Pakistan Journal of Medical Sciences

Published by : PROFESSIONAL MEDICAL PUBLICATIONS

ISSN 1681-715X

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Brief Communication

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Volume 24

April - June 2008 (Part-II)

Number 3


 

Abstract
PDF of this Article

Sero prevalence of Hepatitis B and C
in surgical patients

Abdul Qayoom Daudpota1, Abdul Waheed Soomro2

Summary

The objective of this study conducted in patients above thirteen years of age undergoing surgery at Jacobabad Sindh from February 2007 to July 2007 was to find out the prevalence of hepatitis B & C and compare the incidence with other areas of Pakistan. Sero prevalence of viral hepatitis B & C combined was 23.55% whereas 14% were positive for Hepatitis C and 9.33% for Hepatitis B. In view of this high prevalence rate we feel it is essential to routinely screen all patients undergoing surgery for Hepatitis B and C.

KEYWORDS: Hepatitis B, Hepatitis C, Elective Surgery.

Pak J Med Sci    April - June 2008 (Part-II)    Vol. 24 No. 3    483-484

How to cite this article:

Daudpota AQ, Soomro AW. Sero prevalence of Hepatitis B and C in surgical patients. Pak J Med Sci 2008;24(3):483-4.


1. Dr. Abdul Qayoom Daudpota, MBBS, MS
Consultant General Surgeon,
City Medical Centre,
Jacobabad, Sindh - Pakistan.
2. Dr. Abdul Waheed Soomro, MBBS
Medical Officer,
City Medical Centre,
Jacobabad, Sindh - Pakistan.

Correspondence

Dr. Abdul Qayoom Daudpota
E-mail: surgeonqayoom@yahoo.com

* Received for Publication: January 5, 2008
* Revision Accepted: May 31st 2008


INTRODUCTION

Viral Hepatitis is a serious global health problem. About two billion people have been infected with hepatitis B virus and 350 million have chronic life long infection.1 The prevalence of HCV is higher and it is estimated that about 170 million people are chronically infected while three to four million people are newly infected every year.2

Pakistan has huge burden of these viral diseases, the common risk factors are blood transfusion, heamodialysis, thalassemia, use of unsterilized syringes, barber shaving, tattooing & sexual abuse.3 This problem of viral hepatitis in hospitalized patients is not adequately controlled although the asymptomatic patient pose great danger of spreading the infection to other patients and medical personnel.4,5

METHODOLOGY

This study was conducted in the surgical patients at City Medical Centre Jacobabad from February 2007 to July 2007. All the patients below thirteen years of age admitted through emergency. Patients who were known to be positive for hepatitis B & C were excluded.

Information regarding having symptoms of viral hepatitis like pain in right upper abdomen, anorexia, nausea, dyspepsia, vomiting, fever and Jaundice etc., was collected. All patients were screened for hepatitis B & C using ICT KIT method.

RESULTS

During the study period 150 patients which included 83 male and 67 female were screened. Thirty five (23.5%) patients were found to be positive for Hepatitis B and C, among them twenty one (14%) were positive for HCV and fourteen (9.33%) were positive for hepatitis B Most common age group affected was 20-30 years. (HBV 35.77%, HCV 33.3%). Among HBV positive patients 64.28% were male and 35.71% were female. In HCV 52.33% were male and 47.60% were female. Only three patients (8.57%) had past history of jaundice and five patient (14.28%) had symptoms like malaise and dyspepsia. Among positive patients five cases (14.28%) had previous surgeries and two patients (5.71%) gave history of blood transfusion in the past. One patient was intravenous drug abuser. None of them was vaccinated for hepatitis B. However, many of them agreed for screening and vaccination of their family members against these viral diseases.

DISCUSSION

According to reports HBsAg carrier rate is around 10% in different areas of Pakistan.6 In our study the Seroprevalance was 9.33% slightly lower than described by Yousuf et al.6 Different studies carried out at different areas of Pakistan by Shaikh et al,7 Talpur AA8 and Malik e al9 carrier state of HBsAg has been reported as 2.8%, 8.6% and 10% respectively .

