epid hepatitis eng

8/10/2019 Epid Hepatitis Eng

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Mohamoudetal.BMCInfectiousDiseases2013,13:288

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%&'&(%C)(%*IC+& pen(ccess

*heepidemiolo-ofhepatitisCi!usin&-pt:asstematic!eiewanddatasnthesisous!a(Mohamoud1,hina%Mumta1,'uanne%iome1,DeolfeMille!"and+aith4(u$%addad1,2,35

(st!act

Bac6-!ound:&-pthasthehi-hestp!ealenceofhepatitisCi!us7)C9inthewo!ld,estimatednationall

1".#.u!stud;so%I'M(-uidelines.*hemainsou!cesofdataincluded>uMedand&masedataases.ealsousedamu

a!iate

!e-!essionmodeltoinfe!thetempo!alt!endof)Cp!ealenceamon-the-ene!alpopulationandhi-h!

populationin&-pt.

%esults:eidenti?ed1@0!eleant!eco!ds,fou!ofwhichwe!eincidencestudies.)Cincidence!an-edf!

0.8to

A.8pe!1,000pe!son$ea!s.e!all,)Cp!ealenceamon-p!e-nantwomen!an-edetween@$1@,amo

lood

dono!setween@$2@,andamon-othe!-ene!alpopulation-!oupsetween0$"0.)Cp!ealenceamo

multi$t!ansfusedpatients!an-edetween10$@@,amon-dialsispatientsetween@0$0,andamon-o

!hi-h

!is6populationsetween10and8@.)Cp!ealencea!iedwidelamon-othe!clinicalpopulationsan

populationsatinte!mediate!is6.%is6facto!sappea!toepa!ente!alanti$schistosomalthe!ap,in


2/48

ewo!ds:)epatitisCi!us,&pidemiolo-,>!ealence,Incidence,&-pt,'stematic%eiew

Bac6-!ound

*he &-ptian Demo-!aphic )ealth 'u!e 7&D

)'9, a

c!osssectionalsu!eincludin-hepatitisCi!us7)C

9

ioma!6e!s,wasconductedin2008onala!-enation

all

!ep!esentatie sample 1E. It estimated )C p!e

alence

amon- the 1@F@ ea!s a-e -!oup to e

1".# 1E.

(cco!din-l, &-pt has the hi-hest )C p!e

alence

in the wo!ld 2$"E.*his unpa!alleled leel of eGp

osu!e

5 Co!!espondence: lulic )ealth, eill Co!nell Medical Colle-e, Co!nell

Knie!sit, ew o!6, ew o!6, K'(

to this infection appea!s to !eNect a national lee

epidemic. It has een postulated that the epidemic

has een caused eGtensie iat!o-enic t!ansmission

du!in- the e!a of pa!ente!al$antischistosomal$the!ap

7>(*9 mass$t!eatment campai-ns @,AE. *oda, )C

infection and its complications a!e amon- the leadin-

pulic health challen-es in &-pt #E.

Multiple communit$ and facilit$ased studies we!e

conducted amon- di=e!ent population -!oups in &-pt

oe! the last two decades to assess the dist!iution of

infectioninthepopulation.*hesestudieshaeimmensel

imp!oed ou! unde!standin- of )C epidemiolo- in

&-pt. ee!theless, two lin-e!in- and c!itical uestions

Lull list of autho! info!mation is aailale at the end of the a!ticle

O2013Mohamoudetal.PlicenseeBioMedCent!al+td.*hisisanpen(ccessa!ticledist!iutedunde!thete!msofthe

C!eatieCommons(tt!iution+icense7http://c!eatiecommons.o!-/licenses//2.09,whichpe!mitsun!est!icteduse,

dist!iution,and!ep!oductioninanmedium,p!oidedtheo!i-inalwo!6isp!ope!lcited.
mailto:[email protected]:[email protected]


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Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e2of21


!e-a!din- )C t!ansmission in &-pt a!e et

to e

add!essedsatisfacto!il:

19 Does the hi-h )C p!ealence !eNect mainl

histo!ical eGposu!es du!in- the >(* campai-ns efo

!e

18@, with limited cu!!ent infection incidenceQ

29 If not, to what eGtent is )C t!ansmission still

on-oin-, and what a!e the d!ie!s, !is6 facto!s, a

nd

modes of this t!ansmissionQ

*heo%I'M(-uidelines8E.*he

'M(

chec6list can e found in*ale '1, see (d

onal ?le 1.

*he main data sou!ces fo! this inesti-ation

e!e:

>uMed7Medline9and&masedataases.*hea

edata

sou!ces we!e sea!ched with no time o! lan-

e !est!ic$

tions. >uMed and &mase we!e sea!ched us

oth

Me')/&mt!eete!ms,!espectiel,andteGtte!

Me')/&mt!ee te!ms we!e eGploded to coe! all su

adin-s.

Details of the sea!ch c!ite!ia fo! each of th

dataases

canefoundelow:

>uMed: 77R)epatitis CSMeshE % R)ep

is C

(ntiodiesSMeshE % R)epatitis C (nti-ens

eshE

% R)epacii!usSMeshE % R)epatitis C,

h!onic/

epidemiolo-SMeshE % R)epatitis C, ch!o

tiolo-S

MeshE% R)epatitisC, ch!onic/t!ansmissionS

shE%

R)epatitis C, ch!onic/i!olo-SMeshE %

patitis

CS*eGtE%R)CS*eGtE9(D7R&-ptSMeshE

&-pt*eGtE99.

&mase:7e-pt.mp.o!eGp&-pt/9and7eGph

titisC/

o!eGp )epatitisCi!us/o!hepatitis C.mp.o!

C.mp.

o!hepacii!us.mp.9.

&thicsstatement

u!studdidnotneedanethicscommitteeap

alo!

w!itten info!med consent ecause it !elies

!el on


4/48

pulisheddata.

'tudselection

*he !esults of the sea!ches we!e impo!ted to a !efe!en

mana-e!,&ndnote,whe!eduplicatepulicationswe!eiden$

ti?edandeGcluded.*he!emainin-uniueandpotentiall

!eleant!eco!dswe!ethenimpo!tedintoMic!osoft&Gcel

whe!e sc!eenin- fo! !eleance and eli-iilit too6 place.

*he titles and ast!acts of all !eco!ds !et!ieed we

sc!eenedfo!!eleanceindependentltwooftheautho!s

7M and '%9. 'c!eenin- fo! !eleance was conducted in

two sta-es: 19 'ta-e 1 inoled sc!eenin- all titles and

ast!acts to eGclude all non$!eleant a!ticlesP 29 'ta-e

inoled!et!iein-andsc!eenin-thefull$teGtofalla!ticles

deemed !eleant afte! the initial ast!act sc!eenin-, to

fu!the! eGclude an !emainin- non$eli-ile a!ticles.

Inconsistencies etween !eiewe!s we!e discussed and

so!tedoutconsensus.( pulication was conside!ed eli-ile fo! inclusion in

the!eiew ifithaddata onatleastoneofthefollowin-

outcomes of inte!est: 19 p!ealence of )Cas detected

)CantiodiesPand29incidenceof)Casdetected

)Cantiodies.nl studies !epo!tin- p!ima!data

we!e included. %eiews of lite!atu!e we!e eGcluded, ut

all data !epo!ted we!e chec6ed and compa!ed to the

!esults of ou! sea!ch. (n additional stud identi?ed in

theeGcluded!eiewandnot!et!ieedou!sea!chwas

identi?ed and added to ou! !eiew. Case !epo!ts and

case se!ies we!e eGcluded. (ll othe! stud desi-ns we!

eli-ile fo! inclusion. Distinction was made etween the

nume! of R!epo!tsS 7actual pulications i.e. pape!s,

confe!ence ast!acts etc.9 and the nume! of RstudiesS

7actualstudand!esea!chp!o


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$demo-!aphic cha!acte!istics of the population

a-e,!u!als.u!anetc.9,samplesie,andp!ealence

o! incidence of )C. (lthou-h ou! sea!ch c!ite!ia

not speci?call ta!-et pulications !epo!tin- )C

%(p!ealenceo!!is6facto!sin&-pt,weeGt!actedthis

info!mationf!omeli-ilepulicationswhenaailale.%is6

facto!s we!e eGt!acted onl if the we!e statisticall


6/48



si-ni?cant in a multia!iate !e-!ession analsis w

ithin a

stud that was found !eleant acco!din- to ou! se

a!ch

c!ite!ia.

Dataontheaoementionedindicato!swe!eeGt!act

ed

f!om included !eco!ds and ente!ed into a compute!

ied

dataase on Mic!osoft &Gcel. &Gt!acted data we!e

then

classi?ed and analed on the asis of the stud popula$

tion;s !is6 of acui!in- )C.*he fou! de?ned

maopulations at di!ect o! hi-h !is6: this -!oup

includes IDKs, multi$t!ansfused patients such as

hemophiliacs and thalassemics, dialsis patients,

and

i!al hepatitis patients, amon- othe!s.

29 >opulations at indi!ect o! inte!mediate !is6: this -

!oup

includes familial contacts of )C patients i.e. thei

!

child!en, spouses, and othe! household contactsP

select p!actitione!s of p!ofessions at !is6 of )C s

uch

as dentists, healthca!e wo!6e!s and a!e!sP

populations with potential IDK eGposu!es includin-:

p!isone!s and )I patientsP and populations with

health facilit/in


7/48

chan-ein)Cp!ealenceamon-the-ene!alpopulatio

n

and hi-h !is6 population in &-pt with !espect to time.

e sta!ted conductin- unia!iate linea! !e-!essio

analses eGaminin- the chan-e in )C p!ealence oe!

timeineachofthe-ene!alpopulationsu-!oupssepa!atel.

(simila!analsiswasconductedineachofthehi-h!is6

population su-!oups.*o aoid sstematic iases in an

onesu-!oupandtoinc!easethestatisticalpowe!ofthe

time t!end analsis, we also used a multia!iate linea!

!e-!ession model estimatin- the tempo!al t!end in )C

p!ealence, while ad!ealenceUV0WV1X*ime

WV2X(ntenatalclinicattendees

WV3XBlooddono!s WV"X%u!alilla-e!esidents

WV@XChild!enWVAX)ealthpopulations

WV#X(!m!ec!uitsWV8Xthe!

'imila!l, the hi-h !is6 population !e-!ession model

stipulatesthat:

Mean)C>!ealenceUV0WV1X*ime

WV2XMultiYt!ansfusedpatients

WV3X'chistosomiasispatients

WV"X*halassemicpatients

WV@Xi!alhepatitispatients

Inothmodels,Via!ethepa!amete!softhestatistical

model and *ime and su$population names a!e the

indicato! a!iales.

Data used fo! these analses we!e eGt!acted f!om th

eli-ile studies included in this !eiew. In the p!esenceof oth an oe!all )C p!ealence measu!e as well as

st!ati?ed p!ealence measu!es, we included onl the

oe!all p!ealence measu!e. Includin- oth oe!all and

st!ati?ed p!ealence measu!es f!om the same stud

would hae -ien mo!e wei-ht to those studies, !elati

to othe!s, the!e iasin- ou! !esults.*he ea! of data

collectionwasestimatedfo!studiesmissin-thisa!iale.

*his was done conductin- a co!!elation analsis

etween the ea! of data collection and the ea! of

pulicationfo!studieshain-dataonoth,followed a

pai!edt$testtoestimatethemeandi=e!enceetweenthem.

e then applied this di=e!ence to the ea! of pulicatio


8/48

stimate the ea! of data collection when missin-.

ointswe!ecalculatedandusedfo!studiesconducted

oe! a nume! of ea!s. *he statistical analsis w


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Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e"of21


conductedusin-'*(*(e!sion117'*(*(co!po!ation

,

Colle-e'tation,*eGas9.

%esults

'ea!ch!esults

*he stud selection p!ocess is desc!ied in Li-u!

e 1, as

adapted f!om the >%I'M( 200 Now dia-!am 8E.

*he

nume! of !eco!ds !et!ieed th!ou-h oth >uMed

and&mase was 1,1"A as of (u-ust 1, 2012, out of

which

""@ we!e eGcluded as duplicates. (fte! assess

in- all

documents acco!din- to thei! titles and ast!acts,

the

full$teGt of 183 !eco!ds we!e !et!ieed fo! sc!een

in- in

addition to 11 pape!s identi?ed th!ou-h !efe!ence

s of

!eiews. f those, 1@0 !eco!ds we!e found eli-il

e fo!

inclusioninthep!esenta!ticle.nlone!eleant!eco!d

wasidenti?edoutsidethe>uMedand&masesea!chP

the &D)' 1E. o sin-le !epo!t has !epo!ted oth a

!eleant incidence measu!e and a !eleant p!ealence

measu!e.

)Cincidence

Lie incidence measu!es we!e identi?ed th!ou-h ou!

sea!ch, !epo!ted in fou! incidence !epo!ts 7*ale 19. (ll

studies we!e conducted in !u!al a!eas of &-pt amon-

illa-e !esidents, p!e-nant women, and child!en 10$13Ee!allhi-h)Cincidence!ateswe!eose!edinthese

studies!an-in-f!om0.8toA.8pe!1,000pe!son$ea!s.


10/48

Li-u!e1Llowofa!ticleselectionfo!the)Cp!ealenceandincidencein&-ptsea!ch.*hischa!t,adaptedf!omthe>%I'M(200Nowdia-!am,displastheNowofa!ticleselectionfo!the)Cincidenceandp!ealencein&-ptsea!chofscienti?cdataases,namel>uMed

and&mase.


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Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e@of21


*ale1'tudies!epo!tin-hepatitisCi!usincidencein&-pt

Citation ea! +ocation 'tud population 'ample sie Incidence 7pe! 1,000pe!son$ea!s9

Mohamed,0@1"E 1#$2000 Jaluia, +owe! &-pt illa-e !esidents 2,"A3 A.8

Mohamed,0@1"E 1#$2000 (ssuit, Kppe! &-pt illa-e !esidents ",2#@ 0.8

'aleh,081@E 1#$200A Menou?a, +owe! &-pt >!e-nant women 2,1## @.2

Mostafa,10 1AE 2001$2003 Menou?a, +owe! &-pt illa-e !esidents 3,@80 2."

'aleh,101#E 2000$200A Menou?a, +owe! &-pt Child!en of 3 illa-es with hi-h p!ealence of )C 2,8@2 2.#

>!ealenceof)Cinthe-ene!alpopulation

'iGt$ninestudies!epo!ted)Cp!ealenceinthe-e

ne!alpopulation.Detailsa!eshownin*ale2.)Cp!eale

nce

amon-the-ene!alpopulationof&-ptisdocumentedto

ee!hi-h.*he2008&D)'measu!ed)Cp!eale

nce

to e 1".# amon- a nationall !ep!esentatie sa

mple of

11,12A &-ptians a-ed 1@F@ ea!s old 1E.*he

die!se

)Cstudies conducted amon- di=e!ent -ene!al pop

ula$

tion su-!oups, !e-a!dless of desi-n o! methodo

lo-,

consistentl!epo!tae!hi-h)Cp!ealence,ashi-

has

"1insomestudies10E.e!all,thep!ealenceap

pea!s

to inc!ease d!amaticall with a-e with the hi-hes

t !atesose!edamon-populationsa-ed-!eate!than"0e

a!s.

( nume! of studies we!e conducted amon- lo

od

dono!s.(hi-he!p!ealenceisose!edamon-paidlood

dono!sandfamil!eplacementlooddono!scompa!edto

olunta!dono!s10$12E.Malelooddono!shadahi-he

!

p!ealence than thei! female counte!pa!ts 13E.

Blood

dono!sf!om!u!ala!eashadahi-he!p!ealencethanth

ose

f!omu!ana!eas38E.

Multiple studies we!e conducted amon- il

!esi$

dentsinhi-h)Cp!ealencea!eas7*ale29.*oe!all

p!ealencein!u!ala!easae!a-edaout20,h

e!than

the national ae!a-e. ( stud conducted in

ma, a

illa-eintheileDelta,!epo!ted)Cp!eale

of"0

amon- illa-e !esidents A0E. 'imila! to lo

dono!

studies, illa-e !esidents we!e shown to ha

a hi-he!

p!ealence amon- males compa!ed to fema

A2,81E,

andama!6ed-!owthinp!ealencewitha-e

8,@E.

( studconductedin1#,amon-3,3!esid

sofa

illa-e in the ile Delta !e-ion, ose!ed

alence!ates in child!en, a-es 0F1, !an-in- etwe

# and

..*his !ate inc!eased to 2#.A in thos

0F3 ea!s

andmo!ethandouledto@A.#amon- illa-e

dents

-!eate!than"0ea!sofa-e82E.

)i-h)Cp!ealencewasalsoose!edamon-

-nant

women and child!en in &-pt. %ecent studies con

ted

amon-p!e-nantwomen!epo!tedap!ealenceofa


12/48

8

in(ssuit2#EandBenha28E,[email protected]

!u!al

illa-es of the ile Delta 2AE. 'tudies conducted

amon-

!u!al school child!en !epo!ted an ae!a-e p!ealen

ce of

aout # @3,AA,A8,AE, while the ae!a-e p!eal

ence in

child!en attendin- outpatient clinics was found to

e

app!oGimatel " 18,1,21,22E. )i-h p!ealenc

e was

also ose!ed amon- select su-!oups such as tou!ism

wo!6e!s #0E, a!m !ec!uits @3,#E and ?!e !i-ad

pe!sonnel3"E.

Li-u!e 2( depictsthe !an-e of p!ealencewithin each

su-!oup in studies conducted p!e$ and post$2001.

(mon- lood dono!s, studies appea! to cluste! at lowe

)C p!ealence leels post$ 2001 infection cont!ol

p!o-!ams, compa!ed to p!e$2001. )owee!, no distinct

patte!n can e ose!ed within each of the othe!

su-!oups.

>!ealenceof)Camon-populationsatdi!ecto!hi-h

!is6ofeGposu!e

eclassi?edpopulationsatdi!ecto!hi-h!is6of)CeG$

posu!eintosiGsucate-o!ies:i!alhepatitispatients,multi$

t!ansfused patients, thalassemia patients, schistosmias

patients, patients on hemodialsis and IDKs.*ale 3 listall the studies in each su$cate-o! and the !epo!t

p!ealencemeasu!es.

(mon- patients dia-nosed with acute i!al hepatitis,

)C p!ealence !an-ed f!om as low as ".3 8E to a

hi-h as #8.# 8@E. nce mo!e, we ose!ed a hi-he!

p!ealenceamon-studiesconductedin!u!alpopulations

e!sus u!an populations. ( !ecent stud conducted in

2010!epo!tedan)Cp!ealenceof8.#amon-child!en

withi!alhepatitis8#E.

*he ma


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*ale2'tudies!epo!tin-hepatitisCi!usp!ealenceamon-the-ene!alpopulationin&-pt

Citation ea! +ocation 'amplin- >opulation cha!acte!istic 'ample sie 'e!o$p!ealence %( p!ealenceutpatient clinic attendees

halifa,3 18E 10$1 Cai!o cit, Cai!o C' Child!en 8" 0.0 /(&l$anaw,@ 1E /( (leGand!ia cit, (leGand!ia C' Child!en 110 11.8 /(

Mi!as,02 20E /( *anta, ha!ia, +owe! &-pt C' In/out$patient child!en liin- in )C 10@ 0.0 /(endemic !e-ion

&l$%ai6,0#21E 200" Cai!ocit,Cai!o C' Child!en1F!sold 1,0"2 1." 0.@

andil,0# 22E 200"$A Cai!o cit, Cai!o C' )ealth child!en 20 @.0 /((ntenatal clinic attendees

)assan,3 23E /( /( C' 1,@3A ".3 /((-ha,8 2"E 1A$# Mansou!a, Da6ahlia, +owe! &-pt C' #A# 13.# 23.#assem,00 2@E 1A (leGand!ia cit, (leGand!ia C' 100 1.0 1".0'tose6,0@ 2AE 1#$03 3 !u!al illa-es in ile %ie! Delta, +owe! &-pt C' 2,@8# [email protected] 10.8

[ah!an,10 2#E 2008$ (ssuit, Kppe! &-pt C' @00 8.0 #."(dulawi,10 28E 2003$8 Benha, Jaluia, +owe! &-pt C' 1,22" 8.A A.8

(o &lma-d,11 2E /( /( C' 20$"0 ea! old mothe!s A1 13.0 /(Blood dono!s

amel,230E 12 Cai!ocit,Cai!o C' Maleunie!sitstudents,20F2#ea!s 2,1A" .# /(

&l$[aadi,2 31E /( /( C' #A @.2 /(Da!wish,2 32E /( /( C' 0 1"." /(Da!wish,3 33E 12 Cai!o cit, Cai!o C' 1A3 13.A /(&l$(hmad," 10E /( /( C' >aid lood dono!s 3@." /(Juinti,@ 3"E 12$" (leGand!ia cit, (leGand!ia C' 283 20.8 /(Bassil,@ 3@E /( Cai!o cit, Cai!o C' 188 2A.A /(&l oha!,@ 3AE 10$2 'ue cit, 'ue and Ismailia, +owe! &-pt C' 1,18# 1".@ /(

(ttia,A 3#E /( Cai!o cit, Cai!o C' 1@A 21.8 /((!thu!,# 38E 13 2" oe!no!ates C' 2,A"" 2".8 /(&l$[aadi,# 3E /( /( C' 180 ." /(ad,01 "0E 18 Ismailia, +owe! &-pt C' 20 20.0 /(*ana6a,0" "1E 1 13 -oe!no!ates, Kppe! and +owe! &-pt C' 3,A08 8.8 A.2

)ashish,0@ "2E /( (leGand!ia cit, (leGand!ia C' @ 23.2 /(&l$ilan,0A "3E 2002$3 Mansou!a, Da6ahlia, +owe! &-pt C' 'tudent olunta! lood dono!s 2,1@# 2.# /(

(-ha,0A ""E /(

/( C' 2,"00 8.0 /(


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&l Damat,0# "@E 2001 Cai!o cit, Cai!o C' 2,8"@ #.A /(


15/48

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*ale2'tudies!epo!tin-hepatitisCi!usp!ealenceamon-the-ene!alpopulationin&-pt7Continued9

&l$[aadi,08 "AE 200@ 2A -oe!no!ates %andom (ll lood dono!s #A0 @.0 /(

&l$[aadi,08 "AE 200@ 2A -oe!no!ates Lemale lood dono!s 12" A.@ /(&l$[aadi,08 "AE 200@ 2A -oe!no!ates Male lood dono!s A3A ".# /(Ismail,0 "#E 2000$# Mansou!a, Da6ahlia, +owe! &-pt C' @@,22 12.0 /((shou!,0 "8E 200A$8 8 -oe!no!ates C' @1@,#@8 ".8 /(&l6a!eh,0 11E 2008 Menou?a, +owe! &-pt C' Lamil !eplacement lood dono!s ",#0 12.# /(

&l6a!eh,0 11E 2008 Menou?a, +owe! &-pt C' Blood dono!s 3,@A A.3 /(

&l6a!eh,0 11E 2008 Menou?a, +owe! &-pt C' Lamil !eplacement lood dono!s 8,#0@ 1".A /(&l6a!eh,0 11E 2008 Menou?a, +owe! &-pt C' Blood dono!s "1" 8.# /(

%ushd,0 13E 200A$# 'ue Canal a!ea C' (ll lood dono!s ,1@0 @.A /(

%ushd,0 13E 200A$# 'ue Canal a!ea Male lood dono!s #,1@@ 2. /(

%ushd,0 13E 200A$# 'ue Canal a!ea Lemale lood dono!s 1,@ 1.# /(

&ita,0 12E 200@$8 Da6hilia, +owe! &-pt C' olunta! lood dono!s #3,"31 ".A /(

&ita,0 12E 200@$8 Da6hilia, +owe! &-pt C' Lamil lood dono!s 113,@0" @.@ /(

hatta,10 3AE 2000$8 Mina, +owe! &-pt C' 211,##2 .0 /(%adwan,10 "E 200 /( C' 2#,@3# ".0 /(as?,11 @0E 200#$8 (leGand!ia cit, (leGand!ia C' 3,"20 3.@ /((wadalla,11 @1E /( Cai!o cit, Cai!o C' 1,000 1A.8 /(La!awela,12 @2E 2010$1 Cai!o cit, Cai!o C' 100 @ /(%u!al illa-e !esidents

(del$aha," @3E 12 Menou?a, +owe! &-pt C' 2#0 18.1 /(

amel," @"E 12 'ada, af! &l 'hei6h, +owe! &-pt (ll i lla-e!esidents

&l oha!,@ 3AE 10$2 'ue Canal a!ea C' )ealth lood oluntee!s !esident to

1,2@ 1@. /(

2#1 1"." /(!u!al a!ea with hi-h schistosomiasis

&l oha!,@ 3AE 10$2 o!th 'inai, f!ontie! C' Bedouin population with low schistosomiasis 1"8 1@.@ /(

Da!wish,@ @@E /( /( C' )ealth illa-e!s and non$p!ofessional lood 188 21.8 /(dono!s

Da!wish,A@AE 1" alama,Jaluoia, +owe!&-pt C' illa-e!esidents:1F3ea!s 12 0.0 /(

Da!wish,A@AE 1" alama,Jaluoia, +owe!&-pt C' illa-e!esidents:"Fea!s 21 0.0 /(

Da!wish,A@AE 1" alama,Jaluoia, +owe!&-pt C' illa-e!esidents:10F1ea!s "A 8.0 /(

Da!wish,A@AE 1" alama,Jaluoia, +owe!&-pt C' illa-e!esidents:20F3ea!s 2 20.0 /(

Da!wish,A@AE 1"

alama,Jaluoia, +owe!&-pt C' illa-e!esidents:"0FA#ea!sold "# @1.0 /(


16/48

&l$'aed,# @#E 13$" 'inai, f!ontie! C' Immi-!ants to a newl !eclaimed a!ea endemicfo! schistosomiasis

@0A 10.3 /(


17/48

88

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233

"/13/288


afeh,00@8E /( (ssuit,Kppe!&-pt C' illa-e!esidents\ @ea!sofa-e7oe!all9 A,031 8.# @."

afeh,00@8E /( (ssuit,Kppe!&-pt C' illa-e!esidents]30ea!s ",1A" 3.A 2.0

afeh,00 @8E /( (ssuit, Kppe! &-pt C' illa-e !esidents 30 ea!s 1,8A# 20.0 12.

(del$(i,00@E 1# (-hou!&l'ou-h!a,Jaluoia,+owe!&-pt C' illa-e!esidents\@ea!sold7oe!all9 3, 2".3 1".8

(del$(i,00@E 1# (-hou!&l'ou-h!a,Jaluoia,+owe!&-pt C' illa-e!esidents:]20ea!s 2,10@ .3 /(

(del$(i,00 @E 1# (-hou! &l 'ou-h!a, Jaluoia, +owe! &-pt C' illa-e !esidents 20 ea!s 1,8" "1.0 /(

Da!wish,01 A0E 1"$@ alama, Jaluoia, +owe! &-pt C' illa-e !esidents 10 ea!s of a-e #A "0.0 /(

&l$'adaw,0" A1E /( 'ha!6ia, +owe! &-pt C' 8"2 2#." #."(!afa,0@ A2E 2002$3 [awiat %ain, Menou?a, +owe! &-pt C' ",020 11.8 /(

(!afa,0@ A2E 2002$3 [awiat %ain, Menou?a, +owe! &-pt C' illa-e !esidents: unde! 20 ea!s old 1,#@ 2.8 /(

(!afa,0@ A2E 2002$3 [awiat %ain, Menou?a, +owe! &-pt C' illa-e !esidents: 20 and oe! ea!s old 2,2@2 18. /(

Mohamed,0AA3E 2002 [awiat%ain,Menou?a,+owe!&-pt C' illa-e!esidents18FA@ea!sofa-e 2,"2@ 18.@ /(

&assa,0# A"E 200A$# [a-ai- dist!ict, 'ha!6ia, +owe! &-pt C' illa-e households 30" 10. /(

(-uila!,08 A@E /( La66ous and 8 su!!oundin- illa-es C' illa-e !esidents: males #8 @1.3 38.@

(-uila!,08 A@E /( La66ous and 8 su!!oundin- illa-es, C' illa-e !esidents: females 81 "2.0 2.A'ha!6ia, +owe! &-pt

Child!en

(del$aha," @3E 12 Menou?a, +owe! &-pt C' %u!al male p!ima! school child!en 10 12.1 /(

&l$'he!ini,03 AAE 1" /( C' illa-eschoolchild!enAF1@ea!sold 2" @.8 2."

Mohamed,0AA#E 1# ile%ie!Delta,+owe!&-pt C' illa-echild!en@F18ea!sold 1,823 8.2 /(

Mohamed,0AA#E 1# (ssuit,Kppe!&-pt C' illa-echild!en@F18ea!sold 2,808 2.@ /(

&l 'he!ini,0# A8E 2002 *anta, ha!ia, +owe! &-pt C' 'chool child!en "#0 2.1 0.8

Ba!a6at,11 AE 200@ (leGand!ia cit, (leGand!ia >B' 'chool child!en @00 @.8 "."

)ealth indiiduals

&l$'aed,A #0E 1" 'outh 'inai, f!ontie! C' *ou!ism wo!6e!s #"0 1".3 /(

Mohamed,A #1E /( /( C' &-ptians applin- fo! wo!6 a!oad @,0#1 31.@ /(

Mohamed,A #1E /( /( C' &-ptians applin- fo! wo!6 a!oad: Lemales /( 13.2 /(

Mohamed,A #1E /( /( C' &-ptians applin- fo! wo!6 a!oad: Males /( 3".0 /(

oha!,@ #2E /( /( C' 1@ 13.3 /()alim, #3E 1A Cai!o cit, Cai!o C' )ealth sta= of the unie!sit @0 A.0 /(

)assan,01 #"E 1@$A Cai!o cit, Cai!o C' )ealth indiiduals isitin- hospitalied f!iends 3@ "2. /(

't!ic6land,02 #@E /( ile %ie! Delta, +owe! &-pt C' 212 "A.# 3A.3&l$saed,0A #AE 2002

Cai!o cit, Cai!o C' 3A 8.3 2.8


18/48

&l Bassuoni,08 ##E /( /( C' 10 30.0 /(


19/48

88

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/1"#1$

233

"/13/288


'alama,0 #8E /( /( C' 20 @.0 /((!m !ec!uits/Li!e !i-ade pe!sonnel

La!-hal,3 #E /( /( C' (!m !ec!uits #2A 33.0 /((del$aha," @3E 12 +owe! &-pt C' (!m !ec!uits 300 22.1 /(Juinti,@ 3"E 12$" (leGand!ia cit, (leGand!ia C' Li!e !i-ade pe!sonnel @"1 3.0 /(the! -ene!al populations

&l$(hmad," 10E /( Cai!o cit, Cai!o C' 22 2".3 /(&l$'adaw,0" A1E /( 'ha!6ia, +owe! &-pt >B' 1,"22 [email protected] #.#&l$'adaw,0" A1E /( 'ha!6ia, +owe! &-pt >B' ene!al population in u!an a!eas @80 23." /(&l$'adaw,0" A1E /( 'ha!6ia, +owe! &-pt >B' ene!al population: _20 ea!s "1" ".8 /(&l$'adaw,0"A1E /( 'ha!6ia,+owe!&-pt >B' ene!alpopulation:20F 30ea!s 1A3 1".1 /(&l$'adaw,0"A1E /( 'ha!6ia,+owe!&-pt >B' ene!alpopulation:30F "0ea!s 2@3 30.0 /(&l$'adaw,0" A1E /( 'ha!6ia, +owe! &-pt >B' ene!al population: "0 ea!s @2 "1. /(Mohamed,0" 80E 1A$# 10 -oe!no!ates >B' ene!al population #,3@# 13.@ /(&l [anat,0 1E 2008 ationwide >B' 11,12A 1".# .8C' conenience samplin-, >B' p!oailit$ased samplin-, /( not aailale.


