title: Epidemiology of hepatitis C virus exposure in Egypt: Opportunities for prevention and evaluation.
abstract: OBJECTIVE
  To critically evaluate the current epidemiology data on exposures, rather than infection, to hepatitis C virus (HCV) transmission and recommend epidemiologic strategies to fill gaps.
  
  
  METHODS
  Standard methods for identifying and evaluating relevant epidemiologic literature and available data were used.
  
  
  RESULTS
  There is a large body of literature on the epidemiology of HCV transmission in Egypt that collectively identifies ongoing iatrogenic exposures as the major driver for HCV transmission due to short comings in infection control and standard procedures. Additional epidemiologic studies on HCV transmission that requires the participation of human subject is unwarranted. Alternatively, very little literature was found on the epidemiology of exposure to HCV, infection control, and safe injection practices. The information that is available on patterns of HCV exposure shows high frequencies of inadequate infection control, problems in sterilization in health care facilities, low rates of hand washing, untrained personnel, lack of stated policies in facilities, HCV contamination of instruments and very large injection frequencies with low but very significant syringe and needle reuse. There is an important need to increase the number, size, and diversity of epidemiologic studies on HCV exposures, patterns of risk factors for infection, infection control, and safe injection practices. In addition to health care facilities evaluation, relevant knowledge attitude and practice studies are recommended.
  
  
  CONCLUSIONS
  Epidemiologic methods on HCV exposure can be used to characterize the magnitude of exposures to HCV infection, target interventions to reduce exposures, and provide the best method for evaluating interventions by demonstrating the reduction of exposure to HCV infection.
authors.affiliation: F DeWolfe Miller, Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, United States.
authors.forename: F DeWolfe
authors.initials: FD
authors.lastname: Miller
authors.affiliation: F DeWolfe Miller, Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, United States.
authors.forename: Mahmoud S
authors.initials: MS
authors.lastname: Elzalabany
authors.affiliation: F DeWolfe Miller, Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, United States.
authors.forename: Sara
authors.initials: S
authors.lastname: Hassani
authors.affiliation: F DeWolfe Miller, Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, United States.
authors.forename: Diego F
authors.initials: DF
authors.lastname: Cuadros
keywords: Egypt; Epidemic; Epidemiology; Exposure; Hepatitis C virus; Prevention