title: Prevalence of HBV infection in suspected population of conflict-affected area of war against terrorism in North Waziristan FATA Pakistan.
abstract: BACKGROUND
  Hepatitis B virus (HBV) infection is a major cause of severe liver diseases including fibrosis, hepatocellular carcinoma (HCC) and cirrhosis related end stage liver diseases (ESLD) in mankind. It is a common belief that infectious diseases have historically been responsible for the massiveness of war-related deaths, so the aim of this study was to estimate the prevalence of HBV infection and to demonstrate the various socio-economic, demographic and possible risk factors related to HBV infection among the conflict-affected peoples due to war against terrorism in North Waziristan.
  
  
  METHODS
  Blood samples were collected from total 790 suspected individuals from the conflict-affected population of North Waziristan and were analyzed initially tested for the presence of HBsAg, HBeAg antigens, Anti-HBc and Anti-HBs antibodies using ELISA methods. All the positive samples were tested by real time PCR to confirm the presence of HBV DNA in ELISA positive specimens.
  
  
  RESULTS
  Total of 126 (15.94%) samples were found positive for HBV DNA by real-time PCR. Among these positive subjects, 95 (75.5%) were males while 31 (24.5%) were females in a ratio of approximately 3:1. High HBV prevalence (41.26%) was observed among the subjects of subdivision Miran Shah relating to the high frequency of military activities against terrorism as compared to Mir Ali subdivision (35.7%) and Razmak subdivision (19.8%). Among the age groups, high prevalence (38.88%) was observed in age group 21-30 as compared to children and in older age groups. The modes of HBV transmission in this area was associated with re-uses of contaminated needles/syringes in medical care, barbers shops, sexual exposure and tattooing are the principal causal risks factors. Furthermore HBV infection was significantly higher in people with low socioeconomic status, in illiterate persons and in drivers.
  
  
  CONCLUSIONS
  Our results indicate high prevalence rate of HBV infection in young subjects obviously confirms the entire absence of any program to fight HBV. Mass Immunization programs, awareness campaigns and education efforts should be practiced immediately to reduce HBV transmission among young peoples of this conflict zone.
authors.affiliation: Department of Biotechnology University of Malakand, Chakdara, Khyber Pakhtoonkhaw, Pakistan.
authors.forename: Amjad
authors.initials: A
authors.lastname: Ali
authors.forename: Muhammad
authors.initials: M
authors.lastname: Nisar
authors.forename: Muhammad
authors.initials: M
authors.lastname: Idrees
authors.forename: Habib
authors.initials: H
authors.lastname: Ahmad
authors.forename: Abrar
authors.initials: A
authors.lastname: Hussain
authors.forename: Shazia
authors.initials: S
authors.lastname: Rafique
authors.forename: Sabeen
authors.initials: S
authors.lastname: Sabri
authors.forename: Habib Ur
authors.initials: HU
authors.lastname: Rehman
authors.forename: Liaqat
authors.initials: L
authors.lastname: Ali
authors.forename: Shariatullah
authors.initials: S
authors.lastname: Wazir
authors.forename: Tariq
authors.initials: T
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D012959:Socioeconomic Factors; D023481:Terrorism; D014857:Warfare
chemical_list: D004279:DNA, Viral