Seroepidemiological survey of hepatitis C virus among commercial sex workers and pregnant women in Kinshasa, Democratic Republic of Congo

Autor: Bernard Larouzé, D. Henzel, Geert Maertens, Christian Laurent, Eric Delaporte, Claire Mulanga-Kabeya
Rok vydání: 2001
Předmět:
Urban Population
Epidemiology
Pregnancy
Risk Factors
Seroepidemiologic Studies
GROSSESSE
Prevalence
Medicine
Pregnancy Complications
Infectious
ANALYSE STATISTIQUE
education.field_of_study
Transmission (medicine)
virus diseases
Sexually Transmitted Diseases
Viral
General Medicine
Middle Aged
HEPATITE C
Hepatitis C
PREVALENCE
Data Interpretation
Statistical
Population Surveillance
Democratic Republic of the Congo
VIRUS
Female
MALADIE SEXUELLEMENT TRANSMISSIBLE
Adult
EPIDEMIOLOGIE
medicine.medical_specialty
Sexual transmission
Adolescent
TRANSMISSION
Sexual Behavior
Parenteral transmission
Population
Enzyme-Linked Immunosorbent Assay
ETUDE COMPARATIVE
Humans
Seroprevalence
Risk factor
education
PRO STITUTION
Hepatitis
business.industry
TRANSFUSION SANGUINE
Transfusion Reaction
Hepatitis C Antibodies
medicine.disease
Sex Work
Cross-Sectional Studies
FEMME
Immunology
business
Demography
Zdroj: International Journal of Epidemiology. 30:872-877
ISSN: 1464-3685
0300-5771
DOI: 10.1093/ije/30.4.872
Popis: Background Studies conducted mainly in industrialized countries have shown that the transmission of hepatitis C virus (HCV) is mainly parenteral, and have emphasized the role of nosocomial transmission. In Equatorial Africa, the respective contributions of parenteral and non-parenteral routes of transmission are unknown. The potential role of sexual transmission in this area of high HCV endemicity, where sexually transmitted infections (STI) are frequent, is suggested by the fact that HCV infection is rare in infants and young adolescents, but increases thereafter with age. The present study, conducted in Democratic Republic of Congo, was designed to determine the prevalence of HCV infection and associated sexual risk factors in two female populations with different sexual behaviour. Methods Cross-sectional studies conducted among commercial sex workers (CSW; n = 1144) and pregnant women (n = 1092) in the late 1980s in Kinshasa showed a high frequency of at-risk sexual behaviour, STI and human immunodeficiency virus (HIV) infection, particularly among CSW. We screened samples collected during these epidemiological studies for antibodies to HCV using a second-generation ELISA with confirmation by a third-generation LIA. We also assessed sociodemographic variables, medical history, STI markers and sexual behaviour, and their potential association with HCV infection. Results The overall prevalence of anti-HCV was 6.6% (95% CI : 5.2‐8.2) among CSW and 4.3% (95% CI : 3.2‐5.7) among pregnant women (age-adjusted OR = 1.5, 95% CI : 1.0‐2.1, P = 0.05). Multivariate analysis showed that the presence of anti-HCV among CSW was independently associated with a previous history of blood transfusion (P , 0.001), age .30 years (P , 0.001) and the presence of at least one biological marker of STI (P , 0.03). No such links were found among pregnant women (although the history of blood transfusions was not investigated in this group). Anti-HCV was not associated with sociodemographic variables or sexual behaviour in either group, or with individual markers of STI. Despite the high-risk sexual behaviour and the higher prevalence of STI in CSW, the difference in HCV seroprevalence between CSW and pregnant women (6.6% versus 4.3%) was small, particularly when compared with the difference in the seroprevalence of HIV (34.1% versus 2.8%). Conclusion The role of sexual transmission in the spread of HCV seems to be limited. Parenteral transmission (including blood transfusion and injections), possibly related to the treatment of STI, probably plays a major role.
Databáze: OpenAIRE
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