PREVALENT RISK FACTORS OF HCV TRANSMISSION IN HEALTH CARE WORKERS (HCWS) IN PAKISTAN
Objective: To study and analyze the prevalent risk factors of Hepatitis C Virus (HCV) transmission in Health Care Workers (HCWs) in Pakistan
Methods: A literature survey (2005-2012) was conducted from the available literatures to identify the most prominent risk factors and prevalence rate of HCV affected workers in Pakistan. Health care workers include doctors, nurses, paramedical staffs, dispensers, laboratory technicians and pharmacists. The most common risk factors associated with the high incidence rate of HCV in HCWs are lack of well-trained paramedical staff and their non-scientific behavior, improper disposal of hospital waste, lack of sterilization facilities, poor infrastructure, direct exposure to blood and its products and finally needle stick injury.
Results: The mean prevalence of HCV in HCWs is 4.46%Â±2, with the highest prevalence (6%) in Islamabad and Rawalpindi area.
Conclusion: We recommend for the HCWs to become aware of the possible risks of HCV spread and minimize the complications of hospital care. The government should have to initiate awareness program on HCV infection among health care professionals.
2. Mathew S, Ali A, Abdel-Hafiz H, Fatima K, Suhail M, Archunan G, et al. Biomarkers for virus-induced hepatocellular carcinoma (HCC). Infect Genet Evol 2014;26:327-39.
3. Mathew S, Fatima K, Fatmi MQ, Archunan G, Ilyas M, Begum N, et al. Computational docking study of p7 Ion channel from HCV genotype 3 and genotype 4 and its interaction with natural compounds. PLoS One 2015.10. doi: 10.1371/journal.pone.0126510. [Article in Press]
4. Vinod S WN, Venkatesh V, Tandon R, Singh M, Singh R. Seropositivity rates for Hepatitis B and C viruses in a tertiary care centre of Northern India. Webmed Central Virology; 2010. p. 243-7.
5. Fatima K, Mathew S, Suhail M, Ali A, Damanhouri G, Azhar E, et al. Docking studies of pakistani HCV NS3 helicase: a possible antiviral drug target. PLoS One 2014;9.doi: 10.1371/journal.pone.0106339. [Article in Press]
6. Jagger J DCG, Perry J, Puro V, Ippolito G. Occupational exposure to bloodborne pathogens: epidemiology and prevention. In: Prevention and control of nosocomial infections. Edited. RP W. Vol. 65. 4th edn. Philadelphia: Lippincott Williams and Wilkins; 2003.
7. Beltrami EM WIT, Shapiro CN, Chamberland ME. Risk and management of blood-borne infections in health care workers. Clin Microbiol Rev 2000;13:385-407.
8. JL G. Management of occupational exposures to blood-borne viruses. N Engl J Med 1995;16:444-51.
9. Lemoine M, Nayagam S, Thursz M. Viral hepatitis in resource-limited countries and access to antiviral therapies: current and future challenges. Future Virol 2013;8:371-80.
10. Pruss-Ustun A RE, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med 2005;48:482-90.
11. Hussain S PNA, Shams R. Hepatitis B and C prevalence and prevention awareness among health care workers in a tertiary care hospital. Int J Pathol 2010;8:6-21.
12. Doddaiah V JK, Javagal S. Seroprevalence of hepatitis B virus and hepatitis C virus in healthcare Workers-AIMS, B G Nagara. Am J Life Sci 2013;1:145-9.
13. Pakistan Economic Survey; 2011-12.
14. Umar M BM, Hepatitis C, A Mega Menace. A pakistani perspective. J Pak Med Stud 2012;2:68-72.
15. Mujeeb S, A KY, Khanani R. Frequency of parenteral exposure and seroprevalence of HBV, HCV, and HIV among operation room personnel. J Hosp Infect 1998;38:133-7.
16. Hamid SS, Farooqui B, Rizvi Q, Sultana T, Siddiqui AA. Risk of transmission and features of hepatitis C after needlestick injuries. Infect Control Hosp Epidemiol 1999;20:63-4.
17. Aziz S, Memon A, Tily HI, Rasheed K, Jehangir K, Quraishy MS. Prevalence of HIV, hepatitis B and C amongst health workers of civil hospital karachi. J Pak Med Assoc 2002;52:92-4.
18. Khurum M HZ, Butt A Ul A, Faheem M. Prevalence of anti-HCV antibodies among health care workers of Rawalpindi and Islamabad. Rawal Med J 2003;28:7-11.
19. Sarwar J, Gul N, Idris M, Anis ur R, Farid J, Adeel MY. Seroprevalence of hepatitis B and hepatitis C in health care workers in Abbottabad. J Ayub Med College Abbottabad 2008;20:27-9.
