Assessing knowledge and practices related to hepatitis c among patients in a rural community in Pakistan
Keywords:
hepatitis C, rural community, cross-sectional study, prevention, PakistanAbstract
Background: Hepatitis C is a major global health problem, with a high disease burden in developing countries like Pakistan. Rural communities in Pakistan have limited awareness about hepatitis C transmission, prevention, and control. This study aimed to assess knowledge and practices related to hepatitis C among patients in the rural community of Lasi Goth, Gadap Town, Karachi. Material and Method: A quantitative cross-sectional survey was conducted among 150 adult patients (>18 years) with known hepatitis C infection in Lasi Goth. Data was collected through face-to-face interviews using a structured questionnaire. The questionnaire captured socio-demographic information, knowledge about hepatitis C (causative agent, symptoms, transmission), attitudes towards its prevention, and related practices. Descriptive statistics were used to analyze the data. Results: Of 150 participants, 55% were males and mean age was 25 years. Majority (69.3%) had heard about hepatitis C, with main sources being television (28.7%) and other people (38.7%). Knowledge regarding hepatitis C was low, with less than half aware of the causative agent (42%) and symptoms (41.3%). Around 55% knew it spreads person-to-person, mainly by blood transmission (38%), shared razors/brushes (4.7%), injection drug use (12%), mother to child transmission (18.7%), and sexual contact (26.7%). Most (76%) believed hepatitis C was preventable through screening blood (20%), avoiding sharing razors/brushes (37.3%), and infected persons not donating blood (24.7%). Only 18% reported their families were involved in prevention efforts. A high proportion (88%) were using anti-hepatitis C drugs and 54.7% received hepatitis B vaccination. Conclusion: Patients from the rural community had limited knowledge about hepatitis C transmission routes and prevention measures. Culturally appropriate educational campaigns are required to raise awareness in rural communities regarding risks, prevention strategies, and control of hepatitis C infection.
References
Organización WH. Informe mundial sobre la hepatitis 2017. Organización Mundial de la Salud; 2017.
Hajarizadeh B, Grebely J, Dore GJ. Epidemiología e historia natural de la infección por VHC. Naturereviews Gastroenterología y hepatología. 2013;10(9):553-562.
Webster DP, Klenerman P. Dusheiko GM. Hepatitis C Lancet. 2015;385(9973):1124-1135.
RazaviH, Waked I, Sarrazin C, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm.Journal of viral hepatitis. 2014;21:34-59.
Umer M, Iqbal M. Hepatitis C virus prevalence and genotype distribution in Pakistan: Revisiónexhaustiva de datosrecientes. Revista mundial de gastroenterología. 2016;22(4):1684.
Achakzai M, Kassi M, Kasi PM. Seroprevalences and co-infections of HIV, hepatitis C virus and hepatitis B virus in injecting drug users in Quetta, Pakistan.Tropical doctor. 2007;37(1):43-45.
Edris A, Nour M, Zedan O, et al. Seroprevalence and risk factors for hepatitis B and C virus infection in Damietta Governorate, Egypt. East Mediterr Health J. 2014;20(10):605-13.
Khokhar N, Gill ML, Malik GJ. General seroprevalence of hepatitis C and hepatitis B virus infections in population. Journal of the College of Physicians and Surgeons--pakistan: JCPSP. 2004;14(9):534-536.
Chaudhary IA, Khan SS, Majrooh MA, et al. Seroprevalence of hepatitis-B and C among the patients reporting in surgical OPD at Fauji Foundation Hospital, Rawalpindi: Review of 5 year literature. Pakistan Journal of Medical Sciences. 2007;23(4):514.
Shah HBU, Dar MK, Jamil AA, et al. Knowledge, attitudes and practices of hepatitis B and C among barbers of urban and rural areas of Rawalpindi and Islamabad.Journal of Ayub Medical College Abbottabad. 2015;27(4):832-836.
Janjua N, Nizamy M. Knowledge and practices of barbers about hepatitis B and C transmission in Rawalpindi and Islamabad. Revista de la asociación médica de Pakistán. 2004;54(3):116.
Khan AJ, Luby SP, Fikree F, et al. Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakistan. Boletín de la Organización Mundial de la Salud. 2000;78:956-963.
Khalid GG, Kyaw KWY, Bousquet C, et al. From risk to care: the hepatitis C screening and diagnostic cascade in a primary health care clinic in Karachi, Pakistan-a cohort study. International Health. 2020;12(1):19-27.
Alter MJ, Margolis HS. Recomendaciones para la prevención y el control de la infección por el virus de la hepatitis C (VHC) y las enfermedades crónicas relacionadas con el VHC. 1998.
Waheed Y, Shafi T, Safi SZ, et al. Hepatitis C virus in Pakistan: a systematic review of prevalence, genotypes and risk factors. Revista mundial de gastroenterología: WJG. 2009;15(45):5647.
