Reassessment of Selected Healthcare Associated Risk Factors for Hbv and Hcv Infections among Volunteer Blood Donors, Karachi, Pakistan

By Younus, Muhammad; Siddiqi, Azfar-e-Alam et al. | Central European Journal of Public Health, March 2009 | Go to article overview

Reassessment of Selected Healthcare Associated Risk Factors for Hbv and Hcv Infections among Volunteer Blood Donors, Karachi, Pakistan


Younus, Muhammad, Siddiqi, Azfar-e-Alam, Akhtar, Saeed, Central European Journal of Public Health


SUMMARY

Epidemiologic studies conducted in the 1990s identified several independent healthcare associated risk factors for HBV and HCV infections in Pakistan. In 2002, we re-examined healthcare associated HBV and/or HCV infection risk factors in volunteer blood donors.

In this case-control study, we collected data using a structured questionnaire on socioeconomic attributes, putative healthcare related risk factors, and other known factors for HBV and HCV infections in Karachi, Pakistan.

The multivariable logistic-regression model (166 cases, 394 controls) after adjusting for socio-demographic attributes and other known HBV and HCV risk factors revealed that more cases than controls had multiple lifetime hospitalization, adjusted odds ratio (AOR)=2.48; 95% confidence interval (CI) 1.04,5.94, and had received dental treatment from an unqualified provider (AOR=5.90, CI, 1.66,21.02). More cases than controls had received a large number of therapeutic injections during the last 5 years (1-5 injections vs. 0, AOR=2.64, 95% CI 1.06,6.60; 6-19 injections vs. 0, AOR=4.09, 95% CI 1.59,10.51; ≥20 injections vs. 0,AOR=4.34, 95% CI 1.70,11.07), and had their last injection given using a re-usable glass syringe (AOR=3.41 CI 1.13,10.29).

Our data suggest that risk factors for HBV and HCV infections identified in the last decade have remained unchanged in healthcare facilities in Karachi. Additional multi-disciplinary efforts are needed to control healthcare associated HBV and HCV transmission in Pakistan.

Key words: healthcare, hepatitis B virus, hepatitis C virus, risk factors, blood donors, developing countries, Pakistan

INTRODUCTION

Inadequate infection control practices in healthcare settings have been shown by epidemiologic investigations, to contribute significantly to the global burden of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. This is particularly true in developing countries around the world such as Pakistan (1-3).

Historically hepatitis has been a menace across the world without regards to geographical boundaries, socio-cultural and economic divide. Recognizing this problem, the universal guidelines for infection control were developed in late 1980s (4), and their implementation in the developed nations has led to the application of rigorous infection control practices in healthcare settings. In conjunction with quality assurance systems, higher occupational safety standards, and greater recognition of and respect for patients' rights, the universal precautions have resulted a dramatic improvement in infection control (1, 5). The situation in developing countries such as Pakistan, however, remained unchanged, as standardized infection control did not become widely implemented and/or practiced (6).

Observational studies conducted in the past decade identified parenteral exposures in healthcare settings, including the use of unsterile medical or dental equipment, and intramuscular (IM) and intravenous (TV) therapeutic injections, as major contributors to HBV and HCV infection cases in Pakistan (7-9). In Pakistan, it wasn't until mid 1990s that the efforts were initiated by public health legislators, healthcare providers, and communities towards implementation of several infection control and prevention measures to reduce healthcare associated infections including HBV and HCV An integral part of these efforts were advocacy for campaigns for HB V vaccination. (10).

Several y ears ha ve passed since initiation of these efforts that, common sense dictates, must have had some impact on practices that were previously found to contribute to spread of HBV and/or HCV infections in Pakistan. However, no or minimal efforts have been made to gauge the impact of these efforts, or to quantitatively assess the current magnitude of healthcare associated risk factors for HBV and HCV infections.

The relative importance ofthe modes of transmission of an infectious disease can change over time, particularly when rejuvenated efforts are made to control its spread. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Reassessment of Selected Healthcare Associated Risk Factors for Hbv and Hcv Infections among Volunteer Blood Donors, Karachi, Pakistan
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.