title: The prevalence of HBV infection in the cohort of IDPs of war against terrorism in Malakand Division of Northern Pakistan.
abstract: BACKGROUND
  Hepatitis B is an important public health problem in the Pakistani population and is the major cause of chronic hepatitis, cirrhosis, fibrosis and hepatocellular carcinoma. High prevalence of HBV infections has been observed especially in areas of low economic status. In spite of effective immunization programs, no significant change has been observed in the epidemiology of HBV in the rural areas of Pakistan (~67.5% of the total population) mainly due to lack of interest from government authorities and poor hygienic measures. The current study was aimed at estimating the prevalence and risk factors associated with HBV infection within internally displaced persons (IDPs) due to war against terrorism in the Malakand Division of Northern Pakistan.
  
  
  METHODS
  Blood samples from 950 IDPs suspected with HBV infection (including both males and females) were collected and processed with commercial ELISA kits for HBsAg, Anti HBs, HBeAg, Anti HBe antibodies. The samples positive by ELISA were confirmed for HBV DNA by real-time PCR analysis.
  
  
  RESULTS
  The overall prevalence of HBV observed was 21.05% of which 78.5% were males and 21.5% were females. Most confirmed HBV patients belong to the Malakand and Dir (lower) district. High-risk of infection was found in the older subjects 29.13% (46-60 years), while a lower incidence (11.97%) was observed in children aged <15 years. Lack of awareness, socioecomic conditions, sexual activities and sharing of razor blades, syringes and tattooing needles were the most common risk factors of HBV infection observed during the cohort of patients.
  
  
  CONCLUSIONS
  The present study, revealed for the first time a high degree of prevalence of HBV infection in rural areas of Northern Pakistan. The noticed prevalence is gender- and age-dependent that might be due to their high exposures to the common risk factors. To avoid the transmission of HBV infection proper awareness about the possible risk factors and extension of immunization to the rural areas are recommended.
authors.affiliation: Department of Biotechnology, University of Malakand, Pakistan.
authors.forename: Fawad
authors.initials: F
authors.lastname: Khan
authors.forename: Haji
authors.initials: H
authors.lastname: Akbar
authors.forename: Muhammad
authors.initials: M
authors.lastname: Idrees
authors.forename: Hayat
authors.initials: H
authors.lastname: Khan
authors.forename: Khuram
authors.initials: K
authors.lastname: Shahzad
authors.forename: Mahmood A
authors.initials: MA
authors.lastname: Kayani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006511:Hepatitis B Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012036:Refugees / Q000706:statistics & numerical data*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D023481:Terrorism
chemical_list: D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens