Prevalence and Risk Factors of Hepatitis A, B and C in Neelum Valley District of Azad Kashmir, Pakistan

Tasleem Akhtar; Syed Ayaz Kazmi; Abdul Rauf; Beenish Shahid; Roop Riaz; Muhammad Zahid Latif; Sundus Khawaja; Hassan Abdullah; Iqra Batool; Salma Farooq; Zeeshan Anjum

doi:10.70749/ijbr.v3i2.620

Authors

Tasleem Akhtar Department of Zoology, University of Poonch, Rawalakot, AJ&K, Pakistan.
Syed Ayaz Kazmi Department of Zoology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Abdul Rauf Department of Zoology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Beenish Shahid Department of Zoology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Roop Riaz Department of Wildlife Biology and Conservation, Edinburgh Napier University, 9 Sighthill Ct, Edinburgh EH11 4BN, UK.
Muhammad Zahid Latif Community Medicine/ Public Health, Department of Medical Education, Director PGME Post Graduate Medical Education, Superior University, Lahore, Punjab, Pakistan.
Sundus Khawaja Department of Biotechnology, Main Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Hassan Abdullah Faculty of General Medicine, Kazakh Russian Medical University, Kazakhstan.
Iqra Batool Department of Zoology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Salma Farooq Department of Zoology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.
Zeeshan Anjum Department of Biotechnology, Main Campus, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i2.620

Keywords:

Hepatitis A, Hepatitis B, Hepatitis C, Prevalence and Risk Factors of Viral Hepatitis, Seroprevalence, Tourism and Disease Transmission, Public Health Interventions

Abstract

Background: No prior studies have assessed hepatitis A, B, and C prevalence in Neelum Valley, Azad Kashmir, a major tourist hub along the Line of Control. This study evaluates the prevalence and risk factors associated with these infections in the region. Methods: A total of 374 participants (286 males, 88 females) from Neelum Valley were surveyed, and serum samples were tested for hepatitis markers using immuno-chromatographic tests and Real-Time PCR. Liver function markers (ALT, ALP, and Bilirubin) were also analyzed. Statistical analysis was conducted using GraphPad Prism V. 7.04. Results: The prevalence of recent hepatitis A infection (HAV IgM Positive) was 0.8%, while 4.8% had prior exposure (HAV IgG Positive). Hepatitis B (HBsAg positivity) was detected in 2.4%, with 1.3% showing active viral replication (HBV DNA Positive). Hepatitis C exposure (anti-HCV positivity) was 1.3%, with 0.5% showing active infection (HCV RNA Positive). All participants had normal liver function markers. Younger individuals (18–25 years) had higher infection rates, and males showed a greater prevalence than females for all infections. Significant risk factors (p < 0.0001) included contaminated food or water, jaundice history, hospitalization, blood transfusions, ear/nose piercing, tattooing, and treatment from local practitioners. Conclusions: The prevalence of hepatitis A, B, and C in Neelum Valley is lower than in some regional studies but remains a public health concern. The influx of tourists may facilitate disease transmission, highlighting the need for improved sanitation and healthcare measures.

Downloads

Download data is not yet available.

References

World Health Organization (WHO): 2020, March 11. Hepatitis. Retrieved May 19, 2024, https://www.who.int/health-topics/hepatitis#tab=tab_1

The A, B, CS of viral hepatitis. (n.d.). Retrieved May 19, 2024, https://www.health.ny.gov/diseases/communicable/hepatitis/#:~:text=Viral%20hepatitis%20is%20an%20infection,people%20usually%20improve%20without%20treatment.

Krugman, S. A. U. L. (1992). The Gordon Wilson Lecture. The ABC's of viral hepatitis. Transactions of the American Clinical and Climatological Association, 103, 145. https://pmc.ncbi.nlm.nih.gov/articles/PMC2376677/

Koff, R. S. (1998). Hepatitis a. The Lancet, 351(9116), 1643-1649. https://doi.org/10.1016/s0140-6736(98)01304-x

Wasley, A. (2006). Hepatitis a in the era of vaccination. Epidemiologic Reviews, 28(1), 101-111. https://doi.org/10.1093/epirev/mxj012

Franco, E. (2012). Hepatitis a: Epidemiology and prevention in developing countries. World Journal of Hepatology, 4(3), 68. https://doi.org/10.4254/wjh.v4.i3.68

World Health Organization. (2012). WHO position paper on hepatitis A vaccines—June 2012. Weekly epidemiological record= relevé épidémiologique hebdomadaire, 87(28-29), 261-276.

World Health Organization (WHO)): 2024, April 9. Hepatitis B. Retrieved May 21, 2024, https://www.who.int/news-room/fact-sheets/detail/hepatitis-b#:~:text=Overview,from%20cirrhosis%20and%20liver%20cancer.

Hepatitis B - Symptoms and causes - Mayo Clinic. (2022, September 24). Mayo Clinic. 2024, https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802

World Health Organization (WHO): 2024, April 9. Hepatitis B. Retrieved May 21, 2024, https://www.who.int/news-room/fact-sheets/detail/hepatitis-b#:~:text=WHO%20estimates%20that%20254%20million,carcinoma%20(primary%20liver%20cancer).

