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      Epidemiology and Associated Risk Factors of Hepatitis E Virus Infection in Plateau State, Nigeria

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          Abstract

          A cross-sectional study in Nigeria was undertaken to determine the epidemiology, seroprevalence, and associated risk factors, of hepatitis E virus (HEV). A total of 462 subjects were used for the study, categorized into four groups: apparently healthy persons, pregnant women, HIV positive subjects, and animal handlers. Information was obtained from subjects using interviewer-administered questionnaire. Blood samples were collected and analyzed for HEV antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA) technique. Results obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 17.0 statistical software. The overall seroprevalence of IgG and IgM was 42.7 and 0.9%, respectively. Animal handlers had the highest seroprevalence (66.7%). The associated risk factors for IgM seroprevalence were rural dwelling ( P = 0.039, odds ratio (OR) 3.3, 95% confidence interval (CI) 0.7–15.4), blood transfusion ( P < 0.001, OR 9.6, 95% CI 2.6–35.6), attending to animals ( P = 0.032, OR 4.9, 95% CI 0.9–26.6), and waste disposal ( P < 0.001). Factors associated with IgG were age ( P = 0.044), location ( P < 0.001), marital status ( P < 0.001), formal education ( P < 0.001), farming as occupation ( P < 0.001), rural dwelling ( P = 0.001), waste disposal ( P < 0.001), alcohol consumption ( P = 0.001, OR 2.4, 95% CI 1.4–4.0), open defecation ( P < 0.001, OR 2.9, 95% CI 1.4–5.7), attending to animals ( P < 0.001, OR 2.3, 95% CI 1.6–3.4), consuming unwashed fruits/vegetables ( P < 0.001, OR 4.2, 95% CI 0.3–54.1), and stream/river as a source of drinking water ( P < 0.001, OR 3.6, 95% CI 1.6–7.8). Preventive public health measures should be reinforced among all communities, particularly domestic animal handlers and pregnant women. Potable water should be provided for all communities. Data suggest that HEV remains an under-recognized and significant public health problem, warranting further attention and research.

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          Microbial contamination of drinking water and disease outcomes in developing regions

          Nicholas Ashbolt (2004)
          Drinking water is a major source of microbial pathogens in developing regions, although poor sanitation and food sources are integral to enteric pathogen exposure. Gastrointestinal disease outcomes are also more severe, due to under-nutrition and lack of intervention strategies in these regions. Poor water quality, sanitation and hygiene account for some 1.7 million deaths a year world-wide (3.1% of all deaths and 3.7% of all DALY’s), mainly through infectious diarrhoea. Nine out of 10 such deaths are in children and virtually all of the deaths are in developing countries. Major enteric pathogens in these children include: rotavirus, Campylobacter jejuni, enterotoxigenic Escherichia coli, Shigella spp. and Vibrio cholerae O1, and possibly enteropathogenic E. coli, Aeromonas spp. V. cholerae O139, enterotoxigenic Bacteroides fragilis, Clostridium difficile and Cryptosporidium parvum. All except the latter are easily control by chlorination of water, but recontamination of treated water is a huge problem. Emerging environmental pathogens, such as Helicobacter pylori and Burkholderia pseudomallei, may well be of significance in some regions. In adults, much less is understood of various sequellae such as myocarditis, diabetes, reactive arthritis and cancers some months–years after initial infections. So in addition to the traditional pathogens (helminths, Entamoeba histolytica, Giardia lamblia hepatitis A and E) various enteroviruses, C. jejuni and H. pylori are emerging issues in adults.
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            Persistent carriage of hepatitis E virus in patients with HIV infection.

            Harry R. Dalton, Richard Bendall, Frances E Keane … (2009)
            Article 0 comments Cited 157 times – based on 0 reviews     Review now
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              Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection.

              Manju Puri, S. Patra, Ashish Kumar … (2007)
              Hepatitis E virus (HEV) infection is known to cause severe liver disease in pregnant women. It is unclear whether obstetric and fetal outcomes are worse in pregnant women with HEV infection than in women with other forms of viral hepatitis. To compare maternal, obstetric, and fetal outcomes in pregnant women with acute viral hepatitis caused by HEV and other hepatitis viruses. Observational cohort. Tertiary care hospital, New Delhi, India. 220 consecutive pregnant women presenting with jaundice caused by acute viral hepatitis. Maternal mortality and medical complications, obstetric complications, deliveries, and fetal outcomes. Infection with HEV caused acute viral hepatitis in 60% of included women. Fulminant hepatic failure was more common (relative risk, 2.7 [95% CI, 1.7 to 4.2]; P = 0.001) and maternal mortality was greater (relative risk, 6.0 [CI, 2.7 to 13.3]; P < 0.001) in HEV-infected women than in non-HEV-infected women. Women with HEV infection were more likely than those with other forms of viral hepatitis to have obstetric complications (relative risk, 4.1 [CI, 1.7 to 10.2] for antepartum hemorrhage and 1.9 [CI, 1.3 to 2.7] for intrauterine fetal death; P < 0.001 for both) and poor fetal outcomes (relative risk, 1.2 [CI, 1.0 to 1.4] for preterm delivery [P = 0.005] and 1.8 [CI, 1.2 to 2.5] for stillbirth [P = 0.026]). The findings may not apply to community settings, to women who are asymptomatic or have only minor symptoms, or in the setting of an HEV epidemic. Pregnant women with jaundice and acute viral hepatitis caused by HEV infection had a higher maternal mortality rate and worse obstetric and fetal outcomes than did pregnant women with jaundice and acute viral hepatitis caused by other types of viral hepatitis.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Virology (Auckl)
                Journal ID (iso-abbrev): Virology (Auckl)
                Journal ID (publisher-id): Virology: Research and Treatment
                Title: Virology : Research and Treatment
                Publisher: Libertas Academica
                ISSN (Electronic): 1178-122X
                Publication date Collection: 2014
                Publication date (Electronic): 27 May 2014
                Volume: 5
                Pages: 15-26
                Affiliations
                [1 ]Applied Microbiology Unit, Department of Plant Science and Technology, Faculty of Natural Sciences, University of Jos, Nigeria.
                [2 ]Department of Medical Microbiology, Federal College of Veterinary and Medical Laboratory Technology, National Veterinary Research Institute (NVRI), Vom, Nigeria.
                [3 ]Department of Medical Virology, Federal College of Veterinary and Medical Laboratory Technology, National Veterinary Research Institute (NVRI), Vom, Nigeria.
                Author notes
                Article
                Publisher ID: vrt-5-2014-015
                DOI: 10.4137/VRT.S15422
                PMC ID: 4251053
                PubMed ID: 25512696
                SO-VID: 585a1855-1952-4fa3-a9ee-26a173576d53
                Copyright © © 2014 the author(s), publisher and licensee Libertas Academica Ltd.
                License:

                This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.

                History
                Date received : 16 March 2014
                Date revision received : 21 April 2014
                Date accepted : 22 April 2014
                Categories
                Subject: Original Research

                Keywords: hepatitis e virus,epidemiology,risk factors,nigeria
                Data availability:
                Keywords: hepatitis e virus, epidemiology, risk factors, nigeria

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