O115: Assessing the role of intra‐familial transmission in the ongoing propagation of the Egyptian hepatitis C virus epidemic
Notice bibliographique
Résumé
Egypt has the highest global prevalence of HCV. The Egyptian government campaign to control schistosomiasis with parenteral tartar emetic, the source of Egypt's current HCV epidemic, ended in 1986. Recent studies have investigated risk factors associated with ongoing transmission of HCV and used the 2008 Egypt Demographic and Health Survey (DHS) to assess ecologic risk factors (1, 2). This study adds to recent work by merging the 2008 DHS Health Issues and biomarker datasets to examine evidence of intra-familial transmission (IFT) of HCV and by using paternity information to evaluate the importance of vertical transmission. Birth prior to 1980 was used as a proxy for exposure to the campaign because the campaign ended in 1986 and only children 5 and older were treated. The outcome was defined as a positive HCV test in any respondent born in or after 1980. The odds of infection in respondents who were not exposed to the schistosomiasis campaign living in households where at least one household member who was potentially exposed tested positive were compared to the odds of infection in respondents who were not exposed to the campaign living in households where no exposed member tested positive. Marginal models were estimated using generalized estimating equations with household as the cluster variable. Logistic regressions were adjusted for surgery; blood transfusions; female genital mutilation; urban/rural residence; age; and education. Using data from 2640 households, the presence of a household member who tested positive for HCV and was born before 1980 was a significant predictor of infection in a member of the same household who was born in or after 1980 (OR: 2.06; 95% CI: 1.57, 2.70). The increasing probability of a positive test in respondents who were not exposed to the campaign with an increase in the number of HCV positive household members that were exposed suggests IFT as a pathway for incident HCV. Controlling for maternal HCV, a child whose father tested positive was 2.53 times more likely to have HCV than a child whose father did not have HCV, (95% CI: 1.56, 4.08) indicating the importance of modes of IFT beyond vertical transmission. The importance of IFT of HCV through intra-familiar needle sharing by informal healthcare providers has only been explored in qualitative research. This analysis highlights the importance of exploring extra-vertical pathways of IFT to best understand ongoing HCV transmission. 1. Guerra J, Garenne M, Mohamed MK, Fontanet A. HCV burden of infection in Egypt: results from a nationwide survey. J Viral Hepatitis 2012; 19(8): 560–7. Epub 2012/07/06. 2. Kenyon C, Buyze J, Apers L, Colebunders R. Female Genital Cutting and Hepatitis C Spread in Egypt. ISRN Hepatol 2013; 2013: 3.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».