World Health Organization (WHO). (2024, April 9). Hepatitis C. Retrieved May 21, 2024, https://www.who.int/news-room/fact-sheets/detail/hepatitis-c#:~:text=Hepatitis%20C%20is%20a%20viral,through%20contact%20with%20infected%20blood.

PennMedicine. (2023, February 5). https://www.pennmedicine.org/. Retrieved May 21, 2024, from https://www.scribbr.com/citation/generator/folders/7isYBSiackD4OCjuEjmX45/lists/4GsDDj9mYixiFCmSPba0Eu/cite/webpage/

Centers for Disease Control and Prevention. Viral Hepatitis Surveillance Report – United States, 2020. Published September 2022. Accessed 27 May, 2024. https://www.cdc.gov/hepatitis/statistics/2020surveillance/index.htm.

Arankalle, V. A., Devi, K. S., Lole, K. S., & Shenoy, K. T. (2006). Molecular characterization of hepatitis A virus from a large outbreak from Kerala, India. Indian journal of medical research, 123(6), 760. https://www.proquest.com/openview/9e8b8d081cdaf4b4812682a512732418/1?pq-origsite=gscholar&cbl=37533

Chobe, L. P., & Arankalle, V. A. (2009). Investigation of a hepatitis A outbreak from Shimla Himachal Pradesh. Indian Journal of Medical Research, 130(2), 179-184. https://journals.lww.com/ijmr/abstract/2009/30020/investigation_of_a_hepatitis_a_outbreak_from.14.aspx

Sowmyanarayanan, T. V., Mukhopadhya, A., Gladstone, B. P., Sarkar, R., & Kang, G. (2008). Investigation of a hepatitis A outbreak in children in an urban slum in Vellore, Tamil Nadu, using geographic information systems. Indian Journal of Medical Research, 128(1), 32-37. https://journals.lww.com/ijmr/abstract/2008/28010/investigation_of_a_hepatitis_a_outbreak_in.8.aspx

Chadha, M., Lole, K., Bora, M., & Arankalle, V. (2009). Outbreaks of hepatitis a among children in western India. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103(9), 911-916. https://doi.org/10.1016/j.trstmh.2008.11.014

Shanmugam, Rengasamy P.a; Balakrishnan, Selvakumarb; Varadhan, Hemalathac; Shanmugam, Vivekanandand. Prevalence of hepatitis B and hepatitis C infection from a population-based study in Southern India. European Journal of Gastroenterology & Hepatology 30(11):p 1344-1351, November 2018. DOI: http://doi.org.10/1097/MEG.0000000000001180

Global Hepatitis Report 2024. (n.d.). Drishti IAS. https://www.drishtiias.com/daily-updates/daily-news-analysis/global-hepatitis-report-2024#:~:text=Prevalence%20in%20India%3A,living%20with%20Hepatitis%20C%20infection. Accessed on July 26, 2024.

Muneer, A. (2016). Prevalence of acute hepatitis A virus and hepatitis E virus in urban cities of Sindh, Pakistan. International Journal of Infectious Diseases, 53, 70. https://doi.org/10.1016/j.ijid.2016.11.176

Butt, A. S. (2015). Epidemiology of viral hepatitis andLiver diseases in Pakistan. Euroasian Journal of Hepato-Gastroenterology, 5(1), 43-48. https://doi.org/10.5005/jp-journals-10018-1129

Ochani, S., Ochani, K., Ochani, A., Vohra, L. I., Ochani, S., Hasibuzzaman, M. A., & Ullah, K. (2023). Hepatitis is still a major health concern in Pakistan: Short communication. Annals of Medicine & Surgery, 85(11), 5820-5822. https://doi.org/10.1097/ms9.0000000000001280

Kazmi, S. A., Rauf, A., Shafique, F., Asim, N., Shafi, N., & Hassan, M. U. (2022). Kashmiri refugees at the verge of hepatitis B and C epidemic in the State of Azad Jammu and Kashmir, Pakistan. Revista De Saúde Pública, 56, 33. https://doi.org/10.11606/s1518-8787.2022056003479

Abdul Rauf, Muqaddas Tahir, Humaira Abid, Fahad Alshahrani, Muhammad Zahid Latif, Mohammed Merae Alshahrani, Ahmed Abdullah Al Awadh, Nawal E Al-Hazmi, Abdulfattah Omar, Tasleem Akhtar, Syed Ayaz Kazmi, Zeeshan Anjum, Iqra Bibi, Zia-ur-Rehman, & Zahoor Iqbal. (2024). A HIGH PREVALENCE OF HBV AND HCV INFECTIONS AMONG PREGNANT WOMEN: A PROSPECTIVE CROSS SECTIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 31(1), 75–89.

Syed Ayaz Kazmi, Rauf, A., Muhammad Zahid Latif, Sundus Khawaja, Tasleem Akhtar, Beenish Shahid, Iqra Batool, Nuzhat Shafi, Zeeshan Anjum, Humaira Abid, Mohsin Nazir Awan, Ejaz Ahmad Khan, & Faisal Farooq. (2024). EPIDEMIOLOGICAL INSIGHTS INTO THE PREVALENCE OF HEPATITIS B AND ASSOCIATED RISK FACTORS AMONG COLLEGE POPULATIONS. Journal of Population Therapeutics and Clinical Pharmacology, 31(1), 471–482.

