE It is a study to determine the prevalence of HBV and HCV in the prisoner population, which constitute one of the risk groups because of the communal lifestyle (common use of some tools such as the razor blade, tattoo applications, intravenous drug use and homosexual intercourse), and to compare the results with other groups in Turkey and globally.
Collapse
Affiliation(s)
- Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Pelin Adar
- Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.,Department of Infectious Diseases and Clinical Microbiology, Kelkit State Hospital, Gumushane, Turkey
| | - Ayhan Gozaydin
- Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Lutfiye Kuzucu
- Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gulgun Akkoclu
- Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| |
Collapse
|
13
|
Anfaara FW, Atuoye KN, Mkandawire P, Luginaah I. Factors associated with voluntary testing for HBV in the Upper West Region of Ghana. Health Place 2018; 54:85-91. [PMID: 30248596 DOI: 10.1016/j.healthplace.2018.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 08/17/2018] [Accepted: 09/12/2018] [Indexed: 02/03/2023]
Abstract
This study examined the role of health facilities on testing for Hepatitis B virus in a policy context where screening is only available at a cost. We fitted multivariate multinomial logistic regression models to cross-sectional data (n = 1374) collected from Upper West Region of Ghana. The analysis showed that approximately 28% of respondents reported ever testing for HBV. Although source of healthcare influenced HBV testing, traders (RRR = 0.29, p ≤ 0.001) and farmers (RRR = 0.34, p ≤ 0.01) were significantly less likely to test voluntarily. Wealth generally predicted voluntary testing, although less so for mandatory testing. The findings highlight the need for free HBV services targeting the very poor, especially those who use community-level health facilities as their primary source of care.
Collapse
Affiliation(s)
- Florence Wullo Anfaara
- Environmental Hazards and Health Lab, Department of Geography, Western University, London, Ontario, Canada.
| | - Kilian Nasung Atuoye
- Environmental Hazards and Health Lab, Department of Geography, Western University, London, Ontario, Canada.
| | - Paul Mkandawire
- Institute of Interdisciplinary Studies, Human Rights Program, Carleton University, Ottawa, Canada.
| | - Isaac Luginaah
- Department of Geography, Western University, London, Ontario, Canada.
| |
Collapse
|
14
|
Golrokhi R, Farhoudi B, Taj L, Pahlaviani FG, Mazaheri-Tehrani E, Cossarizza A, SeyedAlinaghi S, Mohraz M, Voltarelli FA. HIV Prevalence and Correlations in Prisons in Different Regions of the World: A Review Article. Open AIDS J 2018; 12:81-92. [PMID: 30369993 PMCID: PMC6176549 DOI: 10.2174/1874613601812010081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 02/08/2023] Open
Abstract
The prevalence of HIV is substantially higher among prisoners than the general population, while the incidence varies considerably in different regions around the world. If we consider Sub-Saharan Africa as one region with the highest prevalence of HIV, data on African prisoners would be limited. Despite the low prevalence of HIV in the Middle East and North Africa, its incidence is rising in these regions with a few exceptions; there are insufficient data on HIV prevalence in prisons. A similar situation is present in both Pacific and Central Asia as well as in Eastern Europe. A high rate of infection is mainly observed among prisoners in Western and Central parts of Europe, since the data from these are more available than other parts. Nowadays, the sexual transmission mode and tattooing are important ways in HIV risks among prisoners after injecting drug use as the most common route of HIV transmission in all regions. However, it is difficult to compare and analyze the prevalence of HIV among prisoners in different regions regarding the limited data and different methods which they used in collecting data. Eventually, it can certainly be said that prisons are one of the high-risk places for HIV transmission; on the other hand, can be a suitable place for implementing HIV case-finding, linkage to treatment and harm reduction programs.
Collapse
Affiliation(s)
- Raheleh Golrokhi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Farhoudi
- Clinical Research Development Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Leila Taj
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Golsoorat Pahlaviani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mazaheri-Tehrani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Andrea Cossarizza
- University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabrício Azevedo Voltarelli
- Federal University of Mato Grosso, Graduation Program in Health Sciences, Faculty of Medicine, Cuiabá, Brazil
| |
Collapse
|
15
|
Pontali E, Bobbio N, Zaccardi M, Urciuoli R. Blood-borne viral co-infections among human immunodeficiency virus-infected inmates. Int J Prison Health 2017; 12:88-97. [PMID: 27219906 DOI: 10.1108/ijph-07-2015-0022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose - The purpose of this paper is to evaluate the prevalence of HBV and/or HCV co-infection among HIV-infected inmates entering the correctional facility. Design/methodology/approach - Prospective collection of data of HIV-infected inmates entered the institution over a ten-year period. Findings - During study period 365 consecutive different inmates were evaluated. HCV co-infection was observed in more than 80 per cent of the tested HIV-infected inmates, past HBV infection in 71.6 per cent and active HBV co-infection was detected in 7.1 per cent; triple coinfection (HIV, HCV and HBs-Ag positivity) was present in 6 per cent of the total. Originality/value - This study confirms high prevalence of co-infections among HIV-infected inmates. Testing for HBV and HCV in all HIV-infected inmates at entry in any correctional system is recommended to identify those in need of specific care and/or preventing interventions.
Collapse
Affiliation(s)
- Emanuele Pontali
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy AND Department of Health in Prison, ASL3 Genovese, Prison of Genoa-Marassi, Genoa, Italy
| | - Nicoletta Bobbio
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy AND Department of Health in Prison, ASL3 Genovese, Prison of Genoa-Marassi, Genoa, Italy
| | - Marilena Zaccardi
- Department of Health in Prison, ASL3 Genovese, Prison of Genoa-Marassi, Genoa, Italy
| | - Renato Urciuoli
- Department of Health in Prison, ASL3 Genovese, Prison of Genoa-Marassi, Genoa, Italy
| |
Collapse
|
16
|
Jaquet A, Nouaman M, Tine J, Tanon A, Anoma C, Inwoley A, Attia A, Ekouevi DK, Seydi M, Dabis F, Wandeler G. Hepatitis B treatment eligibility in West Africa: Uncertainties and need for prospective cohort studies. Liver Int 2017; 37:1116-1121. [PMID: 28561454 PMCID: PMC5524454 DOI: 10.1111/liv.13484] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/26/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV-infected persons in need of antiviral therapy in these settings. METHODS Prisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg-positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy. RESULTS Of 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25-33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication. CONCLUSIONS Among vulnerable populations in West Africa, a minority of HBV-infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti-HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.
