title: Hepatitis B and C: prevalence and risk factors associated with seropositivity among children in Karachi, Pakistan.
abstract: BACKGROUND
  Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age.
  
  
  METHODS
  The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology.
  
  
  RESULTS
  3533 children were screened for HBsAg and anti-HCV. 1826 (52 %) were males. 65 (1.8 %) were positive for HBsAg, male to female ratio 38:27; mean age 10 +/- 4 years. 55 (1.6 %) were positive for anti-HCV with a mean age 9 +/- 4 years. 3 (0.11%) boys were positive for both HBsAg and anti-HCV. The overall infection rate was 3.3 % in the studied population. Hepatitis BsAg was more prevalent in subjects who received therapeutic injections 45 (69.2%) positive [Odd Ratio OR = 2.2; 95% Confidence interval CI: 1.3-3.6] inspite of using new needle and syringe 44 (67.7%) positive [OR = 2.2; 95% CI: 1.3-3.7] and vaccination in the government healthcare facilities 46 (70.7 %) positive with [OR = 3.0; 95% CI: 1.4-6.4]. These factors were not significant in anti-HCV positive cases.
  
  
  CONCLUSIONS
  There is a need to educate general population regarding HBV and HCV infection and risks associated with inappropriate therapeutic injections. Hepatitis B vaccine should be administered to all newborns regardless of maternal HBsAg status.
authors.affiliation: Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan. wasim.jafri@aku.edu
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
authors.forename: Nadim
authors.initials: N
authors.lastname: Jafri
authors.forename: Javed
authors.initials: J
authors.lastname: Yakoob
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
authors.forename: Syed Farhan Ali
authors.initials: SF
authors.lastname: Tirmizi
authors.forename: Tazeen
authors.initials: T
authors.lastname: Jafar
authors.forename: Saeed
authors.initials: S
authors.lastname: Akhtar
authors.forename: Saeed
authors.initials: S
authors.lastname: Hamid
authors.forename: Hasnain Ali
authors.initials: HA
authors.lastname: Shah
authors.forename: Sheikh Qamaruddin
authors.initials: SQ
authors.lastname: Nizami
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies