Epidemiologic study of chronic hepatitis B virus infection in male volunteer blood donors in Karachi, Pakistan.
Epidemiologic study of chronic hepatitis B virus infection in male volunteer blood donors in Karachi, Pakistan.
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DOI：
10.1186/1471-230x-5-26
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发表时间：
2005-08-08
影响因子：
2.4
通讯作者：
Jafri SH
中科院分区：
文献类型：
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作者：
Akhtar S;Younus M;Adil S;Hassan F;Jafri SH
慢性感染B型肝炎病毒（HBV）的程度在各国之间有很大差异。更好地了解HBV感染的发病率和/或流行率以及相关的危险因素，可以深入了解这种感染在社区中的传播。本研究的目的是评估巴基斯坦卡拉奇无症状男性献血志愿者中HBV表面抗原（HBsAg）阳性率，并确定与慢性HBV感染相关的危险因素。对1998年1月1日至2002年12月31日期间在两个大型血库进行的连续献血进行评估，以估计HBsAg阳性的患病率。为了评价潜在的危险因素，实施了病例对照研究设计;病例（HBsAg阳性）和对照（HBsAg阴性）在2001年10月15日至2002年3月15日之间招募。一个预先测试的结构化问卷，通过训练有素的访问者进行管理，以收集数据的假设风险因素的HBV感染。使用市售酶联免疫吸附试验-III试剂盒检测血清中的HBsAg。男性无偿献血者HBsAg阳性率为2.0%（7048/351309）。多因素Logistic回归分析显示，在调整年龄和种族后，病例组比对照组更有可能接受不合格的牙科保健提供者的牙科治疗（调整后的比值比（OR）= 9.8; 95%置信区间（CI）：2.1，46.1），已接受1-5次注射（调整后OR = 3.3; 95% CI：1.1，9.6），在过去5年内注射5次以上（调整后OR = 1.4; 95% CI：1.4，12.7）或接受过玻璃注射器注射（调整后OR = 9.4; 95% CI：2.6，34.3）。理发师剃须时受伤导致出血（调整后OR = 2.3; 95%CI：1.1，4.8）也是HBsAg阳性的重要预测因素。卡拉奇男性无偿献血者HBsAg阳性率为2%。卫生保健机构的感染控制措施，包括安全注射做法和医疗器械的适当消毒技术，以及对理发师进行关于其器械消毒重要性的教育，可能会减少这种和类似环境中HBV感染的负担。还迫切需要制定与当地有关的指导方针，用于HBsAg阳性献血者的咨询和管理。
The magnitude of chronic infection with hepatitis B virus (HBV) varies substantially between the countries. A better understanding of incidence and/ or prevalence of HBV infection and associated risk factors provides insight into the transmission of this infection in the community. The purpose of this investigation was to estimate the prevalence of and to identify the risk factors associated with chronic infection with HBV, as assessed by HBV surface antigen (HBsAg) positivity, in asymptomatic volunteer male blood donors in Karachi, Pakistan. Consecutive blood donations made at the two large blood banks between January 1, 1998 and December 31, 2002 were assessed to estimate the prevalence of HBsAg positivity. To evaluate the potential risk factors, a case-control study design was implemented; cases (HBsAg positives) and controls (HBsAg negatives), were recruited between October 15, 2001 and March 15, 2002. A pre-tested structured questionnaire was administered through trained interviewers to collect the data on hypothesized risk factors for HBV infection. Sera were tested for HBsAg using commercially available kits for enzyme linked Immunosorbant assay-III. HBsAg prevalence in the male volunteer blood donors was 2.0 % (7048/351309). Multivariate logistic regression analysis showed that after adjusting for age and ethnicity, cases were significantly more likely than controls to have received dental treatment from un-qualified dental care provider (adjusted odds ratio (OR) = 9.8; 95% confidence interval (CI): 2.1, 46.1), have received 1–5 injections (adjusted OR = 3.3; 95% CI: 1.1, 9.6), more than 5 injections (adjusted OR = 1.4; 95% CI: 1.4, 12.7) during the last five years or have received injection through a glass syringe (adjusted OR = 9.4; 95% CI: 2.6, 34.3). Injury resulted in bleeding during shaving from barbers (adjusted OR = 2.3; 95% CI: 1.1, 4.8) was also significant predictor of HBsAg positivity. Prevalence of HBsAg positivity in the male volunteer blood donors in Karachi was 2%. Infection control measures in health-care settings including safe injection practices and proper sterilization techniques of medical instruments and education of barbers about the significance of sterilization of their instruments may reduce the burden of HBV infection in this and similar settings. There is also an urgent need of developing locally relevant guidelines for counseling and management of HBsAg positive blood donors.