Collapse
Affiliation(s)
- Antoine Jaquet
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France,Inserm, ISPED, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | | | - Judicaël Tine
- Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Senegal
| | - Aristophane Tanon
- Service de maladies infectieuses et tropicales, CHU de Treichville, Abidjan, Cote d’Ivoire
| | - Camille Anoma
- ONG Clinique de Confiance d’Abidjan, Abidjan, Cote d’Ivoire
| | | | - Alain Attia
- Service de hépato-gastroentérologie, CHU de Yopougon, Abidjan, Cote d’Ivoire
| | - Didier K. Ekouevi
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France,Inserm, ISPED, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France,Programme PACCI, CHU de Treichville, Abidjan, Cote d’Ivoire,Département de Santé Publique, Faculté des Sciences de la santé, Université de Lome, Lome, Togo
| | - Moussa Seydi
- Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Senegal
| | - François Dabis
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France,Inserm, ISPED, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Gilles Wandeler
- Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Senegal,Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland,Institute of Social and Preventive Medicine, University of Bern, Switzerland
| |
Collapse
|
17
|
Sarkodie F, Hassall O, Owusu-Dabo E, Owusu-Ofori S, Bates I, Bygbjerg IC, Owusu-Ofori A, Harritshøj LH, Ullum H. Improving the screening of blood donors with syphilis rapid diagnostic test (RDT) and rapid plasma reagin (RPR) in low- and middle-income countries (LMIC). Transfus Med 2016; 27:52-59. [PMID: 27723157 DOI: 10.1111/tme.12363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/12/2016] [Accepted: 09/14/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Syphilis testing conventionally relies on a combination of non-treponemal and treponemal tests. The primary objective of this study was to describe the positive predictive value (PPV) of a screening algorithm in a combination of a treponemal rapid diagnostic test (RDT) and rapid plasma reagin (RPR) test at Komfo Anokye Teaching Hospital (KATH), Ghana. MATERIALS AND METHODS From February 2014 to January 2015, 5 mL of venous blood samples were taken from 16 016 blood donors and tested with a treponemal RDT; 5 mL of venous blood was taken from 526 consenting initial syphilis sero-reactive blood donors. These RDT reactive samples were confirmed with an algorithm, applying the Vitros® /Abbott-Architect® algorithm as gold standard. RESULTS A total of 478 of 526 RDT reactive donors were confirmed positive for syphilis, making a PPV of 90·9%. Of the 172 (32·7%) donors who were also RPR positive, 167 were confirmed, resulting in a PPV of 97·1%. The PPV of the combined RDT and RPR (suspected active syphilis) testing algorithm was highest among donors at an enhanced risk of syphilis, family/replacement donors (99·9%), and among voluntary donors above 25 years (98·6%). DISCUSSION Screening of blood donors by combining syphilis RDT and RPR with relatively good PPV may provide a reasonable technology for LMIC that has a limited capacity for testing and can contribute to the improvement of blood safety with a minimal loss of donors.
Collapse
Affiliation(s)
- F Sarkodie
- Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana.,Faculty of Health and Life Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - O Hassall
- Faculty of Health and Life Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - E Owusu-Dabo
- School of Public Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S Owusu-Ofori
- Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - I Bates
- Faculty of Health and Life Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - I C Bygbjerg
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - A Owusu-Ofori
- Department of Clinical Microbiology Kumasi, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - L H Harritshøj
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - H Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
18
|
Epidemiology of hepatitis C virus in Ghana: a systematic review and meta-analysis. BMC Infect Dis 2016; 16:391. [PMID: 27507267 PMCID: PMC4977883 DOI: 10.1186/s12879-016-1708-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/12/2016] [Indexed: 02/07/2023] Open
Abstract
Background To fully understand the burden of hepatitis C (HCV) infection in Ghana towards informing appropriate preventive measures, accurate prevalence estimates are needed. In this study, we estimate the prevalence of chronic HCV infection by systematically reviewing primary studies published between 1995 and 2015. Methods A systematic review and meta-analysis was conducted as per the PRISMA guidelines. Comprehensive searches for hepatitis C prevalence studies for the years 1995–2015 were conducted in PubMed, ScienceDirect, Google Scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus databases. We also searched the websites of the ministry of health and Ghana Health service for non-indexed studies or reports on the subject. Further systematic reference screening of published reviews and retrieved studies were also conducted to identify additional publications not captured through the online searches. Results Twenty-Four (24) studies from nine regions of Ghana with a combined sample size of 100,782 were analyzed. No study involving participants from Upper West region was retrieved. The national prevalence of chronic HCV was estimated as 3.0 % (95 % CI = 2.6 % to 3.5 %; I2 = 97.61 %, p < 0. 001). Prevalence rates of chronic HCV infection among blood donors was 2.6 % (95 % CI = 2.1 % to 3.1 %; I2 = 98.33 %, p < 0.001) with higher prevalence rate estimated for replacement blood donors (RBDs) than voluntary blood donors (RBDs). Among pregnant women and parturients, anti-HCV seroprevalence was estimated as 4.6 % (95 % CI = 1.8 % to 7.5 %; I2 = 75.74 %, p = 0.016). The national prevalence of HIV/HCV co-infection was also estimated as 2.8 % (95 % CI = 0.4-6 %; I2 = 65.86 %, p = 0.0053). Regional prevalence of chronic HCV infection were determined for Ashanti (1.5 %, 95 % CI = 1.2 % to 1.9 %; I2 = 96.24 %, p < 0.001) and Greater Accra (6.4 %, 95 % CI = 4.2 % to 8.6 %; I2 = I2 = 88.5 %, P < 0. 001) regions but no estimates were available for the other eight regions. The ascending order of HCV prevalence rates according to years in which studies were conducted was 2006–2010 < 2011–2015 < 1995–2002 < 2001–2005. Higher prevalence of chronic HCV infection was estimated for rural (5.7; 95 % CI 5.0–6.3 %; I2 = 0, p = 0.804) than urban (2.6 %, 95 % CI = 2.1 % to 3.0 %; I2 = 97.3 %, p = 0.0001) settings. Conclusion Our study demonstrates a high prevalence of chronic hepatitis C infection in Ghana. This highlights the urgent need for stronger commitments from government and all stakeholders within the country to outline efficient preventive and curative measures towards reducing the overall burden of the disease.
Collapse
|
19
|
Jaquet A, Wandeler G, Tine J, Dagnra CA, Attia A, Patassi A, Ndiaye A, de Ledinghen V, Ekouevi DK, Seydi M, Dabis F. HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa. BMC Infect Dis 2016; 16:249. [PMID: 27267370 PMCID: PMC4895802 DOI: 10.1186/s12879-016-1601-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 05/27/2016] [Indexed: 12/26/2022] Open
Abstract
Background Prisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa. Methods Screening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis. Results Overall, 680 inmates were included with a median age of 30 years [interquartile range: 24–35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8–32.1), HBV infection (OR = 4.8; CI 1.8–12.8), HCV infection (OR = 52.6; CI 4.1–673.8), use of traditional medicines (OR = 3.7; CI 1.4–10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1–9.8) compared to Dakar. Conclusions HIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.