20/48

Firebrigade Blooddonors Children



A55%

50%

45%

40%

35%

30%

Pre-2001

25%

20%

15%

10%

5%

0%

Post-2001

AntenatalclinicArmyrecruits/

attendees

Other

general

Healthy

populations

Outpatient

clinic

Ruralvillage

residents

B100%

90%

80%

70%

60%

50%

populations attendees

Pre-2001

Post-2001

40%

30%


21/48

20%

10%

0%

Hemodialysis

patients

Injectiondrug

users

Multi

transfused

Schistosomiasis

patients

Thalassemic

patients

Viralhepatitis

patients

patients

Li-u!e2)epatitisCi!us7)C9p!ealenceamon-the-ene!alpopulationandpopulationsatdi!ecto!hi-h!is6in&-pt,instudies

conductedp!e$andpost$2001.(:!aphdepictin-)Cp!ealenceamon-di=e!ent-ene!alpopulation-!oups.B:!aphdepictin-)C

p!ealenceamon-di=e!enthi-h/di!ect!is6populations.Inthis?-u!e,weincludedonlst!ati?ed)Cp!ealencemeasu!es,ifthesest!ati?ed

measu!eswe!eaailale.the!wise,weincludedtheoe!allp!ealencemeasu!esinthestud.


22/48



*ale 3 'tudies !epo!tin- p!ealence of hepatitis C i!us amon- populations at di!ect o! hi-h !is6 of eGposu!e in &-pt

Citation ea! +ocation 'amplin- >opulation cha!acte!istic 'amplesie

'e!o$p!ealence %(p!ealence

i!al hepatitis patients

&l$(hmad,"10E /( Cai!o cit, Cai!o C' @1 2@.@ /(

&l$oha!,"83E /( 'ue cit, 'ue C' 1"0 1.2 /(&l aafa!,0@ 8"E 2002 Cai!o cit, Cai!o C' 30 1". /(Me6,0A8@E 2002$@ ile %ie! Delta, +owe! &-pt C' "# #8.# #0.2

[a6a!ia,0#8AE 2001$2 ia, Kppe! &-pt C' 200 13.0 /(alil,10 8#E 200"$@ (ssuit, Kppe! &-pt C' Child!en with i!al hepatitis 1@0 8.# 8.#

*alaat,1088E 2001$" (leGand!ia cit, (leGand!ia/ C' ",18 2.8

(assia, Cai!o/Mahalla,ha!ia, +owe! &-pt/Jena

and (swan, Kppe! &-pt

&ldin,108E /( /( C' 23@ ".3 /(Badaw,12 0E /( Cai!o cit, Cai!o C' Male milita! !ec!uits 8 /(

with i!al hepatitis

Multi$t!ansfused patients

halifa,318E 10$1 Cai!o cit, Cai!o C' Multi$t!ansfused child!en 8" @@.0 /(

(del$aha,"@3E 12 Cai!o cit, Cai!o C' Multi$t!ansfused child!en #1 @". /(

'aid,0 1E /( Cai!o cit, Cai!o C' Multi$t!ansfused child!enwith hematolo-ical diso!de!s

'aid,01E /( Cai!o cit, Cai!o C' Multi$t!ansfused child!en with

" 81.A ".0

@1 1#.A 23.@hematolo-ical mali-nancies

'alama,0#8E /( Cai!o cit, Cai!o C' Multi$t!ansfused child!en 33 [email protected] /(

alil,10 8#E 200"$@ (ssuit, Kppe! &-pt C' Multi$t!ansfused child!en 1A@ @8.2 "1.2

*ona!,102E 2000$8 Mansou!a, Da6ahlia, C' Multi$t!ansfused child!en #2 11.1 /(+owe! &-pt

&l$La!amaw,12 3E /( Jena, Kppe! &-pt C' Multi$t!ansfused child!en 33 3 /(

(delwaha,12"E /( Cai!o cit, Cai!o C' Multi$t!ansfused child!en 100 "0 /(

*halassemic patients&l$anaw,@1E /( (leGand!ia cit, (leGand!ia C' Child!en with thalassemia 18 ""." /(

&l oha!,@3AE 10$2 Cai!o cit, Cai!o C' Child!en with thalassemia "@ #@.A /(

halifa,0"@E 2000$3 Cai!o cit, Cai!o C' Child!en with thalassemia @A A.A /(

(dalla,0AAE 200@ Cai!o cit, Cai!o / Banha, C' Child!en with thalassemia 33 A0.A /Jaluia, +owe! &-pt

ma!,11#E /( Cai!o cit, Cai!o C' 1#" @1.# 32.2Mansou!,12 8E 200$10 Mansou!a, Da6ahlia, C' Child!en with thalassemia 200 1.@ /

+owe! &-pt

&l$La!amaw,12 3E /( Jena, Kppe! &-pt C' Child!en with thalassemia A# "8 /(

'chistosomiasis patients

Bassil,2E /( ile %ie! Delta, +owe! &-pt C' 31 "1. /(

&l$anaw,@1E /( (leGand!ia cit, (leGand!ia C' 21 38.1 /(


23/48

&l$[aadi,# 3E /( /( C' 320 1A.3 /([e6!i,02100E 18$00 Cai!o cit, Cai!o C' "# "2.@ /((!afa,0@ A2E 2002$3 [awiat %ain, Menou?a,

+owe! &-pt

&l$'aah,11101E /( %u!al a!ea, Cai!o/ ha!ia,

C' 'chistomiasis patientst!eated with >(*

C' 'chistosomiasis patients

20A @1.@ /(

@0 8".0 /(+owe! &-pt

&l$'aah,11101E /( %u!al a!ea, Cai!o/ ha!ia,+owe! &-pt

t!eated with >(*

C' @2 #.#


24/48



*ale 3 'tudies !epo!tin- p!ealence of hepatitis C i!us amon- populations at di!ect o! hi-h !is6 of eGposu!e in &-pt

7Continued9

'chistosomiasis patients

t!eated o!all up to

8 ea!s a-o

)emodialsis patients

)assan,3102E /( /( C' 10@ A#.0 /((del$aha,"@3E 12 Cai!o cit, Cai!o C' #8 "A.2 /(

&l$(hmad,"10E /( Cai!o cit, Cai!o C' 2@ 8".0 /(

&l oha!,@3AE 10$2 'ue cit, 'ue and C' 108 #0."Ismailia, +owe! &-pt

oha!,@#2E /( /( C' A" 8#.@ /()assan,00103E 1A Cai!o cit, Cai!o C' 210 @.0 /('hatat,0010"E 1 /( C' 83 #8.@ /(ad,02 10@E 18 Ismailia, +owe! &-pt C' "# #2.0 /([e6!i,02100E 18$00 Cai!o cit, Cai!o C' 30 @A.A /(&l aeed,0A10AE 2002$" Cai!o cit, Cai!o C' "0 100.0 /(andil,0# 22E 200"$A Cai!o cit, Cai!o C' 31 @1.A /()ammad,02@E 2008 Mansou!a, Da6ahlia, C' 3" ".1

+owe! &-pt

(ttia,10 10#E 2008$ Cai!o cit, Cai!o C' 20A "A.1 /(I!ahim,10108E 200# Cai!o cit, Cai!o C' 100 #@.0 /(In(* pa!ente!al antischistosomiasis the!ap.

e!all, the ae!a-e )C p!ealence amon- sc

histo$

somiasis patients was aout 38. ( !ecent s

tud

'aahetal.!epo!tedap!ealenceof8".0amon-schis$

tosomiasispatientst!eatedwith>(*20to30ea!sa

-o,

andap!ealenceof#.#amon-schistosomiasispatie

nts

t!eatedo!allupto8ea!sa-o101E.

e we!e ale to identif onl one stud conduc

ted

amon-IDKsin&-pt10E.*hestudwasconducted

in

(leGand!ia, amon- 100 IDKs, and )C p!ealenc

e was

!epo!tedtoeA3.010E.

Li-u!e 2B depicts the !an-e of p!ealence

thin each

su-!oup in studies conducted p!e and post$

2001. o

distinct patte!n can e disce!ned in the diution of

)C p!ealence p!e$ and post$2001 within

h of the

di=e!entsu-!oups.

>!ealenceof)Camon-populationsatindi!ect

inte!mediate!is6ofeGposu!e

>opulations at indi!ect o! inte!mediate !is6

eGposu!e

to)Cwe!e classi?ed into thefollowin- su

e-o!ies:

diaeticpatients,hospitaloutpatientattendees,hosp


25/48

ed

populations, household contacts of indeG cases

7)C

positiecases9,seGuallt!ansmittedinfection7'*I9pat

ients,

pe!iodontal disease patients, p!isone!s, and popul

ations

wo!6in- in select p!ofessions. Details a!e sho

wn in

*ale'2,see(dditional?le1.

Conside!ale )C p!ealence was !epo!ted amon-

diaetic child!en in &-pt compa!ed to othe! count!ies.

( !ecent stud conducted in 2010, amon- A2 diaetic

child!en with an ae!a-e a-e of 10." ea!s, !epo!ted a

p!ealence of 2.@ 110E. >!eious studies conducte

amon- diaetic child!en !epo!ted much hi-he! leels of

2." 1E and "".1 22E. In cont!ast,)C p!ealenc

amon-adultdiaeticpatientswas20.0100EandA0.3

111E. 'ustantial )C p!ealence was also ose!ed

amon- patients attendin- hospitals, !an-in- etween 0

8#Eand#2.8112E.eidenti?edonestudconducted

amon-pe!iodontaldiseasepatients!epo!tin-ap!ealence

of 13.0 113E. Multiple studies we!e conducted inesti

-atin-)Cp!ealenceamon-thechild!en,spouses,and

familcontactsof)Cpositiecases.'tudiesconducted

amon-child!enofindeGcasesusuallfocusedonchild!en

of infected mothe!s to eGamine the e!tical t!ansmissio

of )C. )C %( p!ealence amon- infants o!n to)C positie mothe!s !an-ed etween 3.8 28E an

[email protected] 2E. )C p!ealence amon- spouses of inde

patients was as hi-h as 3@.@ 11"E. In a stud of fam

contactsofindeGpatients,thep!ealencewas@.#11@E.

'iGstudieswe!econductedamon-populationsinselect

)C$!eleant p!ofessions 7*ale '2 of (dditional ?le 19.

)C p!ealence amon- health ca!e wo!6e!s ae!a-e

aout 1#, whe!eas amon- a!e!s it was 12.3 11A


26/48



ewe!ealetoidentifonlonestudamon-p!isone

!s

which!epo!tedap!ealenceof31."3"E.

*he!an-eof)Cp!ealencewithineachsu-!oupi

n

studies conducted p!e$ and post$2001 can e ose!

ed

inLi-u!e3(.odistinctpatte!ncanedisce!nedint

he

dist!iution of )C p!ealence p!e$ and post$

2001

1#E. Communit and info!mal health p!oide! !elated

eGposu!es such as ci!cumcision, caute!, and in


27/48

a!easwe!efa!themostcommon!is6facto!so!as

so$

ciations with )C infection ac!oss studies 2A

,A2E.

the! common !is6 facto!s we!e !elated to healt

hca!e

settin-s such as histo! of lood t!ansfusions, in

asie

p!ocedu!es, in


28/48

Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e1"of21


A90%

80%

70%

60%

50%

40% Pre-2001

Post-2001

30%

20%

10%

0%

Childrenofindex

patients

Diabetics Familycontactsofindexpatients

HospitalizedpopulationsHospitalizedoutpatients

Periodontaldisease Prisoners Selectprofessions STIpateints Spousesofindexpatients

B100%

90%

80%

70%

60%

Pre-2001

Post-2001

50%

40%

30%

20%


29/48

10%

0%

BC Cancer CLD CRF CV GIB GN HCC HCCA HL JaundiceKTP LeukemiaLP Dermatoses MDS Meningitis NHL Organo OrthopedicRHD SLE suspected Urologymegally w/LD

Li-u!e3)epatitisCi!us7)C9p!ealenceamon-populationsatindi!ecto!inte!mediate!is6andspecialclinicalpopulationsin&-pt,in

studiesconductedp!eandpostthe2001.(:!aphdepictin-)Cp!ealenceamon-di=e!entpopulationsatindi!ecto!inte!mediate!is6in&-

B:!aphdepictin-)Cp!ealenceamon-di=e!entspecialclinicalpopulations1in&-pt.Inthis?-u!e,weincludedonlst!ati?ed)Cp!ealenc

measu!es,ifthesest!ati?edmeasu!eswe!eaailale.the!wise,weincludedtheoe!allp!ealencemeasu!esinthestud. 1(c!onms:BC:lad

cance!,C+D:ch!oniclie!disease,C%L:ch!onic!enalfailu!e,C:cutaneousasculitis,IB:-ast!ointestinalleedin-,:-lome!uloneph!itis,)CC

hepatocellula!ca!cinoma,)CC(:hila!cholan-ioca!cinoma,)+:)od-6in;slmphoma,*>:6idnet!ansplantpatients,+D:lie!diseae,+>:lichenplanus

MD':melodsplasticsnd!ome)+:non$)od-6in;slmphoma,%)D:!heumatichea!tdisease,'+&:sstematiclupuse!thmatosus.

&-pt.*he !esults of ou! stud indicate that &-

pt is

endu!in- a la!-e )C disease u!den, and is li6el

to e

themosta=ectednationwo!ldwidethisinfection.)

Cp!ealence and incidence ac!oss the die!se populati

on

-!oupswe!efoundtoemuchhi-he!thanthoseinothe!

count!ies a!ound the -loe 3,122,123E.*his ma6es )C

and its complications one of the leadin- pulic health

p!olemsthat&-pthastoconf!onttoda.


30/48

20

40

60

0

20

40

60

0

20

40

60

0

20

40

60

0

Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e1@of21


Outpatientclinicattendees Antenatalclinicattendees

Blooddonors Ruralvillageresidents

Children Healthypopulations

Armyrecruits/Firebrigadepersonnel Othergeneralpopulations

1990 1995 2000 2005 2010 1990 1995 2000 2005 2010

Time(years)

seroprevalence(%) Fittedvalues

Li-u!e"*imet!endofhepatitisCp!ealenceamon-thedi=e!ent-ene!alpopulationsu-!oupsin&-pt.

*he !esults of this snthesis indicate that &-pt

has

endu!ed a la!-e)C epidemic at the national le

el, and

thatthe!eissustantialendemic)Ct!ansmis

ninthis

count!. )C p!ealence is at hi-h leels a

ss essen$

tiall all population -!oups, demonst!atin- th


31/48

Gpansie

natu!e of this epidemic, and that it is not isolate

d to

speci?cpopulation-!oupso!-eo-!aphica!eas.

Despite ein- a ma


32/48

Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e1Aof21


u! stud suppo!ts a ma(* c

am$

pai-ns in d!iin- )C incidence. Di=e!ent studies

hae

shown a d!amatic inc!ease in )C p!ealence wi

th

a-eP a coho!t e=ect that ma e eGplained, at l

east in

pa!t, the ea!l association etween >(* and

)C

t!ansmission 2A,A0$A2,82,12#E. u! !esults also

hi-hli-ht-ende! and -eo-!aphical di=e!ences in )C p!eal

ence

3A,A",#1,#@,128,12E,withhi-he!p!ealenceose!

ed

in males and !u!al dwelle!s compa!ed to females

and

indiidualsliin-inu!ana!eas.*hesedi=e!ences

ma

also e in pa!tatt!iuted tothe >(*campai-ns, a

s !u!al

a!easandmaleswe!emo!ea=ectedtheschistosomi

asis

disease u!den and hence we!e main ta!-ets of

these

campai-ns@E.

)owee!, the totalit of the eidence snthesied

he!e

su--ests that the >(* campai-ns a!e one d!ie! a

mon-othe!sof)Ct!ansmissionin&-pt,andthatsusta

ntial

)Ct!ansmissionisstillon-oin-.)i-h)Cp!ealenc

e

isfoundamon-hospitaliedandthespecialclinicalpop

u$

lationsPpopulationsthathaeeGpe!ienceda!iousfacil

it$

ased medical p!ocedu!es. &leated )C p!ealen

ce is

also found amon- indiiduals eGposed to een

mino!

medical ca!e p!ocedu!es, within and eond

alished

health ca!e facilities. Communit studies

e found

st!on- co!!elations etween )C infection a

di=e!ent

medical eGposu!es such as in(*

campai-ns, ut also a la!-e f!action of the

we!e o!n

afte!theimplementationofthemo!est!in-en

ection

cont!ol measu!es in the count!. ee!thele

conside!$

ale p!ealence leels a!e found amon-

d!en in

multiplestudies.*hesestudiessu--estthatchi

nhae

een eGposed to )Ce!ticall th!ou-h moth

to$child

t!ansmission 2",2@,2#$2E 7hi-h %( p!e

ence was

documented amon- infants of )C positi

mothe!s,

!an-in- etween 3.8 and 11.1 2",2@,2#2,130,131E9,

o! ho!iontall possil th!ou-h household

osu!es

1",11",11@,121,131E.MedicaleGposu!esto)

atae!

oun-a-ehaeeenalsoindicated1,22,110,

E.)i-h

)C leels we!e !epo!ted amon- thalassem

child!en

1,A,133E,child!enonhemodialsis22,132E

ddiaetic

child!en1,22,110E.


33/48

)Cp!ealenceamon-themothe!sofinfectedchil

$

d!en, who tend to e oun- themseles, has e

en also

associated with medical eGposu!es and/o! househ

old

eGposu!es 2",2@,2#,28E. In


34/48

cu!!ent leel of )C t!ansmission. ( !ecent stud

estedthat cu!!ent)C incidence !ateisaout 2.0

000pe!son$ea!12#E.

iletheeidencefo!anepidemicatthenationalleel

is oe!whelmin-, some of the potential d!ie!s of this

epidemic, such as the >(*campai-ns and contaminated

lood,a!enolon-e!p!esent.*he!efo!e,itseemsplausile


35/48

Mohamoudetal.BMCInfectiousDiseases2013,13:288 >a-e1#of21


that )C incidence !ate has declined d!asticall

in the

last two decades since the discoe! of the epid

emic in

11F12 30,13E, as B!ean et al. hae !

ecentl

su--ested th!ou-h thei! incidence estimate 12#E.

ee!$

theless, ou! stud could not identif a si-natu!e f

o! a

ma


36/48

)C p!eention in &-pt must e a national p!

io!it.

>olicma6e!s and pulic health and medical ca!e s

ta6e$

holde!sneedtoint!oduceandimplementfu!the!p!ee

n$

tion measu!esta!-etin- the iat!o-enic t!ansmission

!outes, such as e! st!in-ent infection cont!ol p!

actices.

'cienti?c !esea!ch needs to e eGpanded to

measu!e

cu!!ent )C incidence !ate and to identif p!ecis

el the

modesof)Ct!ansmissioninmedicalca!e,communit,

andhouseholdsettin-s.'uchstudieswillpaethewafo!

e=ectie p!eention inte!entions that can e deeloped

eGpe!imentalltested,andimplemented.Itisalsoessential

todeelopcost$e=ectiest!ate-iesfo!t!eatmentandcase

mana-ement of the la!-epool of @F# million ch!onicall

infectedpe!sonswith)Cin&-pt.

(dditional?le

(dditional?le1:*ale'1.>%I'M(Chec6list.*ale'2.>!ealenceof

hepatitisCi!usamon-populationsatindi!ecto!inte!mediate!is6of

eGposu!ein&-pt.*ale'3.>!ealenceofhepatitisCi!usamon-

specialclinicalpopulationsin&-pt.*ale'".)epatitisCi!ustime

t!endanalsisfo!each-ene!alpopulationsu-!oup.Li-u!e'@.)epatitis

Ci!ustimet!endanalsisamon-populationsatdi!ecto!hi-h!is6of

eGposu!e.