Qureshi H, Bile K, Jooma R, et al. Prevalence of hepatitis B and C viral infections in Pakistan: findings of a national survey appealing for effective prevention and control measures. EMHJ-Eastern Mediterranean Health Journal, 16 (Supp), 15-23, 2010.2010.
Launiala A. ¿Cuánto puede decirnos una encuesta CAP sobre los conocimientos, actitudes y prácticas de las personas? Some observations from medical anthropology research on malaria in pregnancy in Malawi. Anthropology Matters. 2009;11(1).
Hasan A, Aleemuddin S, Mohib M. A Case Study of TheOrangi Pilot Project-Research and Training Institute, Karachi, Pakistán. Borrador preparado para un proyecto de investigación del Max Lock Centre, Westminster University, Londres, Reino Unido LocalizingHabitat Agenda Research Project Karachi: Arif Hasan &Associates, Arquitectos y Consultores de Planificación. 2003.
Bhutta ZA, Hafeez A, Rizvi A, et al. Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities. The Lancet. 2013;381(9884):2207-2218.
Janjua N, Hamza HB, Islam M, et al. Health care risk factors among women and personal behaviours among men explain the high prevalence of hepatitis C virus infection in Karachi, Pakistan. Journal of Viral Hepatitis. 2010;17(5):317-326.
Alam MM, Zaidi SZ, Shaukat S, et al. Common Genotypes of Hepatitis B virus prevalent in Injecting drug abusers (addicts) of North West Frontier Province of Pakistan. Revista de Virología. 2007;4(1):1-6.
Mahmud S, Akbarzadeh V, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Iran: systematic review and meta-analyses. Informescientíficos. 2018;8(1):150.
Chemaitelly H, Mahmud S, RahmaniAM, et al. The epidemiology of hepatitis C virus in Afghanistan: systematic review and meta-analysis. Revistainternacional de enfermedadesinfecciosas. 2015;40:54-63.
Mousawee SMR, Moossavi M, Bahrami A, et al. The prevalence of hepatitis B, hepatitis C and human immunodeficiency viral infections among a large population of Afghans.Hepatitis Monthly. 2020;20(7).
Janjua NZ, Kuo M, Chong M, et al. Assessing hepatitis C burden and treatment effectiveness through the British Columbia Hepatitis Testers Cohort (BC-HTC): design and characteristics of linked and unlinked participants. PloS one. 2016;11(3):e0150176.
Sostre SO, Tiu G. Strategies for treating depression in patients with hepatitis C. Current Psychiatry. 2013;12(4):33.
Hajarizadeh B, Wallace J, Richmond J, et al. Hepatitis B knowledge and associated factors among people with chronic hepatitis B. Australian and New Zealand Journal of Public Health. 2015;39(6):563-568.
Khuwaja A, Qureshi R, Fatmi Z. Knowledge about hepatitis B and C among patients attending family medicine clinics in Karachi. Eastern Mediterranean health journal. 2002;8(6):787.
Dong C, Huang ZJ, Martin MC, et al. The impact of social factors on human immunodeficiency virus and hepatitis C virus co-infection in a minority region of Si-chuan, the people's Republic of China: a population-based survey and testing study. PloSone. 2014;9(7):e101241.
Machado SM, Almeida Neto Cd, Pinho JRR, et al. Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up. Revista de Saúde Pública. 2017;51:40.
Mumtaz Z, Salway S, Bhatti A, et al. Improving maternal health in Pakistan: toward a deeper understanding of the social determinants of poor women's access to maternal health services. Revista americana de salud pública. 2014;104(S1):S17-S24.
Chu CJ, Lee SD. Hepatitis B virus/hepatitis C virus coinfection: epidemiology, clinical features, viral interactions and treatment. Journal of gastroenterology and hepatology. 2008;23(4):512-520.
Zoratti M, Organización WH. Directrices para la atención y el tratamiento de las personas diagnosticadas de infección crónica por el virus de la hepatitis C: anexo web 3.1: revisión sistemática del tratamiento del virus de la hepatitis C en adultos. 2018.
CDC A. Recomendaciones para la prevención y el control de la infección por el virus de la hepatitis C (VHC) y las enfermedades crónicas relacionadas con el VHC. MMWR. 1998;47(RR-19):1-39.
Lim AG, Walker JG, Mafirakureva N, et al. Effects and cost of different strategies to eliminate hepatitis C virus transmission in Pakistan: a modelling analysis. The Lancet Global Health. 2020;8(3):e440-e450.
Lee M-H, Yang H-I, Yuan Y, et al. Epidemiology and natural history of hepatitis C virus infection. Revista mundial de gastroenterología: WJG. 2014;20(28):9270.
Smith A, Sabidó M, Camey E, et al. Lessons learned from integrating simultaneous triple point-of-care screening for syphilis, hepatitis B, and HIV in prenatal services through rural outreach teams in Guatemala. Revista Internacional de Ginecología y Obstetricia. 2015;130:S70-S72.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.