Collapse
Affiliation(s)
- Antoine Jaquet
- Université Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France. .,INSERM, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France.
| | - Gilles Wandeler
- Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Sénégal.,Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Judicaël Tine
- Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Sénégal
| | - Claver A Dagnra
- Service de virologie, BIOLIM, Université de Lomé, Lomé, Togo
| | - Alain Attia
- Service de hépato-gastroentérologie, CHU de Yopougon, Abidjan, Côte d'Ivoire
| | - Akouda Patassi
- Service de maladies infectieuses et tropicales, CHU Sylvanus Olympio, Lomé, Togo
| | | | - Victor de Ledinghen
- Centre d'investigation de la fibrose hepatique, Hopital Haut-Leveque, CHU de Bordeaux & INSERM U1053, Université de Bordeaux, Bordeaux, France
| | - Didier K Ekouevi
- Université Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France.,INSERM, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France.,Département de Santé Publique, Faculté des Sciences de la santé, Université de Lomé, Lomé, Togo
| | - Moussa Seydi
- Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Sénégal
| | - François Dabis
- Université Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France.,INSERM, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France
| |
Collapse
|
20
|
Kok MO, Gyapong JO, Wolffers I, Ofori-Adjei D, Ruitenberg J. Which health research gets used and why? An empirical analysis of 30 cases. Health Res Policy Syst 2016; 14:36. [PMID: 27188305 PMCID: PMC4869365 DOI: 10.1186/s12961-016-0107-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 04/21/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While health research is considered essential for improving health worldwide, it remains unclear how it is best organized to contribute to health. This study examined research that was part of a Ghanaian-Dutch research program that aimed to increase the likelihood that results would be used by funding research that focused on national research priorities and was led by local researchers. The aim of this study was to map the contribution of this research to action and examine which features of research and translation processes were associated with the use of the results. METHODS Using Contribution Mapping, we systematically examined how 30 studies evolved and how results were used to contribute to action. We combined interviews with 113 purposively selected key informants, document analysis and triangulation to map how research and translation processes evolved and contributions to action were realized. After each case was analysed separately, a cross-case analysis was conducted to identify patterns in the association between features of research processes and the use of research. RESULTS The results of 20 of the 30 studies were used to contribute to action within 12 months. The priority setting and proposal selection process led to the funding of studies which were from the outset closely aligned with health sector priorities. Research was most likely to be used when it was initiated and conducted by people who were in a position to use their results in their own work. The results of 17 out of 18 of these user-initiated studies were translated into action. Other features of research that appeared to contribute to its use were involving potential key users in formulating proposals and developing recommendations. CONCLUSIONS Our study underlines the importance of supporting research that meets locally-expressed needs and that is led by people embedded in the contexts in which results can be used. Supporting the involvement of health sector professionals in the design, conduct and interpretation of research appears to be an especially worthwhile investment.
Collapse
Affiliation(s)
- Maarten Olivier Kok
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
- VU University Amsterdam, Amsterdam, The Netherlands.
| | | | - Ivan Wolffers
- Department of Health Care and Culture, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - David Ofori-Adjei
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | |
Collapse
|
21
|
Pacher BM, Costa MRBD, Nascimento MMPD, Moura MCD, Passos ADC. Hepatitis B and C in a Brazilian deaf community. Rev Soc Bras Med Trop 2016; 48:603-6. [PMID: 26516972 DOI: 10.1590/0037-8682-0058-2015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/11/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Although deaf people are exposed to hepatitis B and C risk factors, epidemiological studies regarding these diseases in deaf people are lacking. METHODS After watching an explanatory digital versatile disc (DVD) in Brazilian Sign Language, 88 deaf people were interviewed and tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc), and hepatitis C virus antibody (anti-HCV). RESULTS The prevalence of hepatitis B markers was 8%; they were associated with incarceration and being born outside the State of São Paulo. No cases of hepatitis C were identified. CONCLUSIONS Participants showed a substantial lack of knowledge regarding viral hepatitis, indicating a need for public policies that consider linguistic and cultural profiles.
Collapse
Affiliation(s)
- Bianca Messenberg Pacher
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marina Ribeiro Barreto da Costa
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Afonso Dinis Costa Passos
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
22
|
Ofori-Asenso R, Agyeman AA. Hepatitis B in Ghana: a systematic review & meta-analysis of prevalence studies (1995-2015). BMC Infect Dis 2016; 16:130. [PMID: 26987556 PMCID: PMC4797341 DOI: 10.1186/s12879-016-1467-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/15/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although, chronic hepatitis B (HBV) is considered to be of significant public health importance in Ghana, not many reviews detailing the burden (prevalence) of the disease have been conducted. This study was aimed at summarizing the available information and to make an accurate estimate of HBV infection prevalence in Ghana over the last two decades (1995-2015). METHODS A systematic search was conducted in PubMed, ScienceDirect, Google Scholar and Africa Journals Online (AJOL) databases to retrieve primary studies published between 1st January 1995 and 4th October 2015, assessing the prevalence of HBV among populations in Ghana. This was supplemented by a manual search of retrieved references. RESULTS Thirty (30) studies across all the ten (10) regions of Ghana and involving an overall population size of 105,435 were analyzed. The national prevalence of HBV as determined by HBsAg seropositivity was 12.3%. HBV prevalence among voluntary blood donors (VBDs), replacement blood donors (RBDs) and pregnant women were 10.8, 12.7 and 13.1% respectively. HBV infection prevalence was highest among studies published within the period 1995-2002 (17.3%), followed by those published within 2003-2009 (14.7%) and the lowest prevalence rate being recorded across studies published in the period 2010-2015 (10.2%). Regional prevalence were determined for Ashanti, Greater Accra, Eastern, Northern, central and Brong-Ahafo regions as 13.1, 10.6, 13.6, 13.1, 11.5 and 13.7% respectively. No aggregate data were derived for Volta, Western, Upper East and Upper West regions. Higher prevalence of HBV infection was attained for rural (13.3%) compared to urban settings (12.2%). Across the country, highest HBV infection prevalence rates were recorded in persons within the age group 16-39 years. CONCLUSION Hepatitis B infection is clearly an important public health problem in Ghana. The burden of the disease as dictated by a high prevalence rate calls for urgent public health interventions and strategic policy directions to controlling the disease to avert any potential future explosion.
