Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors.
Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors.
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DOI：
10.1016/j.ijid.2008.06.019
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发表时间：
2009-01
影响因子：
8.4
通讯作者：
Vermund, Sten H.
中科院分区：
文献类型：
--
作者：
Ali, Syed Asad;Donahue, Rafe M. J.;Qureshi, Huma;Vermund, Sten H.
巴基斯坦是世界上慢性肝炎和肝衰竭和肝细胞癌死亡率最高的国家之一。然而，目前还没有关于B型肝炎和C型肝炎流行率和风险因素的国家一级估计数。我们回顾了13年来的医学和公共卫生文献（[Au？1]1994- 2007年9月），以估计巴基斯坦活动性B型肝炎和慢性丙型肝炎的流行率，分别分析一般和高危人群以及四个省的数据。我们纳入了84篇出版物和139项研究（42项研究有两个或更多个子研究）。研究中的方法差异使得不适合进行正式的荟萃分析来确定准确的国家患病率估计值，但我们估计了不同人群亚组的患病率可能范围。儿科人群中B型肝炎抗原患病率的加权平均值为2.4%（范围1.7-5.5%），丙型肝炎抗体患病率为2.1%（范围0.4-5.4%）。健康成人（献血者和非献血者）中B型肝炎抗原患病率的加权平均值为2.4%（范围1.4-11.0%），丙型肝炎抗体患病率为3.0%（范围0.3-31.9% [Au？2]）。高风险亚组的发生率要高得多。数据表明，在巴基斯坦不同地区，B型肝炎和丙型肝炎的发病率为中度至高度。关于巴基斯坦B型肝炎和C型肝炎传播方式的已发表文献表明，医疗保健中使用受污染的针头、滥用药物以及不安全的血液和血液制品输血是主要的致病因素。
Pakistan carries one of the world’s highest burdens of chronic hepatitis and mortality due to liver failure and hepatocellular carcinomas. However, national level estimates of the prevalence of and risk factors for hepatitis B and hepatitis C are currently not available. We reviewed the medical and public health literature over a 13-year period ([Au?1] 1994–September 2007) to estimate the prevalence of active hepatitis B and chronic hepatitis C in Pakistan, analyzing data separately for the general and high-risk populations and for each of the four provinces. We included 84 publications with 139 studies (42 studies had two or more sub-studies). Methodological differences in studies made it inappropriate to conduct a formal meta-analysis to determine accurate national prevalence estimates, but we estimated the likely range of prevalence in different population sub-groups. A weighted average of hepatitis B antigen prevalence in pediatric populations was 2.4% (range 1.7–5.5%) and for hepatitis C antibody was 2.1% (range 0.4–5.4%). A weighted average of hepatitis B antigen prevalence among healthy adults (blood donors and non-donors) was 2.4% (range 1.4–11.0%) and for hepatitis C antibody was 3.0% (range 0.3–31.9% [Au?2]). Rates in the high-risk subgroups were far higher. Data suggest a moderate to high prevalence of hepatitis B and hepatitis C in different areas of Pakistan. The published literature on the modes of transmission of hepatitis B and hepatitis C in Pakistan implicate contaminated needle use in medical care and drug abuse and unsafe blood and blood product transfusion as the major causal factors.
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影响因子：
1.8
作者：
Agresti, A;Coull, BA
通讯作者：
Coull, BA
影响因子：
2.4
作者：
Akhtar S;Younus M;Adil S;Hassan F;Jafri SH
通讯作者：
Jafri SH
影响因子：
4.3
作者：
Agboatwalla, Mubina;Isomura, Shin;Akram, Dure Samin
通讯作者：
Akram, Dure Samin
影响因子：
2.5
作者：
Akhtar, S;Younus, M;Hassan, F
通讯作者：
Hassan, F
影响因子：
2.9
作者：
Aslam, M;Aslam, J
通讯作者：
Aslam, J