Individual-level key associations and modes of exposure for hepatitis C virus infection in the Middle East and North Africa: a systematic synthesis

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Abstract

Purpose: To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. Methods: Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. Results: In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2%), followed by other infections/diseases (n = 20; 17.5%), and incarceration (n = 17; 14.9%). Among modes of exposure, health care–related exposures were most frequently reported (n = 127; 59.5%), followed by injecting drug use exposures (n = 45; 20.9%), community-related exposures (n = 34; 15.8%), and sexual-related exposures (n = 8; 3.7%). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care–related exposures. Conclusions: Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.

Original languageEnglish
JournalAnnals of Epidemiology
DOIs
Publication statusAccepted/In press - 1 Jan 2018

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Northern Africa
Eastern Africa
Middle East
Virus Diseases
Hepacivirus
Pharmaceutical Preparations
Blood Safety
Delivery of Health Care
Harm Reduction
Injections
Information Storage and Retrieval
Health Facilities
Health
Infection Control
Infection
Blood Transfusion
Renal Dialysis
Tooth
Epidemiology
Databases

Keywords

  • Cohort study
  • Cross-sectional study
  • HCV
  • Mode of transmission
  • Risk behavior
  • Viral hepatitis

ASJC Scopus subject areas

  • Epidemiology

Cite this

@article{84d64caffa254f9b81744c5ac2a2b125,
title = "Individual-level key associations and modes of exposure for hepatitis C virus infection in the Middle East and North Africa: a systematic synthesis",
abstract = "Purpose: To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. Methods: Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. Results: In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2{\%}), followed by other infections/diseases (n = 20; 17.5{\%}), and incarceration (n = 17; 14.9{\%}). Among modes of exposure, health care–related exposures were most frequently reported (n = 127; 59.5{\%}), followed by injecting drug use exposures (n = 45; 20.9{\%}), community-related exposures (n = 34; 15.8{\%}), and sexual-related exposures (n = 8; 3.7{\%}). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care–related exposures. Conclusions: Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.",
keywords = "Cohort study, Cross-sectional study, HCV, Mode of transmission, Risk behavior, Viral hepatitis",
author = "Sarwat Mahmud and Silva Kouyoumjian and {Al Kanaani}, Zeinab and Hiam Chemaitelly and Laith Aburaddad",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.annepidem.2018.03.007",
language = "English",
journal = "Annals of Epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Individual-level key associations and modes of exposure for hepatitis C virus infection in the Middle East and North Africa

T2 - a systematic synthesis

AU - Mahmud, Sarwat

AU - Kouyoumjian, Silva

AU - Al Kanaani, Zeinab

AU - Chemaitelly, Hiam

AU - Aburaddad, Laith

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. Methods: Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. Results: In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2%), followed by other infections/diseases (n = 20; 17.5%), and incarceration (n = 17; 14.9%). Among modes of exposure, health care–related exposures were most frequently reported (n = 127; 59.5%), followed by injecting drug use exposures (n = 45; 20.9%), community-related exposures (n = 34; 15.8%), and sexual-related exposures (n = 8; 3.7%). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care–related exposures. Conclusions: Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.

AB - Purpose: To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. Methods: Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. Results: In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2%), followed by other infections/diseases (n = 20; 17.5%), and incarceration (n = 17; 14.9%). Among modes of exposure, health care–related exposures were most frequently reported (n = 127; 59.5%), followed by injecting drug use exposures (n = 45; 20.9%), community-related exposures (n = 34; 15.8%), and sexual-related exposures (n = 8; 3.7%). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care–related exposures. Conclusions: Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.

KW - Cohort study

KW - Cross-sectional study

KW - HCV

KW - Mode of transmission

KW - Risk behavior

KW - Viral hepatitis

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U2 - 10.1016/j.annepidem.2018.03.007

DO - 10.1016/j.annepidem.2018.03.007

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JO - Annals of Epidemiology

JF - Annals of Epidemiology

SN - 1047-2797

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