Collapse
|
23
|
Aslamkhan M, Qadeer M, Akhtar M, Ellahi F. Pre-blood-donation screening of volunteer prisoners for hepatitis B and C in prisons of the Punjab, Pakistan. ACTA MEDICA INTERNATIONAL 2016. [DOI: 10.5530/ami.2016.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
24
|
Abstract
PURPOSE The purpose of this paper is to discuss the extent of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) crisis in Lebanese prisons, propose functional reforms for Roumieh prisons (the country's largest male top-security prison), and outline the main challenges to HIV/AIDS prevention, intervention, and treatment. DESIGN/METHODOLOGY/APPROACH All recommendations were based on previous successful stories, international prison standards as well as cultural considerations. FINDINGS This paper argues that prevention and interventions starts within the prison community including inmates, guards, and other prison and provision of appropriate health care, education, and prison infrastructure. SOCIAL IMPLICATIONS These strategies are not only important in limiting prevention and transmission of HIV/AIDS, but also contribute in optimizing quality of life within the prison system. ORIGINALITY/VALUE This paper is the first of its kind to discuss the prison situation in Lebanese prisons in terms of public health promotion and reforms.
Collapse
Affiliation(s)
- Diala Ammar
- Assistant Professor, based at the Department of Social Sciences, Lebanese American University, Beirut, Lebanon
| | | |
Collapse
|
25
|
Magri MC, Ibrahim KY, Pinto WP, França FODS, Bernardo WM, Tengan FM. Prevalence of hepatitis C virus in Brazil's inmate population: a systematic review. Rev Saude Publica 2015; 49:36. [PMID: 26247383 PMCID: PMC4544450 DOI: 10.1590/s0034-8910.2015049005886] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 12/05/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of hepatitis C virus infection in Brazil’s inmate population. METHODS Systematic review on hepatitis C virus infection in the inmate population. Brazilian studies published from January 1, 1989 to February 20, 2014 were evaluated. The methodological quality of the studies was assessed using a scale of 0 to 8 points. RESULTS Eleven eligible studies were analyzed and provided data on hepatitis C virus infection among 4,375 inmates from seven states of Brazil, with a mean quality classification of 7.4. The overall hepatitis C virus prevalence among Brazilian inmates was 13.6% (ranging from 1.0% to 41.0%, depending on the study). The chances of inmates being seropositive for hepatitis C virus in the states of Minas Gerais (MG), Sergipe (SE), Mato Grosso do Sul (MS), Rio Grande do Sul (RS), Goiás (GO) and Espirito Santo (ES) were 84.0% (95%CI 0.06;0.45), 92.0% (95%CI 0.04;0.13), 88.0% (95%CI 0.09;0.18), 74.0% (95%CI 0.16;0.42), 84.0% (95%CI 0.08;0.31) and 89.0% (95%CI 0.01;0.05) respectively, lower than that observed in the Sao Paulo state (seroprevalence of 29.3%). The four studies conducted in the city of Sao Paulo revealed a lower prevalence in more recent studies compared to older ones. CONCLUSIONS The highest prevalence of hepatitis C virus infection in Brazil’s inmate population was found in Sao Paulo, which may reflect the urban diversity of the country. Despite Brazilian studies having good methodological quality to evaluate the prevalence of the hepatitis C virus, they are scarce and lack data on risk factors associated with this infection, which could support decisions on prevention and implementation of public health policies for Brazilian prisons.
Collapse
Affiliation(s)
- Mariana Cavalheiro Magri
- Laboratório de Investigação Médica em Hepatologia por Vírus, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Karim Yaqub Ibrahim
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Walkyria Pereira Pinto
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - Wanderley Marques Bernardo
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Fátima Mitiko Tengan
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
26
|
Shirani K, Nokhodian Z, Kassaian N, Adibi P, Naeini AE, Ataei B. The prevalence of isolated hepatitis B core antibody and its related risk factors among male injected drug users in Isfahan prisons. Adv Biomed Res 2015; 4:17. [PMID: 25709982 PMCID: PMC4333428 DOI: 10.4103/2277-9175.148675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 02/19/2014] [Indexed: 01/15/2023] Open
Abstract
Background: The prevalence of isolated hepatitis B core antibody (anti-HBc) varies between 1% and 30% in different populations. Isolated anti-HBc-positive patients who suffer from occult hepatitis B virus (HBV) infection have the potential to transmit HBV infection. So isolated anti-HBc screening is a valuable tool to prevent HBV transmission. Considering the importance of isolated anti-HBc screening and high prevalence of HBV among injected drug users (IDU) prisoners, we designed this study to evaluate the isolated anti-HBc positivity among inmates with the history of IDU in our area. Materials and Methods: We did this cross-sectional study from September 2009 to March 2010 among volunteer male IDU prisoners in Isfahan. Blood samples were taken from all of subjects and tested for HBV markers. Then a questionnaire containing socio-demographic, drug histories and high risk behaviors information was completed for all participants. Data analysis was done utilizing univariate analysis and multiple logistic regressions. A P < 0.05 was considered significant. Results: Totally 970 male IDU prisoners (mean age 32.6 ± 8.1) were included in our study. The prevalence of isolated HBc Ab was 4.5%. Isolated anti-HBc significantly was related to tooth filling (OR: 2.62, CI: 1.20-7.14) and imprisonment (OR: 3.95, CI: 1.39-11.18). We couldn’t find any relationship between isolated anti-HBc positivity and addiction duration, incarceration frequency, recent incarceration duration or number of injection per month. Conclusion: For screening high risk groups in parallel with hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb) and other viral markers, maybe it is better to check HBcAb too, because isolated HBcAb-positive patients may have occult hepatitis B infection which could transfer the infection to others.
Collapse
Affiliation(s)
- Kiana Shirani
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zary Nokhodian
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Kassaian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Department of Gastroenterology, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Emami Naeini
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
27
|
Maan MA, Hussain F, Jamil M. Epidemiology of hepatitis C viral infection in Faisalabad, Pakistan: a retrospective study (2010-2012). Afr Health Sci 2014; 14:810-5. [PMID: 25834487 DOI: 10.4314/ahs.v14i4.6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hepatitis viral infections are major health challenge leading to high morbidity and mortality worldwide. OBJECTIVES Although the magnitude of hepatitis in Pakistan has been well documented, information regarding the prevalence of hepatitis C virus (HCV) infection in Faisalabad, Pakistan is scarce. The present retrospective study was undertaken to determine the epidemiology of HCV in Faisalabad, Pakistan. METHODS Between May, 2010 and December, 2012, medical records of 39780 subjects visiting sexually transmitted infections (STIs) clinic, district headquarter (DHQ) hospital, Faisalabad, Pakistan were reviewed. Regression analysis was used to determine independent risk factors. RESULTS HCV prevalence was 21.99%. With mean age of 49.5 ± 2.7 years (range 27-63 years), majority (67.15%) of the individuals were male. Marital status and low literacy rates were associated with HCV (P<0.05). Reference to the potential risk factors, the injection drug use was the major mode (72.77%) of infection transmission. Age (OR 1.5, 95% CI 1.2-1.9), male gender (OR 1.2, 95% CI 0.9-1.6) and injection use (OR 1.9, 95% CI 1.0-2.7) were significantly associated with HCV. CONCLUSIONS Most important finding was higher HCV prevalence in Faisalabad region as compared to the previous assessments that demands an urgent need for preventive intervention strategies.
