title: Further evidence for association of hepatitis C infection with parenteral schistosomiasis treatment in Egypt.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection and schistosomiasis are major public health problems in the Nile Delta of Egypt. To control schistosomiasis, mass treatment campaigns using tartar emetic injections were conducted in the 1960s through 1980s. Evidence suggests that inadequately sterilized needles used in these campaigns contributed to the transmission of HCV in the region. To corroborate this evidence, this study evaluates whether HCV infections clustered within houses in which household members had received parenteral treatment for schistosomiasis.
  
  
  METHODS
  A serosurvey was conducted in a village in the Nile Delta and residents were questioned about prior treatment for schistosomiasis. Sera were evaluated for the presence of antibodies to HCV. The GEE2 approach was used to test for clustering of HCV infections, where correlation of HCV infections within household members who had been treated for schistosomiasis was the parameter of interest.
  
  
  RESULTS
  A history of parenteral treatment for schistosomiasis was observed to cluster within households, OR for clustering: 2.44 (95% CI: 1.47-4.06). Overall, HCV seropositivity was 40% (321/796) and was observed to cluster within households that had members who had received parenteral treatment for schistosomiasis, OR for clustering: 1.76 (95% CI: 1.05-2.95). No such evidence for clustering was found in the remaining households.
  
  
  CONCLUSIONS
  Clustering of HCV infections and receipt of parenteral treatment for schistosomiasis within the same households provides further evidence of an association between the schistosomiasis treatment campaigns and the high HCV seroprevalence rates currently observed in the Nile delta of Egypt.
authors.affiliation: Epidemiology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, USA. mrao@niaid.nih.gov
authors.forename: Malla R
authors.initials: MR
authors.lastname: Rao
authors.forename: Abdollah B
authors.initials: AB
authors.lastname: Naficy
authors.forename: Medhat A
authors.initials: MA
authors.lastname: Darwish
authors.forename: Nebal M
authors.initials: NM
authors.lastname: Darwish
authors.forename: Enrique
authors.initials: E
authors.lastname: Schisterman
authors.forename: John D
authors.initials: JD
authors.lastname: Clemens
authors.forename: Robert
authors.initials: R
authors.lastname: Edelman
mesh_terms: D004534:Egypt / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D012552:Schistosomiasis / Q000150:complications* / Q000188:drug therapy; D012698:Serologic Tests