(!eiations

)C: )epatitisCi!usP&D)':&-ptiandemo-!aphichealthsu!eP

>(*:>a!ente!alantischistosomiasisthe!apPIDK:InB':>!oailit$asedsamplin-P

C':Coneniencesamplin-P)CC(:)ila!cholan-ioca!cinomaP *>:idne

t!ansplantpatientP+>:+ichenplanusP)+:)od-6in;slmphomaP

C:CutaneousasculitisPC+D:Ch!oniclie!diseasePBC:Bladde!cance!P

%heumatic)D:%heumatichea!tdiseasePC%L:Ch!onic!enalfailu!eP+D:+ie!

diseasePIB:ast!ointestinal leedin-P'+&:'stemiclupuse!thematosusP

MD':Melodsplasticsnd!omeP:lome!uloneph!itis.

Competin-inte!ests

*heautho!sdecla!ethatthehaenocompetin-inte!ests.

(utho!s;cont!iutions

Mand'%conductedthelite!atu!e!eiewanddata!et!ieal.MconductedeGt!action,analsisandw!otethe?!std!aftofthepape!.Mpa!ticipatedin

studdesi-n.LDMcont!iutedtothestuddesi-nandanalses.+4(

conceiedandledthedesi-nofthestud,analses,andd!aftin-ofthe

a!ticle.(llautho!scont!iutedtodiscussionofthe!esultsandw!itin-ofthe

manusc!ipt.(llautho!s!eadandapp!oedthe?nalmanusc!ipt.

(c6nowled-ements

ea!e-!atefulfo!theJata!ational%esea!chLundfo!suppo!tin-this

wo!67>%>0"$2"$3$2@19,andthesuppo!tp!oidedtheBiostatistics,

&pidemiolo-,andBiomathematics%esea!chCo!eattheeillCo!nell

MedicalColle-einJata!.*heautho!sa!ealso-!atefulfo!thealuale

su--estionsandcommentsthe!eiewe!softhisa!ticle.
http://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docxhttp://www.biomedcentral.com/content/supplementary/1471-2334-13-288-S1.docx


37/48

-

ata!ational%esea!chLund7>%>0"$2"$3$2@19andtheBiostatistics,

miolo-,andBiomathematics%esea!chCo!eattheeillCo!nell

lColle-e$Jata!.

details

ous Disease &pidemiolo- !oup, eill Co!nell Medical Colle-e $

Co!nell Knie!sit, Jata! Loundation $ &ducation Cit, Doha, Jata!.

2Depa!tment of >ulic )ealth, eill Co!nell Medical Colle-e, Co!nell

Knie!sit, ew o!6, ew o!6, K'(. 3accine and Infectious Disease

Diision, L!ed )utchinson Cance! %esea!ch Cente!, 'eattle, ashin-ton, K'(.

"Depa!tment of *!opical Medicine, Medical Mic!oiolo- and >ha!macolo-,

4ohn (. Bu!ns 'chool of Medicine, Knie!sit of )awaii, )onolulu, )I A813,

)awaii.

%eceied:1"(u-ust2012(ccepted:14une2013

>ulished:2"4une2013


38/48



%efe!ences

1. &l$[anatL,a(:&-ptDemo-!aphicand)ealth'u!e2008.&-ptia

n:

Minist!of)ealth.Cai!o:&l$[anatand(ssociates,andMac!o

Inte!nationalP 200.

2. +aanchD:&olin-epidemiolo-ofhepatitisCi!us.ClinMic!oiol

Infect2011,1#729:10#F11@.

3. (lte!M4:&pidemiolo-ofhepatitisCi!usinfection.o!ld4ast!oente!

ol

200#,1371#9:2"3AF2""1.

". 'hepa!dC,Linelli+,(lte!M4:loalepidemiolo-ofhepatitisCi!us

infection.+ancetInfectDis200@,@79:@@8F@A#.@. L!an6C,MohamedM,'t!ic6land*,+aanchD,(!thu!%%,Ma-de!+',

&l

ho*,(del$aha,(lhn&',(nwa!,etal:*he!oleof

pa!ente!alantischistosomalthe!apinthesp!eadofhepatitisCi!usi

n

&-pt.+ancet2000,3@@720#9:88#F81.

A. 't!ic6land*:+ie!diseasein&-pt:hepatitisCsupe!seded

schistosomiasisasa!esultofiat!o-enicandiolo-icalfacto!s.

)epatolo-200A,"37@9:1@F22.

#. Mille!LD,(u$%addad+4:&idenceofintenseon-oin-endemic

t!ansmissionofhepatitisCi!usin&-pt.>!ocatl(cad'ciK'(2010,

10#7339:1"#@#F1"#A2.

8. Mohe!D,+ie!ati(,*etla=4,(ltmanD,*he>:>!efe!!ed%epo!tin-

Itemsfo!'stematic%eiewsandMeta$(nalses:*he>%I'M(

'tatement.>+o'Med200,A7#9:e10000#.

. *alaatM,andeel(,%asslan,)a!ealenceof)Cand)Binfectionsamon-looddono!sin

Da6ahilia,&-pt.oG'an-200,A:10AF10#.

13. %ushd,MoftahL,[a6a!ea':*!asmittedt!ansfusedi!alinfections

amon-looddono!sdu!in-ea!s200Aand200#insuecanala!ea,

&-pt.oG'an-200,A:8AF8#.

1". MohamedM,(del$)amidM,Mi6hail,(del$(iL,Medhat(,

Ma-de!+',LiG(D,'t!ic6land*:Int!afamilialt!ansmissionofhepatitis

C

in&-pt.)epatolo-200@,"2739:A83FA8#.

1@. 'alehD(,'helL,(del$)amidM,a!oo',Mi6hail,&l$Bata

M,

&l$af!aw',&l$DalM,'ha!af',)ashemM,etal:Incidence

s6

facto!sfo!hepatitisCinfectioninacoho!tofwomenin!u!al

t.

*!ans%'oc*!opMed)-2008,10279:21F28.

1A. Mostafa(,*alo!'M,&l$DalM,&l)oseinM,Ba6!I,(!afa

s,

%imlin-e!L,(del$)amidM,Lontanet(,etal:Isthehepatitis

us

epidemicoe!in&-ptQIncidenceand!is6facto!sofnewhe

sC

i!usinfections.+ie!Int2010,307"9:@[email protected]#. 'alehD(,'helLM,&l$ama!'',Ma-de!+',(llam(,(del$)

M,

Mi6hail,)ashemM,'ha!af','tose6',etal:Incidenceand

acto!s

fo!communit$acui!edhepatitisCinfectionf!omi!thto@

of

a-ein!u!al&-ptianchild!en.*!ans%'oc*!opMed)-2010

10"7@9:3@#F3A3.

18. halifa(',MitchellB',attsDM,&l$'amahM),&l$'aedM),)assan

4ennin-sB,)is%,Co!win(+:>!ealenceofhepatitisCi

tiod

int!ansfusedandnont!ansfused&-ptianchild!en.(m4*!op

)-

13,"739:31AF321.

1. el$anaw((,el(ouniL,'oliman(*,(me!(&,Demian%',

'aed

)M:>!ealenceofhepatitis$Cantiodse!opositiitinhealt

ptian

child!enandfou!hi-h!is6-!oups.4*!op>ediat!1@,"17A9:33"3.

20. Mi!as(,Mo!!is,'ope!C:)epatitisCi!usp!ealenceinch

ina

hi-hlendemic!e-ionof&-pt.>ediat!InfectDis42002,217

#.

21. &l$%ai6M',&l$)awa!M,&smat,(ouied(M,&l$oof,M

n,

Mansou!','haheen(,(del)amidM,&l$a!a6s):>!ealen

!is6

facto!sofasmptomatichepatitisCi!usinfectionin&-ptia

d!en.

o!ld4ast!oente!ol200#,137129:1828F1832.


39/48

22. andilM&,%asheedM(,'aad&:)epatitisCandBi!usesamon-some

hi-h!is6-!oupsof&-ptianchild!en.4Med'ci200#,#789:12@F12A#.

23. )assanL,ot6at(:>!ealenceofantiodiestohepatitisCi!usin

p!e-nantwomenin&-pt.4InfectDis13,1A8719:2"8F2".

2". (-ha','he!if+',(llamM(,LawM:*!ansplacentalt!ansmissionof

hepatitisCi!usin)I$ne-atiemothe!s.%esi!ol18,1"7"9:22F

23".

2@. assem(',&l$awaw((,MassoudM,(ou&l$aa!','ohi&M:

>!ealenceofhepatitisCi!us7)C9infectionanditse!tical

t!ansmissionin&-ptianp!e-nantwomenandthei!newo!ns.

4*!op>ediat!2000,"A7"9:231F233.

2A. 'tose6',(del$)amidM,a!oo',&lDalM,'alehD(,Mi6hail,

assem&,)awash,&laf!aw','aid(,etal:>!ealenceofand!is6

facto!sfo!hepatitisCin!u!alp!e-nant&-ptianwomen.*!ans%'oc

*!opMed)-200A,100729:102F10#.

2#. [ah!anM,Bada!M',(-anM,(del(i):>atte!nofhepatitis

i!usinfectionamon-p!e-nantwomenandthei!newo!nsatthe

omen;s)ealthCente!of(ssiutKnie!sit,Kppe!&-pt.Int4naecol

stet2010,111729:1#1F1#".

28. (dulJawi,oussef(,MetwallM(,%a-ihI,(dul)amidM,'haheen(:

>!ospectiestudofp!ealenceand!is6facto!sfo!hepatitisCin

p!e-nant&-ptianwomenanditst!ansmissiontothei!infants.

C!oatMed42010,@1739:21F228.

2. (o&lma-d&,(del$aha',(l!asheed[&,halifa(':(n&-ptian

studofmothe!tochildt!ansmissionofhepatitisCi!us.Int4i!olo-

2011,#739:100F108.

30. amelM(,ha=a!(,asefM(,!i-htM,Cla!6+C,Mille!LD:)i-h)C

p!ealencein&-ptianlooddono!s.+ancet12,3"07881A9:"2#.

31. el$[aadi(,'elim,%a?6M,el$)addad':>!ealenceofhepatitisCi!us

amon-non$(,non$B$!elatedch!oniclie!diseasein&-pt.4)epatol

12,1"72F39:"1AF"1#.

32. Da!wishM,(asM,(delfattahLM,Da!wishM(:)epatitisCi!us

infectioninlooddono!sin&-pt.4&-pt>ulic)ealth(ssoc12,

A#73F"9:223F23A.

33. Da!wishM(,%aouf*(,%ushd>,Constantine*,%aoM%,&delman%:%is6

facto!sassociatedwithahi-hse!op!ealenceofhepatitisCi!usinfection

in&-ptianlooddono!s.(m4*!opMed)-13,"7"9:""0F""#.

3". JuintiI,%en-anathan&,&lhaawi&,DiiiaM,'awaf,(wad',>ana(,

%occhi:'e!op!ealenceof)Iand)Cinfectionsin(leGand!ia,&-pt.