Collapse
Affiliation(s)
- Muhammad Arif Maan
- Punjab Medical College/Sexually Transmitted Infections (STIs) clinic, District Headquarter (DHQ) hospital, Department of Dermatology
| | - Fatma Hussain
- University of Agriculture, Department of Chemistry and Biochemistry
| | - Muhammad Jamil
- Clinical Pathology Laboratory, District Headquarter Hospital
| |
Collapse
|
28
|
Epidemiology of HIV among female sex workers, their clients, men who have sex with men and people who inject drugs in West and Central Africa. J Int AIDS Soc 2013; 16 Suppl 3:18751. [PMID: 24321113 PMCID: PMC3852130 DOI: 10.7448/ias.16.4.18751] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/26/2013] [Accepted: 09/25/2013] [Indexed: 11/12/2022] Open
Abstract
Introduction
The West and Central Africa (WCA) sub-region is the most populous region of sub-Saharan Africa (SSA), with an estimated population of 356 million living in 24 countries. The HIV epidemic in WCA appears to have distinct dynamics compared to the rest of SSA, being more concentrated among key populations such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and clients of FSWs. To explore the epidemiology of HIV in the region, a systematic review of HIV literature among key populations in WCA was conducted since the onset of the HIV epidemic. Methods
We searched the databases PubMed, CINAHL and others for peer-reviewed articles regarding FSWs, MSM and PWID in 24 countries with no date restriction. Inclusion criteria were sensitive and focused on inclusion of any HIV prevalence data among key populations. HIV prevalence was pooled, and in each country key themes were extracted from the literature. Results
The search generated 885 titles, 214 abstracts and 122 full articles, of which 76 met inclusion and exclusion criteria providing HIV prevalence data. There were 60 articles characterizing the burden of disease among FSWs, eight for their clients, one for both, six for MSM and one for PWID. The pooled HIV prevalence among FSWs was 34.9% (n=14,388/41,270), among their clients was 7.3% (n=435/5986), among MSM was 17.7% (n=656/3714) and among PWID from one study in Nigeria was 3.8% (n=56/1459). Conclusions
The disproportionate burden of HIV among FSWs appears to be consistent from the beginning of the HIV epidemic in WCA. While there are less data for other key populations such as clients of FSWs and MSM, the prevalence of HIV is higher among these men compared to other men in the region. There have been sporadic reports among PWID, but limited research on the burden of HIV among these men and women. These data affirm that the HIV epidemic in WCA appears to be far more concentrated among key populations than the epidemics in Southern and Eastern Africa. Evidence-based HIV prevention, treatment and care programmes in WCA should focus on engaging populations with the greatest burden of disease in the continuum of HIV care.
Collapse
|
29
|
|
30
|
Mkandawire P, Richmond C, Dixon J, Luginaah IN, Tobias J. Hepatitis B in Ghana's upper west region: A hidden epidemic in need of national policy attention. Health Place 2013; 23:89-96. [DOI: 10.1016/j.healthplace.2013.06.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 05/17/2013] [Accepted: 06/02/2013] [Indexed: 10/26/2022]
|
31
|
Mamoojee Y, Tan G, Gittins S, Sarfo S, Stephenson L, Carrington D, Bedu-Addo G, Phillips R, Appiah LT, Chadwick D. Diagnosis of treponemal co-infection in HIV-infected West Africans. Trop Med Int Health 2012; 17:1521-6. [DOI: 10.1111/j.1365-3156.2012.03090.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
32
|
Reid SE, Topp SM, Turnbull ER, Hatwiinda S, Harris JB, Maggard KR, Roberts ST, Kruuner A, Morse JC, Kapata N, Chisela C, Henostroza G. Tuberculosis and HIV Control in Sub-Saharan African Prisons: "Thinking Outside the Prison Cell". J Infect Dis 2012; 205 Suppl 2:S265-73. [DOI: 10.1093/infdis/jis029] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
33
|
Tresó B, Barcsay E, Tarján A, Horváth G, Dencs A, Hettmann A, Csépai MM, Gyori Z, Rusvai E, Takács M. Prevalence and correlates of HCV, HVB, and HIV infection among prison inmates and staff, Hungary. J Urban Health 2012; 89:108-16. [PMID: 22143408 PMCID: PMC3284587 DOI: 10.1007/s11524-011-9626-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim of this national, multicenter, cross-sectional study was to assess the prevalence of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency viruses (HIV) among prisoners, and to identify related risk behaviors including injection drug use. Overall, 4,894 inmates from 20 prisons were enrolled. To have a comparison group, prison staff were also asked to take part. Altogether, 1,553 of the 4,894 inmates from seven prisons completed a questionnaire on risk behaviors. According to the survey, 1.5%, 4.9%, and 0.04% of the prisoners were tested positive for HBsAg, anti-HCV and anti-HIV, respectively. These prevalence data are among the lowest reported from prisons worldwide, although comparable to the Central European data. The prevalence of HBV, HCV, and HIV in the Hungarian prison staff was low (0.38%, 0.47%, and 0%, respectively). The rate of HCV infection was significantly higher among inmates who have ever injected drugs (22.5%) than among inmates who reported they had never injected drugs (1.1%). This first prevalence study of illegal drug injection-related viral infections among Hungarian prisoners points out that ever injecting drugs is the main reason for HCV infection among inmates. The opportunity to reach drug users infected with HCV for treatment underlines the importance of screening programs for blood-borne viruses in prisons.