Franco, E. (2012). Hepatitis A: Epidemiology and prevention in developing countries. World Journal of Hepatology, 4(3), 68. https://doi.org/10.4254/wjh.v4.i3.68

Carlos, J. C., Quinones, V. M., Adversario, M. P., Nailes, J. M., Songco, J. C., Garcia, D. R., Cacayorin, M. G., Cero, M. P., Benedicto-Delfin, M. P., Blanco, M. C., Natividad, N. S., Bernabe, J. D., Chacon, H. C., Ascue, R. A., Paggao, J. N., Comendador, L. O., Hernandez-Suarez, G., & Guzman-Holst, A. (2024). Seroprevalence and shifting Endemicities of hepatitis a virus infection in two different geographical areas in the Philippines. Infectious Diseases and Therapy, 13(5), 1019-1035. https://doi.org/10.1007/s40121-024-00955-w

Saffar, F., Sellaoui, F., Hechaichi, A., Chelly, S., Bouguerra, H., Cherif, A., Talmoudi, K., Ben Hadj, M., Bahrini, A., Letaief, H., Bahri, O., Chahed, M. K., & Bouafif ép Ben Alaya, N. (2022). Epidemiologic patterns of hepatitis a infection during the pre–vaccination era: A population-based survey in Tunisia in 2015. International Journal of Infectious Diseases, 117, 162-168. https://doi.org/10.1016/j.ijid.2022.01.004

Gloriani NG, de Paz-Silava SLM, Allison RD, Takashima Y, Avagyan T. The Shifting Epidemiology of Hepatitis A in the World Health Organization Western Pacific Region. Vaccines. 2024; 12(2):204. https://doi.org/10.3390/vaccines12020204

Raza, Q., Ullah, A., Khaliq, M., Anis, R. A., Imran, K., Batool, R., & Imran, S. (2024). Frequency of hepatitis B and C in relation to lifestyle and socio-demographic characteristics among adults in Lahore. Journal of Population Therapeutics & Clinical Pharmacology, 1221-1230. https://doi.org/10.53555/jptcp.v31i3.5106

Zahoor, S., Khan, A., Asif, S., Tabraiz, S. A., Mustafa, H., Ansar, S., Hanif, S., & Raza, H. A. (2021). Past and future perspectives for hepatitis B and C in Pakistan. Cureus. https://doi.org/10.7759/cureus.17521

Olaru, I. D., Meier, M. B., Mirzayev, F., Prodanovic, N., Kitchen, P. J., Schumacher, S. G., & Denkinger, C. M. (2023). Global prevalence of hepatitis B or hepatitis C infection among patients with tuberculosis disease: systematic review and meta-analysis. EClinicalMedicine, 58, 101938. https://doi.org/10.1016/j.eclinm.2023.101938

Juhar, S., Nurahmed, N., Kebede, S., Getahun, M., Arega, T., & Abdi, A. M. (2018). Prevalence of hepatitis B and C viruses infections among hemodialysis patients in Addis Ababa, Ethiopia. Journal of Interventional Nephrology, 1(1), 8-14.

Méndez-Sánchez, N., Motola-Kuba, D., Zamora-Valdés, D., Ara, K. S., Ponciano-Rodríguez, G., Uribe-Ramos, M. H., Vásquez-Fernández, F., Lezama-Mora, J., Pérez-Sosa, J. A., Baptista-González, H. A., & Uribe, M. (2006). Risk factors and prevalence of hepatitis virus B and C serum markers among nurses at a tertiary-care hospital in Mexico City, Mexico: a descriptive study. Annals of Hepatology, 5(4), 276–280. https://doi.org/10.1016/s1665-2681(19)31988-x

Nadeem, M., Sattar, Z., Mohammad Khan, S., Ahsan, I., Naheed, R., Mehmood Khattak, T., Akbar, S., Talha Khan, M., Ilyas Khan, M., Zubair Khan, M., Shafiq, M., & Muhammad Faheem, S. (2015). Identification of risk factors for hepatitis B and C in Peshawar, Pakistan. HIV/AIDS - Research and Palliative Care, 223. https://doi.org/10.2147/hiv.s67429

Mohd Suan, M. A., Said, S. M., Lim, P. Y., Azman, A. Z., & Abu Hassan, M. R. (2019). Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case–control study. PLOS ONE, 14(10), e0224459. https://doi.org/10.1371/journal.pone.0224459

Kazmi, S. A., Rauf, A., Alshahrani, M. M., Awadh, A. A., Iqbal, Z., Soltane, R., Tag-Eldin, E., Ahmad, A., Ansari, Z., & Zia-ur-Rehman, Z. (2022). Hepatitis B among University population: Prevalence, associated risk factors, knowledge assessment, and treatment management. Viruses, 14(9), 1936. https://doi.org/10.3390/v14091936