[ent!allattfu!Ba6te!iolo-ie:inte!national


40/48

e!no!atesin&-pt.*!ans%'oc*!opMed)-1#,1739:2#1F2#".

$[aadi(%,'elim,I!ahim&),)amd),Daous),(hd(,Moneim

(:Doesschistosomiasisplaa!oleinthehi-hse!op!ealenceof)C

tiodamon-&-ptiansQ*!opast!oente!ol1#,18739:8F100.

ad(,*ana6a&,!ii,%o6uha!a(,ooman[,'e!wah(),'hoai!M,

shiawa,iosawa:%elationshipetweenhepatitisCi!usinfection

dschistosomallie!disease:notsimplanadditiee=ect.4ast!oente!ol

01,3A7119:#@3F#@8.

na6a,(-ha','aud,u!anoL,!ito&,ato*,(o$[eidM,halaf

Mia6awa,Mio6amiM:&Gponentialsp!eadofhepatitisCi!us

notpe"ain&-pt.4Mol&ol200",@8729:11F1@.

ashishM),&l$Ba!!awM(,Mahmoud(,(del%ahman:**i!us

amon-looddono!sin(leGand!ia.4&-pt>ulic)ealth(ssoc200@,

807@FA9:A@1FAA".

"3. &l$ilan(),&l$Ledaw':Bloodo!neinfectionsamon-student

olunta!looddono!sinMansou!aKnie!sit,&-pt.&astMedite!!

)ealth4200A,127A9:#"2F#"8.

"". (-ha',&l$Mashad,&l$Mal6M,&l$'hon),&l$'he!ifM[,&l$)asanM(,

*ana6a,Mio6amiM:>!ealenceoflowpositieanti$)Cantiodiesin

looddono!s:'chistosomamansonico$infectionandpossile!oleof

autoantiodies.Mic!oiolImmunol200A,@07A9:""#F"@2.

"@. &lDamat'I,)assan',MohamedM,&l)osiniM,%e6acewicC,Lontanet

(:'u!eillancesstemfo!)Cinfection:testin-amodelasedon

loodan6s.4&-pt>ulic)ealth(ssoc200#,827@FA9:"@1F"#1.


41/48



"A. &l$[aadi(%,I!ahim&),Bad!an)M,'aeid(,Monei(,'hemisM(,

(del$'atta!%M,(hmad(M,&l$a6ee(:(nti$)Bcsc!eenin-in

&-ptianlooddono!s!educesthe!is6ofhepatitisBi!ust!ansmissio

n.

*!ansfusMed2008,18719:@@FA1.

"#. Ismail(M,[iada),'heashaa)(,'heha&l$Din(B:Declineofi!al

hepatitisp!ealenceamon-asmptomatic&-ptianlooddono!s:a

-limme!ofhope.&u!4Inte!nMed200,207@9:"0F"3.

"8. (shou!D,MoftahL,o!an),&6!amD:Dec!easin-the!is6oft!ansfusi

on

t!ansmittedinfections7**I'9inthe&-ptianBlood*!ansfusion'e!ice

s.

oG'an-200,A:103F10".

". %adwanD,MoftahL,ou!an),MosaM,I!ahem:e!all

!ep!esentationof(*!esultsandco!!elationof(*ne-atiitwith

se!opositielooddono!s.oG'an-2010,:8#.

@0. as?(,'ade6(:>!ealenceofhepatitisBsu!faceanti-enand

hepatitisCi!usantiodiesamon-looddono!sin(leGand!ia,&-pt.

&astMedite!!)ealth42011,1#739:238F2"2.

@1. (wadalla)I,%a-aM),assa!(,smanM():%is6facto!sofhepatitisC

infectionamon-&-ptianlooddono!s.Cent&u!4>ulic)ealth2011,

17"9:21#F221.

@2. La!awela),ho!shiedM,'haheenI,ouda),asef(,(ulata,

Mahmoud)(,[awam)M,Mousa'M:*heassociationetweenhepatitis

Ci!usinfection,-eneticpolmo!phismsofoGidatiest!ess-enesand

B$cellnon$)od-6in;slmphoma!is6in&-pt.Infectenet&ol2012,

127A9:118F11".

@3. (del$ahaML,[a6a!ia',amelM,(del$haliM,Ma!ou6M(,

'alama),&smat,*homasD+,'t!ic6land*:)i-hse!op!ealenceof

hepatitisCinfectionamon-!is6-!oupsin&-pt.(m4*!opMed)-

1",@17@9:@A3F@A#.@". amelM(,Mille!LD,elMas!(,[a6a!ia',hattaM,&ssmat,ha=a

!

(:*heepidemiolo-of'chistosomamansoni,hepatitisBandhepatiti

s

Cinfectionin&-pt.(nn*!opMed>a!asitol1",887@9:@01F@0.

@@. Da!wishM,(asM,)ad'I,Mohammed*(:'tudofthehi-h

p!ealenceof)Cin&-pt.4&-pt>ulic)ealth(ssoc1@,

#073F"9:3#F"1".

@A. Da!wishM(,La!is%,Clemens4D,%aoM%,&delman%:)i-hse!op!ealenc

e

ofhepatitis(,B,C,and&i!usesin!esidentsinan&-ptianilla-ein

theiledelta:(pilotstud.(m4*!opMed)-1A,@"7A9:@@"F@@8.

@#. el$'aed)L,(aa'M,Mehanna',inch>4:*hep!ealenceo

titis

BandCinfectionsamon-immi-!antstoanewl!eclaimeda

endemicfo!'chistosomamansoniin'inai,&-pt.(cta*!op1

A8729:22F23#.

@8. afehM(,Medhat(,'hehataM,Mi6hail),'wifee,(del$)

M,

atts',LiG(D,'t!ic6land*,(nwa!,etal:)epatitisCina

munit

inuppe!&-pt:I.C!oss$sectionalsu!e.(m4*!opMed)-

A37@FA9:23AF2"1.

@. (del$(iL,)aiM,MohamedM,(del$)amidM,amilL,Mad6ou

Mi6hail,*homasD,LiG(D,'t!ic6land*,etal:)epatitisC

7)C9

infectioninacommunitintheileDelta:>opulationdesc!ipand

)Cp!ealence.)epatolo-2000,32719:111F11@.

A0. Da!wishM(,La!is%,Da!wish,'houman(,adallahM,&l$'ha

M',

&delman%,!umach,%aoM%,Clemens4D:)epatitisCand

otic

lie!diseaseintheiledeltaof&-pt:(communit$aseds

(m4*!opMed)-2001,A"73F"9:1"#F1@3.

A1. el$'adawM,%a-a),el$*ou6h),el$Mo!(el+,Man-oud(M,&is

),

(fef(L,el$'ho!a-&,I!ahemI(,Mah!ous',etal:)epatit

!us

infectionat'ha!6iaoe!no!ate,&-pt:se!op!ealenceand

iated

!is6facto!s.4&-pt'oc>a!asitol200",3"719:3A#F38".

A2. (!afa,&l)oseinM,%e6acewicC,Ba6!I,&l$af!aw',&lDalM,(o

Ma!ou6D,MohamedM,Lontanet(:Chan-in-patte!nofhe

sC

i!ussp!eadin!u!ala!easof&-pt.4)epatol200@,"3739:"18A3. MohamedM,Ba6!I,&l$)oseinM,(!afa,)assan(,Ismail',

M,

(ttalaM,%e6acewicC,[alata,etal:)C$!elatedmo!idit

u!al

communitof&-pt.4Medi!ol200A,#879:118@F118.

A". &assa',&issaM,'ha!af'M,I!ahimM),)assaneinM:>!e

eof

hepatitisCi!usinfectionandealuationofahealtheducatio

-!am

inel$-ha!illa-eina-ai-,e-pt.4&-pt>ulic)ealth(sso

#,

827@FA9:3#F"0".


42/48

A@. (-uila!C&,'oliman(',McConnellD',[e6!i(%,Bane!ediat!2003,"7A9:38"F38@.

A#. MohamedM,Ma-de!+',(del$)amidM,&l$DalM,Mi6hail,(del$(i

L,Medhat(,*hie!s,'t!ic6land*:*!ansmissionofhepatitisCi!us

etweenpa!entsandchild!en.(m4*!opMed)-200A,#@719:1AF20.

A8. &l'he!ini(,Mohsen'(,)asan,Mostafa',&loha!,Monei(,

(aa():*hepea6impactofan&-ptainout!ea6ofhepatitisCi!us:

)asitpassedo!hasnotetoccu!!edQ+ie!Int200#,2#7A9:8#AF8##.

A. Ba!a6at'),&l$Bashi!:)epatitisCi!usinfectionamon-health&-ptian

child!en:>!ealenceand!is6facto!s.4i!al)epat2011,187119:##F#8".

#0. &l$'aedM,omatos>4,%odie!%,ie!a*L,Da!wish(,hashaa',

(!thu!%%:'e!op!ealencesu!eof&-ptiantou!ismwo!6e!sfo!

hepatitisBi!us,hepatitisCi!us,humanimmunode?cienci!us,and

*!eponemapalliduminfections:(ssociationofhepatitisCi!us

infectionswithspeci?c!e-ionsof&-pt.(m4*!opMed)-1A,@@729:1#F18".

#1. MohamedM,)usseinM),Massoud((,%a6haaMM,'hoei!',(oun((,

(oulase!M:'tudofthe!is6facto!sfo!i!alhepatitisCinfection

amon-&-ptiansapplin-fo!wo!6a!oad.4&-pt>ulic)ealth(ssoc

1A,#171F29:113F1"#.

#2. oha!'(,halil%,&laishM,hed!&M,(hmedM':>!ealenceof

antiodiestohepatitisCi!usinhemodialsispatientsand!enal

t!ansplant!ecipients.4&-pt>ulic)ealth(ssoc1@,#07@FA9:"A@F"8".

#3. )alim(B,a!!%L,Dash',e!e!M(:&=ectofschistosomiasisand

hepatitisonlie!disease.(m4*!opMed)-1,A07A9:1@F20.

#". )assanMM,[a-hloul(',&l$'e!a-)B,'oliman,>att[,ChappellC+,

Beasle%>,)wan-+:*he!oleofhepatitisCinhepatocellula!

ca!cinoma:acasecont!olstudamon-&-ptianpatients.

4Clinast!oente!ol2001,33729:123F12A.

#@. 't!ic6land*,&lhefni),'alman*,a6edI,(del$)amidM,Mi6hail,

&smat,LiG(:%oleofhepatitisCinfectioninch!oniclie!diseasein

&-pt.(m4*!opMed)-2002,A#7"9:"3AF""2.