Collapse
Affiliation(s)
- Bálint Tresó
- National Center for Epidemiology, Budapest, Hungary
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Peña-Orellana M, Hernández-Viver A, Caraballo-Correa G, Albizu-García CE. Prevalence of HCV risk behaviors among prison inmates: tattooing and injection drug use. J Health Care Poor Underserved 2011; 22:962-82. [PMID: 21841290 DOI: 10.1353/hpu.2011.0084] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hepatitis C virus (HCV) is the most common blood-borne chronic viral infection in the United States and it is over represented in incarcerated populations. This study estimates if in prison tattooing is associated with self reported HCV infection in a probabilistic sample of 1,331 sentenced inmates in Puerto Rico prisons anonymously surveyed in 2004, who had previously been tested for HCV. Analysis were carried out with the total sample and among non-injectors (n=796) to control for injection drug use (IDU) and other confounders. Nearly 60% of inmates had acquired tattoos in prison. HCV was reported by 27% of subjects in the total sample and by 12% of non-injectors who had undergone tattoos in prison. IDU was the strongest predictor of HCV in the total sample (OR=5.6, 95% CI=3.2-9.7). Among non injectors, tattooing with reused needles or sharp objects and/ or reusing ink was positively associated with HCV self-report (OR=2.6, 95% CI=1.3-5.5). Tattooing is a common occurrence in this prison setting. Findings suggest that preventive interventions are required to reduce the risk of HCV transmission through unsterile tattooing and injection practices.
Collapse
Affiliation(s)
- Marisol Peña-Orellana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | | | | | | |
Collapse
|
35
|
Jürgens R, Nowak M, Day M. HIV and incarceration: prisons and detention. J Int AIDS Soc 2011; 14:26. [PMID: 21595957 PMCID: PMC3123257 DOI: 10.1186/1758-2652-14-26] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 05/19/2011] [Indexed: 11/18/2022] Open
Abstract
The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners.The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.
Collapse
Affiliation(s)
- Ralf Jürgens
- 97 de Koninck, Mille-Isles, Quebec, J0R 1A0, Canada
| | - Manfred Nowak
- University Vienna; Director, Ludwig Boltzmann Institute of Human Rights, Vienna; UN Special Rapporteur on Torture; Ludwig Boltzmann Institute of Human Rights, Freyung 6/2, 1010 Vienna, Austria
| | - Marcus Day
- Caribbean Drug & Alcohol Research Institute, Box 1419, Castries, Saint Lucia
| |
Collapse
|
36
|
Sekar R, Amudhan M, Sivashankar M, Mythreyee M. Higher prevalence of sexually transmissible co-infections among the human immunodeficiency virus-infected population of South India. J Med Microbiol 2010; 60:394-395. [PMID: 21127159 DOI: 10.1099/jmm.0.024000-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Ramalingam Sekar
- Department of Microbiology, Faculty of Medicine, Government Theni Medical College, Tamilnadu Dr M. G. R. Medical University, Theni 625512, India
| | - Murugesan Amudhan
- Department of Microbiology, Faculty of Medicine, Government Theni Medical College, Tamilnadu Dr M. G. R. Medical University, Theni 625512, India
| | - Moorthy Sivashankar
- Department of Microbiology, Faculty of Medicine, Government Theni Medical College, Tamilnadu Dr M. G. R. Medical University, Theni 625512, India
| | - Manoharan Mythreyee
- Department of Microbiology, Faculty of Medicine, Government Theni Medical College, Tamilnadu Dr M. G. R. Medical University, Theni 625512, India
| |
Collapse
|
37
|
Awofeso N. Prisons as social determinants of hepatitis C virus and tuberculosis infections. Public Health Rep 2010; 125 Suppl 4:25-33. [PMID: 20626190 DOI: 10.1177/00333549101250s406] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Effects of place or neighborhood--locations where individuals reside, shop, recreate, and work--have been widely studied as sources of environmental influences on individual behaviors, exposures, and physiology, as well as reference points for public health interventions. However, despite modern prisons' strong influence on the transmission and clinical outcomes of infectious diseases, custodial authorities and public health officials in many countries have yet to implement credible interventions to minimize the adverse impacts prison settings exert on the epidemiology of communicable diseases--particularly with respect to inmates. Among many vulnerable populations, prisons are evolving as one of the social institutions that determine their health status and health outcomes. This article highlights the effects of prisons in mediating the risk of hepatitis C virus and tuberculosis infections, as well as feasible interventions and policy approaches for limiting the deleterious consequences prisons exert on the transmission and clinical courses of these diseases.
Collapse
Affiliation(s)
- Niyi Awofeso
- School of Population Health, The University of Western Australia, c/o M431, 35 Stirling Hwy, Crawley, WA 6009, Australia.
| |
Collapse
|
38
|
Ko N, Yen C, Chen C, Lee H, Ko W, Lin H, Hsu S. Applying the Transtheoretical Model to the Readiness to Change Blood‐Borne Virus Transmission Behaviors among Drug‐Dependent Inmates. Am J Addict 2010; 19:433-9. [DOI: 10.1111/j.1521-0391.2010.00068.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nai‐Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
- Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Cheng‐Fang Yen
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University and Hospital, Kaohsiung, Taiwan
| | - Cheng‐Hui Chen
- Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hsin‐Chun Lee
- Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Wen‐Chien Ko
- Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Hsi‐Hsun Lin
- Department of Internal Medicine, Section of Infectious Diseases, Department of Medicine, E‐Da Hospital and I‐Shou University, Kaohsiung County, Taiwan
| | - Su‐Ting Hsu
- Department of Psychiatry, Chang‐Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung County, Taiwan
- School of Medicine, Chang‐Gung University, Taoyuan, Taiwan
| |
Collapse
|
39
|
Detection of highly prevalent hepatitis B virus coinfection among HIV-seropositive persons in Ghana. J Clin Microbiol 2010; 48:3223-30. [PMID: 20631103 DOI: 10.1128/jcm.02231-09] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Simple hepatitis B surface antigen (HBsAg) tests may facilitate ascertainment of hepatitis B virus (HBV) infection in settings with high endemicity but limited infrastructure. We evaluated two rapid HBsAg tests and characterized HBV coinfection in a Ghanaian HIV-positive cohort. Samples from 838 patients were tested by the rapid assays Determine and Vikia and the reference assays Architect, Murex version 3, and Liaison Ultra. The assays were also evaluated using the 2nd International Standard, a seroconversion panel, and two mutant panels. HBsAg-positive samples underwent HBV DNA quantification by real-time PCR and surface and polymerase gene population sequencing. Overall, 140/838 patients (16.7%; 95% confidence interval, 14.2 to 19.2%) were HBsAg positive, and of these, 103/140 (73.6%) were e-antigen negative and 118/140 (84.3%) showed an HBV DNA level of >14 IU/ml (median, 8,279 IU/ml). Assay sensitivities and specificities were as follows: Architect, 97.9 and 99.6%; Liaison, 97.1 and 99.4%; Murex, 98.6 and 99.3%; Determine, 69.3 and 100%; and Vikia, 70.7 and 100%. With Determine, the limit of detection was >1.5 to 3.4 HBsAg IU/ml, and the median HBV DNA loads were 598 and 10,905 IU/ml in Determine-negative and -positive samples, respectively (P = 0.0005). Results were similar with the Vikia assay. HBV DNA sequencing indicated infection with genotype E in 82/86 (95.3%) patients. HBsAg mutations affected assay performance, including a T123A mutant that escaped detection by Architect. Major drug resistance mutations were observed in 4/86 patients (4.6%). The prevalence of HBV coinfection was high in this HIV-positive Ghanaian cohort. The two rapid assays identified HBsAg-positive patients at risk for liver disease with high specificity, albeit with only moderate sensitivity.