20. Khan S, U AS, Ayaz S, Khan SN, Shams S, Ali I, et al. Molecular epidemiology of HCV among healthcare workers of khyber pakhtunkhwa. Virol J 2011;8:105.
21. Memon A R SK, Memon A, Draz A U, Uzair M, Rauf A, Afsar S. Hepatitis B and C prevalence among the high risks groups of pakistan. A cross sectional study. Arch Public Health 2012;70:70-9.
22. Ganju S, Goel A. Prevalence of HBV and HCV infection among health care workers. Journal of communicable diseases. Lancet 2000;32:69-71.
23. Jindal N, Jindal M, Jilani N, Kar P. Seroprevalence of hepatitis C virus (HCV) in health care workers of a tertiary care centre in New Delhi. Indian J Med Res 2006;123:179-80.
24. Poddar N LPR, Chayani N, Mohanty S, Mallick B, Pattnaik D. Seroprevalence of hepatitis-c virus in blood donors and high risk individuals. J Evol Med Dent Sci 2012;1:959-65.
25. Sharma A GR, Bhalla P. Study on prevalence of needle stick injury among health care workers in a tertiary care hospital in New Delhi: a two-year review. Indian J Public Health 2012;56:101-3.
26. Alam S AN, Khan M, Mustafa G, Al Mamun A, Mashud G. Seroprevalence of Hepatitis C Virus Infection among health care workers. J Bangladesh College Physicians Surgeons 2007;25:126-9.
27. Ghosh DK RSAS, Ghosh CK, Mahmuduzzaman M, Rahman MM, Rahaman A. The prevalence of HCV among Healthcare workers in Dhaka city. J Shaheed Suhrawardy Med College 2010;2:12-7.
28. Henderson DK. Managing occupational risks for hepatitis C transmission in the health care setting. Clin Microbiol Rev 2003;16:546-68.
29. Sepkowitz KA. Occupationally acquired infections in health care workers. Part I. Ann Intern Med 1996;125:826-34.
30. Panlilio AL OJ, Srivastava PU, Jagger J, Cohn RD, Cardo DM. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States. Infection Control Hospital Epidemiol 2004;25:556-62.
31. Rorat M JT, Szleszkowski L, Gladysz A. Outbreak of hepatitis C among patients admitted to the department of gynecology, obstetrics, and oncology. Am J Infect Control 2014;42:7-10.
32. Dawar M, Stuart TL, Sweet LE, Neatby AM, Abbott LP, Andonov AP, et al. Canadian hepatitis C look-back investigation to detect transmission from an infected general surgeon. Can J Infect Dis Med Microbiol 2010;21:e6-e11.
33. Siddique K MS, Syeda Fizza Tauqir SF, Anwar I, Malik A. Z Knowledge attitude and practices regarding needle stick injuries amongst healthcare providers. Pak J Surgery 2008;24:243-8.
34. Rele M, Mathur M, Turbadkar D. Risk of needle stick injuries in health care workers-a report. Indian J Med Microbiol 2002;20:206-7.
35. Reis C, Heisler M, Amowitz LL, Moreland RS, Mafeni JO, Anyamele C, et al. Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria. PLoS Med 2005;2:e246.
36. Joukar F, Mansour-Ghanaei F, Soati F, Meskinkhoda P. Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection. World J Gastroenterol 2012;18:2238-44.
37. D'Souza RF GM, Alstead E, Osonayo C, Foster GR. Knowledge of chronic hepatitis C among east london primary care physicians following the department of health's educational campaign. Q J Med 2004;97:331-6.
38. Ali I SL, Rehman L, Khan N, Iqbal A, Munir I, Rashid F, et al. Prevalence of HCV among the high risk groups in Khyber Pakhtunkhwa. Virol J 2011;8:296.
39. Janjua NZ HYAS. Inappropriate sharp waste disposal at first level health care facilities in Pakistan. In: In: ISQua 24th. International Conference. Vol. 618. Boston: Boston; 2007.
40. A N: Deficiencies of medical system in Pakistan. Pak J Med Edu 2003;1:6-9.
41. Kumar N SR, Ara J. Frequency of hepatitis C virus in the spouses of HCV positive patients and risk factors of the two groups. J Surg Pak 2010;9:36-9.
42. Bryant J. Organized systems of care. Am J Infect Control 1997;25:363-4.
43. Manzoor I DS, Hashmi NR, Sardar H, Babar MS, Rahman A, Malik M. Needle stick injuries in nurses at tertiary health care facility. J Ayub Med College Abbottabad 2010;22:174-8.
44. Goniewicz M W-SA, Niemcewicz M, Witt M, Marciniak-Niemcewicz A, Jarosz MJ. Injuries caused by sharp instruments among healthcare workersâ€“international and Polish perspectives. Ann Agric Environ Med 2012;19:523-7.
45. https://www.rcn.org.uk/__data/assets/pdf_file/0019/203374/003_304.pdf. [last accessed on 2015 May 02].
46. Talaat M KA, El-Shoubary W. Occupational exposure to needle sticks injuries and hepatitis B vaccination coverage among health care workers in Egypt. Am J Infect Control 2003;31:469-74.
47. Alauddin U KAB, Dar MI, Kashmiri Z U A, Batool A, Khan Q, Sanam Mohammad D. Prevalence of hepatitis B and hepatitis C among cardiac surgery patients in relation to post operative recovery. Pakistan Heart J 2007;40:31-7.
48. Monsalve-Castillo F, Gomez-Gamboa L. [Hepatitis C virus. Iatrogenic and nosocomial transmition? Invest Clin 2004;45:193-5.
49. Froio N, Nicastri E, Comandini UV, Cherubini C, Felicioni R, Solmone M, et al. Contamination by hepatitis B and C viruses in the dialysis setting. Am J Kidney Dis 2003;42:546-50.
50. Azhar S, Hassali MA, Ibrahim MI, Ahmad M, Masood I, Shafie AA. The role of pharmacists in developing countries: the current scenario in Pakistan. Hum Resour Health 2009;7:54.
51. http://www.heartfile.org/pdf/phpf-GWP.pdf. [last accessed on 2015 May 02].
52. Jiwani N GR. A silent storm: hepatitis c in pakistan. J Pak Med Stud 2011;1:89-91.
53. Akhtar S, Moatter T. Hepatitis C virus infection in polytransfused thalassemic children in Pakistan. Indian Pediatr 2004;41:1072-3.
54. Waheed Y SU, Safi SZ, Chaudhry WN, Qadri I. Awareness and risk factors associated with barbers in transmission of hepatitis B and C from Pakistani population: barberâ€™s role in viral transmission. Asian Biomed 2010;4:435-42.
55. Adams BO, Dal Poz, MR, Shengelia B, Kwankam S, Issakov A, Stilwell B, et al. Health systems performance assessment debates, Methods and Empiricism. In: Edited by Evans CJLMaDB, World Health Organization; 2003.
56. Diallo K, Zurn P, Gupta N, Dal Poz M. Monitoring and evaluation of human resources for health: an international perspective. Hum Resour Health 2003;1:3.
57. Habib F KDK, Shan-e-Abbas, Bhatti F, Zafar A. Knowledge and Beliefs among health care workers regarding hepatitis B Infection and needle stick injuries at tertiary Care hospital, Karachi. J College Physicians Surgeons Pakistan 2011;21;317-8.
58. Gurubacharya DL MKC, Karki DB. Knowledge, attitude and practices among health care workers on needle-stick injuries. Kathmandu University Med J 2003;1:91-4.
59. Mirmomen S, Alavian SM, Hajarizadeh B, Kafaee J, Yektaparast B, Zahedi MJ, et al. Epidemiology of hepatitis B, hepatitis C, and human immunodeficiency virus infecions in patients with beta-thalassemia in Iran: a multicenter study. Arch Iran Med 2006;9:319-23.
60. Kohler H. The prevalence of hepatitis C in different countries of the ERA/EDTA area. Nephrol Dial Transplant 1995;10:468-9.
61. Yazdanpanah Y, Boelle PY, Carrat F, Guiguet M, Abiteboul D, Valleron AJ. Risk of hepatitis C virus transmission to surgeons and nurses from infected patients: model-based estimates in France. J Hepatol 1999;30:765-9.
62. Hernandez ME, Bruguera M, Puyuelo T, Barrera JM, Sanchez Tapias JM, Rodes J. Risk of needle-stick injuries in the transmission of hepatitis C virus in hospital personnel. J Hepatol 1992;16:56-8.
63. Kassi M, Afghan AK, Khanani MR, Khan IA, Ali SH. Safe blood transfusion practices in blood banks of Karachi, Pakistan. Transfus Med 2011;21:57-62.
64. Rahman M JSA. Need for national blood policy to ensure safe blood transfusion. Pak J Med Sci 2004;20:81-4.
65. Z HAt. Healthcare Workers and Hepatitis C; 2006.
66. Deuffic-Burban S, Delarocque-Astagneau E, Abiteboul D, Bouvet E, Yazdanpanah Y. Blood-borne viruses in health care workers: prevention and management. J Clin Virol 2011;52:4-10.