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Hepatitis C in Egypt

The following background data on Hepatitis C in Egypt are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] Primary references available on request.

Incidence and Prevalence:
Hepatitis C is the most common cause of chronic liver disease in Egypt. The nationwide carriage rate in 1997 was estimated at 6 to 8 million, or 18.1% of the population – the highest rate in the world.

A study published in 2010 estimated the yearly rate at 500,000 new cases (0.7% of the population); while a study published in 2013 estimated the yearly rate at fewer than 150,000 cases. An analysis published in 2009 predicted that 127,821 deaths from chronic liver disease and 117,556 deaths from hepatocellular carcinoma would occur in Egypt over the next 20 years

The high rate of Hepatitis C infection in Egypt is largely attributed to previous mass-injection (antimony tartrate) treatment campaigns for schistosomiasis, which involved repeated use non-sterilized needles. 84% of patients who had received intravenous schistosomiasis therapy during the 1980’s were found to be HCV-positive; and anti-Schistosoma antibodies were found in 29% of patients with chronic hepatitis C infection (2013 publication). There is also evidence for ongoing transmission of hepatitis C from parents to children

Co-infection by other hepato-tropic viruses is common. 72.0% of children with hepatitis C are seropositive toward hepatitis E virus. (2008 publication); and occult Hepatitis B is present in 3.9% of patients with hepatitis C (2010 publication)

Prevalence surveys:
29.8% of viral hepatitis cases (2001)
3.6% of acute hepatitis patients hospitalized in Cairo (2002).
8% of acute hepatitis among military recruits (2012 publication)
2.02% of asymptomatic children ages 1 to 9 years (2007 publication)
21% of acute hepatitis in children (2013 publication)
78.5% of patients with hepatocellular carcinoma (2008 publication)
89.2% of patients with hepatocellular carcinoma and 49.3% of those with other forms of cancer (2012 publication)
18% of dental instruments tested in Alexandria (HCV RNA, 2012 publication)

Seroprevalence surveys:
14.7% of persons ages 15 to 59 years, nationwide (2008)
5% to 15% of pregnant women, 5% to 25% of blood donors and 0% to 40% of other groups (meta-analysis, 2013 publication)
24.8% of blood donors, nationwide – highest rates in the central and north-eastern Nile River delta, and the Nile River valley south of Cairo (1993)
4.3% of blood donors (2006 to 2012)
8% of blood donors (2006 publication)
16.8% of blood donors (2011 publication)
11.95% of volunteer blood donors (2009 publication)
9.02% of blood donors in Minya Governorate (2000 to 2008)
3.5% of blood donors in Alexandria (2007 to 2008)
13.9% of healthy persons and 78.5% of hepatocellular carcinoma patients (literature review, 2009 publication)
5.8% of healthy children ages 6 to 15 (Alexandria, 2011 publication)
65% of children ages 1 to 9 years in Cairo (2011 publication)
9.7% of university students
22.1% of army recruits
13.6% to 19% (Cairo) to 20.8% (Alexandria, 1992 to 1994) of blood donors
10.9% of persons in El-ghar village, Zagazig (2006 to 2007)
2.7% of voluntary student blood donors in Mansoura (2006 publication)
19% of pregnant women in Alexandria (2000 publication)
15.8% of pregnant women in the Nile Delta (2006 publication)
7.4% of pregnant women in Assiut (2010 publication)
8.6% of pregnant women (2010 publication)
12.1% of rural school children
51% of adults above age 40 (Nile Delta)
75.8% to 83% of patients with hepatocellular carcinoma (2001 publication)
2% of Bedouins in Al Arish (Northern Sinai) and 5% in Nuweiba (Southern Sinai) (2001)
23.4% (urban) to 27.4% (rural) of the population of Sharkia Governorate (2004 publication)
14.3% of tourism workers in South Sinai governorate (1996 publication)
72.9% of persons with elevated serum hepatic enzymes in Ismailia (2009 publication)
8.5% of patients with chronic fascioliasis (1998 publication)
51.7% of multitransfused thalassemic children (2011 publication)
19.5% of multitransfused thalassemic patients (2009 to 2010)
34.4% of multitransfused thalassemic patients and 19.2% of their family members (2013 publication)
82% of multitransfused patients with beta thalassemia (2013 publication)
76% of children with beta thalassemia (Mid-Delta, 2010 to 2011)
35% of hemodialysis patients in Al Gharbiyah Governorate (2011)
40% of hemophiliac children (2012 publication)
18.5% of patients admitted to a rheumatology department (Cairo, 2011 publication)
16.6% of health care workers at the National Liver Institute (Nile Delta, 2008 to 2010)
63% of IDU, vs. 27.5% of controls (1995 publication)
15.8% of prisoners (2013 publication)
8.5% of STD patients (1993 to 1995)
12.3% of barbers and 12.7% of their clients in Gharbia (2010 publication)
84% of patients who had received intravenous schistosomiasis therapy during the 1980’s (2011 publication)
2.4% of first-generation Egyptian migrants living in the Netherlands (Amsterdam, 2009 to 2010)

References:
1. Berger SA. Infectious Diseases of Egypt, 2013. 415 pages, 53 graphs, 2324 references. Gideon e-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-egypt/
2. Berger SA. Hepatitis C: Global Status, 2013. 181 pages, 163 graphs, 2251 references. Gideon e-books. https://www.gideononline.com/ebooks/disease/hepatitis-c-global-status/

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