Collapse
|
40
|
Kheirandish P, SeyedAlinaghi S, Jahani M, Shirzad H, Seyed Ahmadian M, Majidi A, Sharifi A, Hosseini M, Mohraz M, McFarland W. Prevalence and correlates of hepatitis C infection among male injection drug users in detention, Tehran, Iran. J Urban Health 2009; 86:902-8. [PMID: 19844670 PMCID: PMC2791818 DOI: 10.1007/s11524-009-9393-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
For the benefit of planning for the future care and treatment of people infected with hepatitis C virus (HCV) and to help guide prevention and control programs, data are needed on HCV seroprevalence and associated risk factors. We conducted a cross-sectional sero-behavioral survey of injection drug users (IDU) detained for mandatory rehabilitation during a police sweep of Tehran, Iran, in early 2006. During the study period, a consecutive sample comprising 454 of 499 (91.0%) men arrested and determined to be IDU by urine test and physical examination consented to a face-to-face interview and blood collection for HCV antibody testing. Overall, HCV prevalence was 80.0% (95% confidence interval (CI) 76.2-83.6). Factors independently associated with HCV infection included history of incarceration (adjusted OR 4.35, 95% CI 1.88-10.08), age of first injection < or =25 years (OR 2.72, 95% CI 1.09-6.82), and history of tattooing (OR 2.33, 95% CI 1.05-5.17). HCV prevalence in this population of IDU upon intake to jail was extremely high and possibly approaching saturation. Findings support that incarceration is contributing to the increased spread of HCV infection in Iran and calls for urgent increased availability of HCV treatment, long-term preparation for the care of complications of chronic infection, and rapid scale-up of programs for the primary prevention of parenterally transmitted infections among drug users.
Collapse
Affiliation(s)
- Parastoo Kheirandish
- Iranian Research Center for HIV/AIDS (IRCHA), Department of Infectious and Tropical Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Coelho HC, Oliveira SAND, Miguel JC, Oliveira MDLA, Figueiredo JFDC, Perdoná GC, Passos ADC. Predictive markers for hepatitis C virus infection among Brazilian inmates. Rev Soc Bras Med Trop 2009; 42:369-72. [DOI: 10.1590/s0037-86822009000400002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 07/20/2009] [Indexed: 11/22/2022] Open
Abstract
Hepatitis C virus (HCV) infection has quite high prevalence in the prison system, reaching rates of up to 40%. This survey aimed to estimate the prevalence of HCV infection and evaluate risk factors for this exposure among male inmates at the Ribeirão Preto Prison, State of São Paulo, Brazil, between May and August 2003. A total of 333 participants were interviewed using a standardized questionnaire and underwent immunoenzymatic assaying to investigate anti-HCV. The prevalence of HCV infection among the inmates was 8.7% (95% CI: 5.7-11.7). The participants'mean age was 30.1 years, and the prevalence was predominantly among individuals over 30 years of age. Multivariate analysis showed that the variables that were independently associated with HCV infection were age > 30 years, tattooing, history of previous hepatitis, previous injection drug use and previous needle-sharing.
Collapse
|
42
|
Coelho HC, Oliveira SAND, Miguel JC, Oliveira MDLA, Figueiredo JFDC, Perdoná GC, Passos ADC. Soroprevalência da infecção pelo vírus da Hepatite B em uma prisão brasileira. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2009. [DOI: 10.1590/s1415-790x2009000200003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Esta pesquisa objetivou estimar a prevalência do marcador do HBV e seus fatores de risco na população masculina carcerária da Penitenciária de Ribeirão Preto - SP, Brasil. De 1.030 presidiários, foram sorteados 333 participantes, os quais foram submetidos à aplicação de um questionário e à coleta de sangue, no período de maio a agosto de 2003. Para diagnóstico de exposição ao HBV foi utilizado o ensaio imunoabsorvente de ligação de enzimas (ELISA) para detecção dos marcadores HBsAg, anti-HBsAg e anti-HBc total. A prevalência total de infecção pelo HBV nos presidiários foi de 19,5% (IC95%: 15,2 - 23,8). A média de idade dos participantes foi de 30,1 anos. Na análise univariada, a infecção pelo HBV esteve associada à idade acima de 30 anos (p<0,001), uso prévio de drogas injetáveis (p<0,001) e compartilhamento de agulhas prévio (p<0,001). Em um modelo multivariado, de regressão logística, a infecção pelo HBV foi associada à idade acima de 30 anos (OR = 3,3: IC95%: 1,8 - 6.1) e uso prévio de droga injetável (OR = 2,7; IC95%: 1.9 - 6.4). Infecção pelo HBV nas prisões representa grave problema de saúde pública, principalmente relacionado à idade acima de 30 anos e uso prévio de drogas injetáveis.
Collapse
|
43
|
Nyirenda M, Beadsworth MBJ, Stephany P, Hart CA, Hart IJ, Munthali C, Beeching NJ, Zijlstra EE. Prevalence of infection with hepatitis B and C virus and coinfection with HIV in medical inpatients in Malawi. J Infect 2008; 57:72-7. [PMID: 18555534 DOI: 10.1016/j.jinf.2008.05.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Revised: 05/12/2008] [Accepted: 05/12/2008] [Indexed: 01/03/2023]
Abstract
BACKGROUND Coinfection with hepatitis B (HBV) or hepatitis C (HCV) adversely affects the prognosis of HIV infection and vice versa, and results in complex interactions with antiretroviral therapy. These infections are common in sub-Saharan Africa but there are few data on prevalence of coinfection. All three components of the most common ART regimen used in Africa, stavudine, lamivudine and nevirapine, can cause hepatic problems and lamivudine resistant HBV is known to emerge after HBV monotherapy in coinfected patients. Point of care (POC) tests for HBV and HCV are widely used but have not been validated in field tests in sub-Saharan Africa. METHODS Prospective observational study of sequential adult inpatients in medical wards of a large urban teaching hospital in Malawi in 2004. Comparison of demographic risk factors with HIV antibody status determined using local double POC test protocols, and with HBsAg and HCV antibody prevalence as estimated in a reference laboratory in Liverpool, UK. Results of locally performed POC tests for HBV using Determine HBsAg (Abbott) and for HCV antibody using HCV-SPOT (Genelabs) were compared with results of reference methods in the UK. RESULTS Of 226 adults (39% male), median (range) age 35 (14-80) years, 81% had a history of traditional scarification, 12% a history of blood transfusion and 11% a history of jaundice. HIV antibodies were present in 76.1%, HBsAg in 17.5% and HCV in 4.5%, with HIV/HBV coinfection in 20.4% and HIV/HCV coinfection in 5% of those with HIV. There was no correlation between prevalence of any of the three viruses and demographic risk factors or presence of either of the other two viruses. Point of care tests gave misleading results with prevalence estimates of 38% for HBV and 4.5% for HCV. For both of these POC tests the performance indices were unacceptable for individual patient management or epidemiological survey purposes. CONCLUSIONS The high prevalence of hepatitis/HIV coinfections may impact on treatment with antiretroviral therapy, especially if there are unintended interruptions of therapy, and studies are needed to document the possible clinical impact on ART programmes. The poor performance of POC tests for HBV and HCV may be due to local operational problems or to unexpected technical issues not revealed by early validation tests. These tests are widely used in resource poor settings and should be revalidated in prospective field studies in areas of the tropics with high HIV prevalence rates.
