Samer S El-Kamary1, Mohamed Hashem2, Doa'a A Saleh3, Mohamed Ehab4, Sahar A Sharaf5, Fatma El-Mougy5, Lobna Abdelsalam5, Ravi Jhaveri6, Ahmed Aboulnasr4, Hesham El-Ghazaly4. 1. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: selkamar@epi.umaryland.edu. 2. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. 3. Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt. 4. Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt. 5. Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt. 6. Division of Infectious Diseases, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, NC, USA.
Abstract
OBJECTIVES: The Centers for Disease Control and Prevention (CDC) only recommends risk-based HCV screening for pregnant women in the United States. This study sought to determine the reliability of risk-based versus universal HCV screening for pregnant women in Egypt, a country with the world's highest HCV prevalence that also relies on risk-based screening, and to identify additional characteristics that could increase the reliability of risk-based screening. METHODS: Pregnant women attending the Cairo University antenatal clinic were tested for anti-HCV antibodies and RNA, and demographic characteristics and risk factors for infection were assessed. RESULTS: All 1250 pregnant women approached agreed to participate (100%) with a mean age of 27.4 ± 5.5 years (range:16-45). HCV antibodies and RNA were positive in 52 (4.2%) and 30 (2.4%) women respectively. After adjustment, only age (OR:1.08, 95%CI:1.002-1.16, p < 0.01), history of prior pregnancies (OR:1.20, 95%CI:1.01-1.43, p < 0.04), and working in the healthcare sector (OR:8.68, 95%CI:1.72-43.62, p < 0.01), remained significantly associated with chronic HCV infection. CONCLUSIONS: Universal antenatal HCV screening was widely accepted (100%) and traditional risk-based screening alone would have missed 3 (10%) chronically infected women, thereby supporting universal screening of pregnant women whenever possible. Otherwise, risk-based screening should be modified to include history of prior pregnancy and healthcare employment.
OBJECTIVES: The Centers for Disease Control and Prevention (CDC) only recommends risk-based HCV screening for pregnant women in the United States. This study sought to determine the reliability of risk-based versus universal HCV screening for pregnant women in Egypt, a country with the world's highest HCV prevalence that also relies on risk-based screening, and to identify additional characteristics that could increase the reliability of risk-based screening. METHODS: Pregnant women attending the Cairo University antenatal clinic were tested for anti-HCV antibodies and RNA, and demographic characteristics and risk factors for infection were assessed. RESULTS: All 1250 pregnant women approached agreed to participate (100%) with a mean age of 27.4 ± 5.5 years (range:16-45). HCV antibodies and RNA were positive in 52 (4.2%) and 30 (2.4%) women respectively. After adjustment, only age (OR:1.08, 95%CI:1.002-1.16, p < 0.01), history of prior pregnancies (OR:1.20, 95%CI:1.01-1.43, p < 0.04), and working in the healthcare sector (OR:8.68, 95%CI:1.72-43.62, p < 0.01), remained significantly associated with chronic HCV infection. CONCLUSIONS: Universal antenatal HCV screening was widely accepted (100%) and traditional risk-based screening alone would have missed 3 (10%) chronically infected women, thereby supporting universal screening of pregnant women whenever possible. Otherwise, risk-based screening should be modified to include history of prior pregnancy and healthcare employment.
Authors: Susan M Lopata; Elizabeth McNeer; Judith A Dudley; Carolyn Wester; William O Cooper; James G Carlucci; Claudia M Espinosa; William Dupont; Stephen W Patrick Journal: Pediatrics Date: 2020-02-14 Impact factor: 7.124
Authors: Isabelle A Nakhla; John W Sanders; Emad W Mohareb; Sahar Samy; Michael T Cosby; Manal M Mostafa; Mark S Riddle; Robert W Frenck Journal: Trop Dis Travel Med Vaccines Date: 2015-10-01