Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal
Abstract Background As one of the causative agents of viral hepatitis, hepatitis E virus (HEV) has gained public health attention globally. HEV epidemics occur in developing countries, associated with faecal contamination of water and poor sanitation. In industrialised nations, HEV infections are as...
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| Format: | Article |
| Language: | English |
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BMC
2016-11-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-016-2043-8 |
| _version_ | 1819171982777778176 |
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| author | Ashish C. Shrestha Robert L. P. Flower Clive R. Seed Manita Rajkarnikar Shrawan K. Shrestha Uru Thapa Veronica C. Hoad Helen M. Faddy |
| author_facet | Ashish C. Shrestha Robert L. P. Flower Clive R. Seed Manita Rajkarnikar Shrawan K. Shrestha Uru Thapa Veronica C. Hoad Helen M. Faddy |
| author_sort | Ashish C. Shrestha |
| collection | DOAJ |
| description | Abstract Background As one of the causative agents of viral hepatitis, hepatitis E virus (HEV) has gained public health attention globally. HEV epidemics occur in developing countries, associated with faecal contamination of water and poor sanitation. In industrialised nations, HEV infections are associated with travel to countries endemic for HEV, however, autochthonous infections, mainly through zoonotic transmission, are increasingly being reported. HEV can also be transmitted by blood transfusion. Nepal has experienced a number of HEV outbreaks, and recent earthquakes resulted in predictions raising the risk of an HEV outbreak to very high. This study aimed to measure HEV exposure in Nepalese blood donors after large earthquakes. Methods Samples (n = 1,845) were collected from blood donors from Kathmandu, Chitwan, Bhaktapur and Kavre. Demographic details, including age and sex along with possible risk factors associated with HEV exposure were collected via a study-specific questionnaire. Samples were tested for HEV IgM, IgG and antigen. The proportion of donors positive for HEV IgM or IgG was calculated overall, and for each of the variables studied. Chi square and regression analyses were performed to identify factors associated with HEV exposure. Results Of the donors residing in earthquake affected regions (Kathmandu, Bhaktapur and Kavre), 3.2% (54/1,686; 95% CI 2.7–4.0%) were HEV IgM positive and two donors were positive for HEV antigen. Overall, 41.9% (773/1,845; 95% CI 39.7–44.2%) of donors were HEV IgG positive, with regional variation observed. Higher HEV IgG and IgM prevalence was observed in donors who reported eating pork, likely an indicator of zoonotic transmission. Previous exposure to HEV in Nepalese blood donors is relatively high. Conclusion Detection of recent markers of HEV infection in healthy donors suggests recent asymptomatic HEV infection and therefore transfusion-transmission in vulnerable patients is a risk in Nepal. Surprisingly, this study did not provide evidence of a large HEV outbreak following the devastating earthquakes in 2015. |
| first_indexed | 2024-12-22T19:59:57Z |
| format | Article |
| id | doaj.art-5c0a174f6b794b478f6d9ced906f37ee |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-22T19:59:57Z |
| publishDate | 2016-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-5c0a174f6b794b478f6d9ced906f37ee2022-12-21T18:14:18ZengBMCBMC Infectious Diseases1471-23342016-11-011611910.1186/s12879-016-2043-8Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in NepalAshish C. Shrestha0Robert L. P. Flower1Clive R. Seed2Manita Rajkarnikar3Shrawan K. Shrestha4Uru Thapa5Veronica C. Hoad6Helen M. Faddy7Research and Development, Australian Red Cross Blood ServiceResearch and Development, Australian Red Cross Blood ServiceMedical Services, Australian Red Cross Blood ServiceCentral Blood Transfusion Services, Nepal Red Cross SocietyCentral Blood Transfusion Services, Nepal Red Cross SocietyCentral Blood Transfusion Services, Nepal Red Cross SocietyMedical Services, Australian Red Cross Blood ServiceResearch and Development, Australian Red Cross Blood ServiceAbstract Background As one of the causative agents of viral hepatitis, hepatitis E virus (HEV) has gained public health attention globally. HEV epidemics occur in developing countries, associated with faecal contamination of water and poor sanitation. In industrialised nations, HEV infections are associated with travel to countries endemic for HEV, however, autochthonous infections, mainly through zoonotic transmission, are increasingly being reported. HEV can also be transmitted by blood transfusion. Nepal has experienced a number of HEV outbreaks, and recent earthquakes resulted in predictions raising the risk of an HEV outbreak to very high. This study aimed to measure HEV exposure in Nepalese blood donors after large earthquakes. Methods Samples (n = 1,845) were collected from blood donors from Kathmandu, Chitwan, Bhaktapur and Kavre. Demographic details, including age and sex along with possible risk factors associated with HEV exposure were collected via a study-specific questionnaire. Samples were tested for HEV IgM, IgG and antigen. The proportion of donors positive for HEV IgM or IgG was calculated overall, and for each of the variables studied. Chi square and regression analyses were performed to identify factors associated with HEV exposure. Results Of the donors residing in earthquake affected regions (Kathmandu, Bhaktapur and Kavre), 3.2% (54/1,686; 95% CI 2.7–4.0%) were HEV IgM positive and two donors were positive for HEV antigen. Overall, 41.9% (773/1,845; 95% CI 39.7–44.2%) of donors were HEV IgG positive, with regional variation observed. Higher HEV IgG and IgM prevalence was observed in donors who reported eating pork, likely an indicator of zoonotic transmission. Previous exposure to HEV in Nepalese blood donors is relatively high. Conclusion Detection of recent markers of HEV infection in healthy donors suggests recent asymptomatic HEV infection and therefore transfusion-transmission in vulnerable patients is a risk in Nepal. Surprisingly, this study did not provide evidence of a large HEV outbreak following the devastating earthquakes in 2015.http://link.springer.com/article/10.1186/s12879-016-2043-8Blood donorEarthquakeHepatitis E virusHepatitisJaundice |
| spellingShingle | Ashish C. Shrestha Robert L. P. Flower Clive R. Seed Manita Rajkarnikar Shrawan K. Shrestha Uru Thapa Veronica C. Hoad Helen M. Faddy Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal BMC Infectious Diseases Blood donor Earthquake Hepatitis E virus Hepatitis Jaundice |
| title | Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal |
| title_full | Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal |
| title_fullStr | Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal |
| title_full_unstemmed | Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal |
| title_short | Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal |
| title_sort | hepatitis e virus seroepidemiology a post earthquake study among blood donors in nepal |
| topic | Blood donor Earthquake Hepatitis E virus Hepatitis Jaundice |
| url | http://link.springer.com/article/10.1186/s12879-016-2043-8 |
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