Collapse
Affiliation(s)
- M Nyirenda
- Department of Medicine, College of Medicine, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Pontali E, Ferrari F. Prevalence of Hepatitis B virus and/or Hepatitis C virus co-infections in prisoners infected with the Human Immunodeficiency Virus. Int J Prison Health 2008; 4:77-82. [PMID: 18464061 DOI: 10.1080/17449200802038207] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Correctional facilities host a disproportionately high prevalence of HBV, HCV and HIV infection. We evaluated the prevalence of HBV and/or HCV co-infection among HIV-infected inmates entering our correctional facility. Over a 30-month period, 173 consecutive HIV-infected inmates entered our institution and were evaluated. HCV co-infection was observed in more than 90% of the tested HIV-infected inmates, past HBV infection in 77.4% and active HBV co-infection in 6.7%; triple coinfection (HIV, HCV and HBs-Ag positivity) was seen in 6.1% of them. Given the observed high prevalence of co-infection, testing for HBV and HCV in all HIV-infected inmates at entry in any correctional system is recommended to identify those in need of specific care and/or preventing interventions.
Collapse
|
45
|
Adjei AA, Armah HB, Gbagbo F, Ampofo WK, Boamah I, Adu-Gyamfi C, Asare I, Hesse IFA, Mensah G. Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: A national multicenter study. BMC Infect Dis 2008; 8:33. [PMID: 18328097 PMCID: PMC2311310 DOI: 10.1186/1471-2334-8-33] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2007] [Accepted: 03/07/2008] [Indexed: 12/13/2022] Open
Abstract
Background Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana. Methods A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques. Results Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84) and 38.1 years (range 25–59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25–46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases. Conclusion The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of infection control practices and risk reduction programs targeted at prison inmates and officers in Ghana is urgently required to address this substantial exposure risk.
Collapse
Affiliation(s)
- Andrew A Adjei
- Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Adjei AA, Armah HB, Gbagbo F, Ampofo WK, Quaye IKE, Hesse IFA, Mensah G. Correlates of hepatitis C virus infection among incarcerated Ghanaians: a national multicentre study. J Med Microbiol 2007; 56:391-397. [PMID: 17314372 DOI: 10.1099/jmm.0.46859-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A national multicentre cross-sectional study was undertaken on the correlates of hepatitis C virus (HCV) infection in a sample of inmates from eight Ghanaian prisons. A total of 1366 inmates from eight of the ten regional central prisons in Ghana were enrolled between May 2004 and December 2005. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies to HCV. These data were analysed using both univariate and multivariate techniques. The median age of participants was 36.5 years (range 16-84 years). Of the 1366 inmates tested, HCV seroprevalence was 18.7%. On multivariate analysis, the independent determinants of HCV infection were being incarcerated for longer than the median time served of 36 months [odds ratio (OR) 5.8; 95% confidence interval (95% CI) 5.0-6.9], history of intravenous drug use (OR 4.5; 95% CI 3.8-5.4) and homosexuality (OR 3.1; 95% CI 2.5-3.9). Consistent with similar studies worldwide, the prevalence of HCV in prison inmates was higher than the general population in Ghana, suggesting probable transmission in prisons in Ghana through intravenous drug use and unsafe sexual behaviour.
Collapse
Affiliation(s)
- Andrew A Adjei
- Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Henry B Armah
- Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Foster Gbagbo
- Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - William K Ampofo
- Virology Unit, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Isaac K E Quaye
- Department of Medical Biochemistry, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Ian F A Hesse
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - George Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| |
Collapse
|
47
|
Azevedo RCSD, Botega NJ, Guimarães LAM. Crack users, sexual behavior and risk of HIV infection. REVISTA BRASILEIRA DE PSIQUIATRIA 2006. [DOI: 10.1590/s1516-44462006005000017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE: To compare a sample of injecting cocaine users and crack users, assessing sexual behavior, risk for infection by HIV and its seroprevalence. METHOD: 109 injecting cocaine users and 132 crack users were assessed, using the World Health Organization questionnaire from the expanded "Cross-Site Study of Behaviors and HIV Seroprevalence among Injecting Drug Users" and HIV serology. Data were assessed by Multiple Correspondences Analysis. RESULTS: Crack users showed less time of drug consumption when compared to the injecting cocaine users. Despite this fact, they had higher rates of risky sexual activity, differences in poli-consumption of drugs, and higher rates of involvement in illegal issues. HIV seroprevalence among crack users, although lower than for injecting cocaine users (7% vs. 33%) is high when compared to the general population at the same age. CONCLUSIONS: Sexual behavior of crack users in the studied sample may be considered a risk factor for HIV infection. Crack users have access to information on HIV/ AIDS, but do not make use of it to change risk behaviors that may expose them to HIV infection and dissemination. HIV seroprevalence among crack users (7%) is concerning, which makes it necessary to create preventive strategies for HIV infection and dissemination that are specifically directed toward this population.
Collapse
|
48
|
Senok AC, Botta GA. Human immunodeficiency virus and hepatitis virus infection in correctional institutions in Africa: is this the neglected source of an epidemic? J Med Microbiol 2006; 55:481-482. [PMID: 16585631 DOI: 10.1099/jmm.0.46535-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- A C Senok
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Kingdom of Bahrain
| | - G A Botta
- Udine Medical School, Department of Morphological and Medical Sciences, Pzle Kolbe 1, 33100, Udine, Italy
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Kingdom of Bahrain
| |
Collapse
|