The Seroprevalance of hepatitis C in Pakistan varies from 4% to 7%,10 11.6% Talpur AA,8 11.26% Chaudhary et al,4 but our result are higher than these studies. Overall Hepatitis B and C Seroprevalence was found to be 23.33% in our study which is similar to the figures reported from other parts of Pakistan.

Zubia et al11 in their study looked at 387 patients admitted for elective surgery. Aftrer screening they found that 6% of the patients enrolled in this study were positive for both HBV and HCV. HBsAg was positive in 6.5% of patients while 11.3% were positive for HCV. Risk factors in their study included reuse of contaminated syringes, contaminated surgical instruments and blood products. They concluded that presvalence of HBsAg and anti HCV in hospitalized surgical patients is very high. They suggested that screening for HBv and HCV should be a routine pre operative investigation.11

Chaudhry et al also conducted another study among patients reporting in surgical OPD of Fauji Foundation Hospital Rawalpindi during 2006. They screened 2056 patinets and found prevalence of Hepatitis B as 2.8%, sereoprevalence of Hepatitis-C was 7.56 with male predominance in both the groups.12 Khan from Mardan 13 and Amin et al14 from Lahore have reported prevalence of HCV as 9% and 13.5% respectively.

CONCLUSIONS

High prevalence of hepatitis B and C in this study as well as other studies suggest that pre operative screening of patients going for surgery should be mandatory. Further more in view of the high infection and carrier rate, all preventive measures should be adopted to check and control these viral disorders.

REFERENCES

1. Hepatitis-B Fact Sheet No.204. Geneva, World Health Organization, 200C. (http/www.who.int/media centre/fact sheet/fs 164/en/accessed 31st May 2004).

2. Hepatitis-C Fact Sheet No.164.Geneva, World Health Organization; 200C. (http/www.who.int/me-dia centre/fact sheet/fs 164en/accessed 31st May 2004).

3. Luby S. The relationship between therapeutic injections and high prevalence of Hepatitis-C infection in Hafizabad, Pakistan. Epidemiol infection 1997;119(3):349-56.

4. Choudhary IA, Khan SA, Samiullah. Should we do Hepatitis-B and C screening on each patient before surgey. Pak J Med Sci 2005;21(3):278-80.

5. Meri K, Maria E, Joanna M, Stelosis S, Nikolas T, Pandelis ED, et al. Prevalence of Hepatitis –B and C Markers in high risk hospitalized patients in Crete. A 5-year observational study. BMC Public Health, Greece 2001;1-17.

6. Yousef A, Mahmood A, Ishaque M, Yousef M. Can we afford to operate on patients without HBsAg screening J Coll Physi Surg Pak 1996;9(2):98-100.

7. Shaikh MH, Shams K. Prevalence of HBV markers in health care personals Vs Matched control. J Coll Physi Surg Pak 1995;5:19-21.

8. Talpur AA, Ansari AG, Awan MS, Ghumro AA, Prevalence of Hepatitis B and C in Surgical Patients. Pak J of Surgery 2006;22(3):150-53.

9. Malik IA, Legters LJ, Luqman M. Ahmed A, Qamar MA, Akhtar KAK, et al. The serological markers of Hepatitis-A and B in Healthy Population in Northern Pakistan. J Pak Med Assoc 1988;38:69-72.

10. Malik AI, Tariq WUZ. Hepatitis-C infection in prospective. Where do we stand (Editorial). J Coll Physic Surg Pak 1999;9(4):234-7.

11. Masood Z, Jawaid M, Khan RA, Rehan S. Screening for Hepatitis B and C: A routine pre operative investigation. Pak J Med Sci 2005;21(4):455-9.

12. Chaudhry IA, Khan SS, Majrooh MA, Alvi AA. Seroprevalence of Hepatitis B and C among the patients reporting at surgical OPD at Fauji Foundaiton Hospital, Rawalpindi. Pak J Med Sci 2007;23(4):514-17.

13. Khan MSA,Khalid M, Ayub N,Javed M. Seroprevalence and risk factors for Hepatitis C virus in Mardan NWFP. Rawal Med J 2004;29(2):57-60.

14. Amin J, Yousuf H, Mumtaz A, Iqbal M, Ahmed R, Adhmi SZ et al. Prevalence of Hepatitis B surface antigen & Anti Hepatitis C virus. Professional Med J 2004;11(3):334-7.


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