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Kamel, M.A., Ghaffar, Y.A., Wasef, M.A., Wright, M., Clark,
L.C., Miller, F.D., 1992. Lancet.
340 (8816): p. 427.
This was the FIRST report in the scientific literture that HCV was an epidemic in Egypt. This report was a ground breaking
discovery of the HCV epidemic in
The epidemiology of Schistosoma mansoni, hepatitis B and hepatitis C infection in Egypt.
Kamel, M.A., Miller, F.D. and others. 1994. Annals of Tropical Medicine and Parasitology. 88 (5): 501-509.
This was the first population community based study of HCV in Egypt. The study from the urban Cairo blood donors was from blood donors and not a representative sample of a community population. Working with Dr. Rashida Barakat from the University of Alexandria, we established a study of the entire population of a remote rural village in northern Nile Delta. This would be a population based study and it would be in a rural area rather than urban Cairo and it would be remote from all major cities of Egypt. 15.9% of the village population was found positive for HCV antibody. This study was also the first to publish an age specific prevalence of HCV as shown in the figure below. The y axis on the left is the prevalence of HCV antibody and the x axis on the bottom is age.For example, people who are 40 to 44 years old, the prevalence of HCV was 36.8%. This was a remarkable discovery. We noted that the prevalence of HCV increased with age in the blood donors in the same way but only lower overall.
The role of
parenteral antischistosomal therapy in the spread of hepatitis C virus in
Christina Frank, Mostafa K Mohamed, G Thomas Strickland,
Daniel Lavanchy, Ray R Arthur, Laurence S Magder, Taha El Khoby, Yehia
Abdel-Wahab, El Said Aly Ohn, Wagida Anwar, Ismail Sallam. 2000. Lancet
2000; 355: 887–891
study suggested that the epidemic of HCV in
M. Karmochkine, F Carrat, O Dos Santos, and others. A case-control study of risk factors for hepatitis C infection in patients with unexplained routes of infection. Journal of Viral Hepatitis 13(11): 775-782. November 2006.
suggests that Iatrogenic Infections which are very important
Summarized Results from this report are:
Among the 66 items considered, multivariate analysis identified 15 independent risk factors for HCV infection:
admission to a medical facility (OR 2.1);
digestive endoscopy (OR 1.9);
admission to a surgical ward (OR 1.7);
surgical abortion (OR 1.7).>
Cutaneous ulcer or wound care (OR 10.1);
diathermy (OR 3.0);
gamma globulin administration (OR 1.7);
intravenous injections (OR = 1.7);
varicose vein sclerotherapy (OR 1.6);
acupuncture (OR 1.5);
intramuscular injections (OR 1.4).http://www2.hawaii.edu/%7Edewolfe/Iatrogenic.html
intranasal cocaine use (OR 4.5);
engaging in contact sports (OR 2.3);
beauty treatments (OR 2.0);
professional pedicure or manicure (OR 1.7).
These factors explained 73% of community-acquired HCV infections.
In conclusion, the authors wrote, "for patients with unexplained routes of HCV infection, our data incriminate previously unidentified risk factors (abortions, some dermatological procedures, outpatient injections, contact sports, beauty treatments, professional pedicure/manicure) and confirm those already recognized (hospitalization, digestive endoscopy, acupuncture and intra-nasal cocaine use)."
These results suggest that prevention education materials and programs should include a broader range of exposures and activities that may put individuals at risk for contracting HCV. They also emphasize the need for universal precautions and sterile procedures in medical settings.
Mohamed, M. K.et al. Intrafamilial transmission of hepatitis C in Egypt. Hepatology.
42: 683-7. 2000.
Mohamed, M. K.et al. Intrafamilial transmission of hepatitis C in Egypt. Hepatology. 42: 683-7. 2000.
This publication was an
important contribution to understanding HCV transmission in
conclusion is that HCV transmission is ongoing in
This report also suggests that there is transmission of HCV within household or family members. This is an unexpected and unlikely finding. The transmission of HCV virus is low even when exposed directly to for example a needle contaminated with blood from a person known to have HCV viremia. We know this from studies of accidental needle stick injury.
This report did not demonstrate exactly how HCV transmission occurred within the family. Only indirect evidence was given. Also the absolute numbers of new incident cases in the study was small, 28 cases in one village and 5 in the other village. Therefore the analysis was based on small numbers. It is not possible to rule out that exposure and infection of family members did not occur outside the household and confounded by health care provider.
The results from
this single prospective study have not been confirmed by other prospective
studies. Even if there were household transmission, the attributable risk of
this exposure to the total exposure of HCV infection in
report potentially stigmatizes family members who may find themselves tested
positive for HCV. This is unnecessary and unfortunate.
Saleh, DA et al. Incidence and risk factors for hepatitis C
infection in a cohort of women in rural
This very recent report estimates incidence of HCV in rural women at 0.5% per year.
El-Zanaty F, Way A. Egypt Demographic and
Health Survey 2008. Egyptian: Ministry of Health. El-Zanaty and Associates, and
This study completed the first representative national sample of HCV antibody and HCV RNA. The final estimated prevalence of HCV antibody was 14.7%. See Figure 1