Trends in the Reported Cases of Hepatitis C Virus Infection, Ministry of Health, Kingdom of Saudi Arabia, 2008 - 2012 Open Access

Alshahrani, Abdullah Jaber (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/9p2909841?locale=en
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Abstract

OBJECTIVE: Infection with hepatitis C virus (HCV) is a risk factor for liver disease and responsible for significant morbidity and mortality. Considered one of the most challenging infectious diseases, the prevalence and risk factors are not well known. Therefore, we determined the trends in the distribution of case reports and incidence rates (IRs) of HCV infection in the Kingdom of Saudi Arabia (KSA) from 2008 - 2012.

METHODS: Using a retrospective design, we analyzed all cases of HCV infection reported to the KSA Ministry of Health (MoH) from 2008 - 2012 to determine trends in cumulative numbers and incidence rates (IRs) by gender, nationality, and region.

RESULTS: A total of 12,336 cases of HCV infection were reported to the KSA MoH from 2008 - 2012. A statistically significant reduction in the IRs of reported cases of HCV infection was observed; in 2008, the IR was 10.6 (95% CI = 10.2 - 11) per 100,000 populations, and by 2012, it had fallen to 8 (95% CI = 7.7 - 8.3) per 100,000 population. Males had a consistently higher IR than females. We observed a statistically significant reduction in the IR of HCV infection from 2008 to 2012 for males and females separately. Saudi citizens had a higher HCV infection IR than non-Saudis, and IRs significantly decreased for both Saudis and non-Saudis. In 2012, Makkah had the highest IR for reported cases of HCV infection (13.5 per 100,000 population 95% CI =12.65 - 14.31). The IR in Asir region increased significantly from 8.2 per 100,000 (95% CI = 6.87 - 9.49) in 2008 to 11 per 100,000 (95% CI = 9.61 - 12.49) in 2012. Those >45 years old had the highest number of HCV cases.

CONCLUSION: The reported IRs of HCV infections significantly decreased over the 5-year study period in each of the thirteen administrative regions from 2008 - 2012. Despite some inconsistencies with the population data, the reduction in HCV infection is encouraging, and the KSA MoH should review the policies and procedures of the HCV infection prevention and control program.

Table of Contents

Table of Contents

List of Figures............................................................................................................................. 7 List of Tables............................................................................................................................... 8 CHAPTER 1: INTRODUCTION.......................................................................................................... 9 1.1 Mode of Transmission............................................................................................................... 9 1.2 Nature of Infection.................................................................................................................. 9

1.3 Diagnosis of HCV Infection..................................................................................................... 10

1.4 Global Epidemiology of HCV Infection.................................................................................... 11

1.5 Epidemiology of HCV Infection in the Kingdom of Saudi Arabia (KSA)........................................ 11

CHAPTER 2: LITERATURE REVIEW................................................................................................ 15 CHAPTER 3: MANUSCRIPT............................................................................................................ 18 3.1 Introduction......................................................................................................................... 18 3.2 Methods................................................................................................................................ 21 Data Sources.......................................................................................................................... 21 Statistical Analyses................................................................................................................ 22 Ethics..................................................................................................................................... 23 3.3 Results.................................................................................................................................. 23 3.4 Discussion.............................................................................................................................. 28 Chapter 4: CONCLUSION............................................................................................................. 31 Recommendations................................................................................................................... 31 References.................................................................................................................................. 33 Appendix...................................................................................................................................... 36

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