Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan

Abstract Background Seroprevalence of hepatitis C in Khyber Pakhtunkhwa province of Pakistan was determined by screening blood samples of expectant mothers seeking antenatal care in gynecological units of district hospitals. The rationale behind this cohort study was that the availability of free-of...

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Main Authors: Zobia Afsheen, Bashir Ahmad, Shumaila Bashir
Format: Article
Language:English
Published: BMC 2017-10-01
Series:Virology Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12985-017-0861-y
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author Zobia Afsheen
Bashir Ahmad
Shumaila Bashir
author_facet Zobia Afsheen
Bashir Ahmad
Shumaila Bashir
author_sort Zobia Afsheen
collection DOAJ
description Abstract Background Seroprevalence of hepatitis C in Khyber Pakhtunkhwa province of Pakistan was determined by screening blood samples of expectant mothers seeking antenatal care in gynecological units of district hospitals. The rationale behind this cohort study was that the availability of free-of-cost antenatal care in district hospitals brings expectant mothers from a broader geographical range in each district and thus provides a large sample-size of healthy pregnant women of known medical history for Hepatitis C Virus (HCV) surveillance. The study was carried out along a south west to north east transact of five districts, Kohat-Peshawar-Nowshera-Charsadda-Mardan, with the central district Peshawar and outer districts Kohat and Mardan bordering northern mountainous ranges of the Khyber Pakhtunkhwa province. This distribution of districts along the transact allowed the study to gauge the impact of proximity to remote highland communities on the HCV burden of visiting pregnant women tested for HCV infection. Methods The cohort study randomly selected 150 pregnant women visiting each hospital for serological screening for Anti-HCV carried out by ELISA assay. The feasibility of ICT and RT-PCR assays for HCV prevalence was also examined in the present study. Results With a total of 750 blood specimen screened, the results of ELISA tests revealed a staggering 5.9% frequency of Anti-HCV in the five districts with the frequency of ELISA positive cases ranging from 3.3% in Nowshera, 4.7% in Charsadda, 6.0% in Peshawar, 6.7% in Kohat, and 8.7% in Mardan. The relatively higher frequencies of Anti-HCV cases among hospital visiting pregnant women in Peshawar, Kohat and Mardan were consistent with the proximity of these hospitals to the highland communities in the bordering mountain ranges. Compared to 44 Anti-HCV positive serologic specimens detected by ELISA, only 26 and 10 blood specimens were tested positive by ICT and PCR methods, respectively. Our study validates ELISA as a reliable diagnostic technique for both acute and chronic HCV infection. Conclusion The HCV infection rate of 5.9% in Khyber Pakhtunkhwa province clearly exceeds the HCV prevalence rates reported for other regions in Pakistan, making this province a hotspot of HCV infection in the country.
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spelling doaj.art-bac177f96d2d47a19c5f2ea6e4c5cf9a2022-12-21T18:46:17ZengBMCVirology Journal1743-422X2017-10-011411610.1186/s12985-017-0861-yHospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of PakistanZobia Afsheen0Bashir Ahmad1Shumaila Bashir2Department of Microbiology and Biotechnology, Abasyn University PeshawarCentre for Biotechnology and Microbiology, University of PeshawarDepartment of Pharmacy, University of PeshawarAbstract Background Seroprevalence of hepatitis C in Khyber Pakhtunkhwa province of Pakistan was determined by screening blood samples of expectant mothers seeking antenatal care in gynecological units of district hospitals. The rationale behind this cohort study was that the availability of free-of-cost antenatal care in district hospitals brings expectant mothers from a broader geographical range in each district and thus provides a large sample-size of healthy pregnant women of known medical history for Hepatitis C Virus (HCV) surveillance. The study was carried out along a south west to north east transact of five districts, Kohat-Peshawar-Nowshera-Charsadda-Mardan, with the central district Peshawar and outer districts Kohat and Mardan bordering northern mountainous ranges of the Khyber Pakhtunkhwa province. This distribution of districts along the transact allowed the study to gauge the impact of proximity to remote highland communities on the HCV burden of visiting pregnant women tested for HCV infection. Methods The cohort study randomly selected 150 pregnant women visiting each hospital for serological screening for Anti-HCV carried out by ELISA assay. The feasibility of ICT and RT-PCR assays for HCV prevalence was also examined in the present study. Results With a total of 750 blood specimen screened, the results of ELISA tests revealed a staggering 5.9% frequency of Anti-HCV in the five districts with the frequency of ELISA positive cases ranging from 3.3% in Nowshera, 4.7% in Charsadda, 6.0% in Peshawar, 6.7% in Kohat, and 8.7% in Mardan. The relatively higher frequencies of Anti-HCV cases among hospital visiting pregnant women in Peshawar, Kohat and Mardan were consistent with the proximity of these hospitals to the highland communities in the bordering mountain ranges. Compared to 44 Anti-HCV positive serologic specimens detected by ELISA, only 26 and 10 blood specimens were tested positive by ICT and PCR methods, respectively. Our study validates ELISA as a reliable diagnostic technique for both acute and chronic HCV infection. Conclusion The HCV infection rate of 5.9% in Khyber Pakhtunkhwa province clearly exceeds the HCV prevalence rates reported for other regions in Pakistan, making this province a hotspot of HCV infection in the country.http://link.springer.com/article/10.1186/s12985-017-0861-yElisaHepatitis C virusImmuno chromatographic techniquePCRPregnancy
spellingShingle Zobia Afsheen
Bashir Ahmad
Shumaila Bashir
Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan
Virology Journal
Elisa
Hepatitis C virus
Immuno chromatographic technique
PCR
Pregnancy
title Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan
title_full Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan
title_fullStr Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan
title_full_unstemmed Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan
title_short Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan
title_sort hospital visiting pregnant women signal an increased spread of hepatitis c infection in khyber pakhtunkhwa region of pakistan
topic Elisa
Hepatitis C virus
Immuno chromatographic technique
PCR
Pregnancy
url http://link.springer.com/article/10.1186/s12985-017-0861-y
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