#A. &l$'aedM,Mohamed',ouhM(,Monee!MM,&l$Mahallaw)(:i!al

-enomesandanti-endetectionofhepatitisBandCi!usesininoledlmphnodesof&-ptiannon$)od-6in;slmphomapatients.&-pt4

Immunol200A,13719:10@F11".

##. &lBassuoniM(,adaM(,o!ah*,&l'aed':(ssessmentof*!e-cells

CD"CD2@inch!onicci!!hoticlie!diseaseandhepatocellula!

ca!cinoma&-ptianpatients.)epatitisMonthl2008,8739:1#3F1##.

#8. 'alamaM,'elimel':)epatitisi!usinfectioninmultit!ansfused

&-ptianchild!en.>ediat!)ematolncol200,2A7"9:232F23.

#. La!-hal(,Ba!a6at%M:>!ealence,impactand!is6facto!sofhepatitis

Cinfection.4&-pt>ulic)ealth(ssoc13,A871F29:A3F#.

80. MohamedM:&pidemiolo-of)Cin&-pt200".*he(f!o$(!a+ie!

4ou!nal200",3729:"1F@2.

81. 'ha!af$&ldeen','alama,&ldeme!dash',)assan)M','emesemM:


43/48

epatitisBandCi!usesin&-ptianchild!enwithmali-nanc.4Med'ci

0#,#7A9:1003F1008.

aiM,MohamedM,(del$(iL,Ma-de!+',(del$)amidM,amilL,

ad6ou!',Mi6hail,(nwa!,'t!ic6land*,etal:)epatitisCi!us

fectioninacommunitintheileDelta:%is6facto!sfo!se!opositiit.

epatolo-2001,33719:2"8F2@3.

$oha!(,)assan(,Kchida*,'hi6ata*,ooman[:>!ealenceof

patitis&i!usamon-acutespo!adichepatitispatientsin'ue.Int

epatolCommun1",27"9:218F222.

aafa!MM,%e6acewicC,(del$%ahman(,(llamML,&l)osseinM,

midM(,ColomaniL,'ultan,&l$(id',Lontanet(,etal:'u!eillance

acutehepatitisCinCai!o,&-pt.4Medi!ol200@,#A7"9:@20F@2@.

8@. Me6L(,'tose6',(del$)amidM,'elim',(del$aha(,Mi6hail,&l$

af!aw',&l$DalM,(del$(iL,'ha!af',etal:(ctiesu!eillancefo!

acutei!alhepatitisin!u!alilla-esintheileDelta.ClinInfectDis200A,

"27@9:A28FA33.

8A. [a6a!ia',Louad%,'ha6e!,[a6i',)ashem(,&l$ama!'',&smat:

Chan-in-patte!nsofacutei!alhepatitisatama


44/48



88. *alaatM,&l$'aed,andeel(,(aM(,(??',oussefL,Ismael*,

)aa!asitol2012,"2719:203F20A.

1. 'aid[,&l$'aedM),&l$BishishiI(,&l$LouhilDL,(del$%heem'&,

&l$(edinM[,'alamaII:)i-hp!ealenceofocculthepatitisBinhepatiti

s

C$infected&-ptianchild!enwithhaematolo-icaldiso!de!sand

mali-nancies.+ie!Int200,27"9:@18F@2".

2. *ona!(,&lash!%,[a6iMel':Desc!iptieepidemiolo-ofhemophili

a

andothe!coa-ulationdiso!de!sinmansou!a,e-pt:!et!ospectie

analsis.Medite!!anean),)ussein):*!ansfusion

t!ansmittedhepatitis:he!edowestandnowQ(onecente!studin

uppe!&-pt.)epatitisMonthl2012,127"9:28AF21.

". (delwahaM',&l$%ai6M',addah(,(ou$&lew)):>!ealenceof

hepatitisCi!usinfectionandhumanimmunode?cienci!usina

coho!tof&-ptianhemophiliacchild!en.(nn'audiMed2012,

32729:200F202.

@. halifa(','alemM,Mouni!&,&l$*awilMM,&l$'awM,(d(l$(iMM:

(no!mal-lucosetole!ancein&-ptianeta$thalassemicpatients:

possileassociationwith-enotpin-.>ediat!Diaetes200",@739:12AF

132.A. (dallaM,alal(,Latouh((,&id,'alama&&&,omma)&:*!ansfusion

t!ansmittedi!us7**9infectioninpolt!ansfused&-ptianthalassemi

c

child!en.4Med'ci200A,A7@9:833F83#.

#. ma!,'alama,(dolf',&l$'aeed',(delha=a!,&at:Ma


45/48

Cai!o,&-pt.)emodialInt2010,1"719:A1FA#.

10. el$haawi&,D!ew+,)amd+,&l$'he!ini&,'ade6'elD,'aleh&:

Int!aenousd!u-addicts:ahi-h!is6-!oupfo!infectionwithhuman

immunode?cienci!us,hepatitisi!uses,ctome-aloi!usand

acte!ialinfectionsin(leGand!ia&-pt.4&-pt>ulic)ealth(ssoc1@

,

#071F29:12#F1@0.

110. &l$a!a6s),(nwa!),&l$%ai6M',&l$)awa!M,)ashemM,&l$'aed%,

&l$'ha!awiM,Mohsen,Louad),&smat:(nti$)Cp!ealenceamon-

diaeticandnon$diaetic&-ptianchild!en.Cu!!Diaetes%e2010,

A7A9:388F32.

111. &lma-dMM,Ba6!M(,Metwall(),aha(M:Clinicoepidemiolo-ic

studofpostt!ansplantdiaetesafte!liin-$dono!!enalt!ansplant.

&GpClin*!ansplant2008,A719:"2F"#.

112. &l$MedanM:&l$Din(delaha',(u'had&(,ad&l$)a6:

Ch!oniclie!diseaseandhepatitisCi!usin&-ptianpatients.

)epato-ast!oente!olo-1,"A72#9:18@F103.

113. La!-hal(,Mansou!(,Mahd),ous!i(:)epatitisBandCi!us

infectionsamon-patientswith-in-iitisandadultpe!iodontitis:

se!op!ealenceandpulichealthimpo!tance.4&-pt>ulic)ealth(ssoc

18,#37@FA9:#0#F#3@.

11". Mo!ad':*!ansmissionofhepatitisCetweenspousesan

epidemiolo-icalstudatational+ie!Institutehospital.Int4InfectDis

2011,1@:'81.

11@. &l$[aadi(,halifa((,&l$Misie!(,ase!(M,Daous),(oul$&((:

&aluationof!is6facto!sfo!int!afamilialt!ansmissionof)Cinfection

in&-pt.4&-pt>ulic)ealth(ssoc1#,#271F29:33F@1.

11A. 'hala',aashI(,&l'aleet,Mansou!,ma!(,&lawaw(:

)epatitisBandCi!alinfection:p!ealence,6nowled-e,attitudeand

p!acticeamon-a!e!sandclientsinha!ia-oe!no!ate,&-pt.

&astMedite!!)ealth42010,1A719:10F1#.

11#. &at',(del$)amidM,(del$+atif&issa',Mo6hta!,+ai(,

&l$ho!o!+,Mi6hail,(del$)amid(,)ifnaw*,'t!ic6land*,etal:

(ssociationsofpesticides,)C,)B,andhepatocellula!ca!cinomain

&-pt.Int4)-&ni!on)ealth200@,2087@9:32F33.

118. Mei!),BalawiI,ael),&la!a6s),&l)addad(:)epaticdsfunctionin

child!enwithacutelmpholasticleu6emiain!emission:%elationto

hepatitisinfection.Med>ediat!ncol2001,3A7"9:"AF"#3.

11. Mostafa&&(,Mansou!*,(minM,'idhomI,hai!(,&l[omo!):

'e!op!ealenceof)epatitisBandCin>ediat!icMali-nancies.4&-pt

atlCancInst2003,1@719:33F"2.

120. Medhat(,'hehataM,Ma-de!+',Mi6hail,(del$Ba6i+,afehM,(del$)amidM,'t!ic6land*,LiG(D:)epatitiscinacommunitinKppe!&-pt:

!is6facto!sfo!infection.(m4*!opMed)-2002,AA7@9:A33FA38.

121. >lancoulaine',MohamedM,(!afa,Ba6!I,%e6acewicC,*!e-ouetD(,

achD,&lDalM,*hie!s,Le!aC,etal:Dissectionoffamilial

co!!elationsinhepatitisCi!us7)C9se!op!ealencesu--ests

int!afamiliali!alt!ansmissionand-eneticp!edispositiontoinfection.

ut2008,@#79:12A8F12#".

122. asle(,(lte!M4:&pidemiolo-ofhepatitisC:eo-!aphicdi=e!ences

andtempo!alt!ends.'emin+ie!Dis2000,20719:1F1A.

123. 'iee!t,(lt!aifI,%aai)(,(do(,(hmed&(,(lomai!(,(ma!apu!6a!D,

ChenC),Dou,&lhaat),etal:(sstematic!eiewofhepatitisCi!us

epidemiolo-in(sia,(ust!aliaand&-pt.+ie!Int2011,317'K>>+.29:A1F80.


46/48

ceiulic)ealth(ssoc1,#"73F"9:313F332.

131. 'helLM,&l$ama!'','alehD(,(del$)amidM,Mi6hail,(llam(,

&l$(!ai),&lhenawI,&l$af!aw',&l$DalM,etal:>!ospectiecoho!t

studofmothe!$to$infant infectionandclea!anceofhepatitisCin!u!al

&-ptianilla-es.4Medi!ol200,817A9:102"F1031.


47/48



132. )ammad(M,[a-hloulM):)epatitisi!usinfectionin&-ptian

child!enwithch!onic!enalfailu!e7sin-lecent!estud9.(nnClinMic!oiol

(ntimic!o200,8:3A.

133. &loha!(,)assan(,ooman[,+aanchD,Mae!atC,&l(at(,Lawa

,o!anL,(hmedM,awanoL,etal:)i-hp!ealenceofhepatitisC

i!usamon-u!anand!u!alpopulation-!oupsin&-pt.(cta*!op1@,

@729:1@@F1A1.

13". (u$%addad+,(6alaL(,'eminiI,%iedne!,ilsonD,*awil:

Cha!acte!iin-the)I/(ID'epidemicintheMiddle&astando!th(f!ica:

*imefo!'t!ate-ic(ction.Middle&astando!th(f!ica)I/(ID'&pidemiolo-

'nthesis>!o


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