Microsoft Word - Khan Muhammad Corrected 27 Original Article Prevalence of Hepatitis B and C in the Patients Undergoing Cataract Surgery at Eye Camps Khan Mohammad Nangrejo, Manzoor Ahmed Qureshi, Amjad Ali Sahto, Shahid Jamal Siddiqui Pak J Ophthalmol 2011, Vol. 27 No. 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See end of article for authors affiliations …..……………………….. Correspondence to: Khan Mohammad Nangrejo Department of Ophthalmology. Peoples Medical College Nawabshah Received for publication October’ 2010 …..……………………….. Purpose: To assess the prevalence of hepatitis B and hepatitis C viral infection in the patients undergoing elective eye surgery. Material and Method: All patients who were selected for cataract surgery were included in the study. After history, examination and Investigations patients were screened for Hepatitis B and C virus antibody with chromatography (Kit) method. All the details were recorded on preformed proforma and data was compiled and analyzed for age and sex mean values. Pearson’s correlation coefficients were calculated to assess the prevalence of Hepatitis B and C in general population undergoing cataract surgery. Results: Four hundred and thirty seven patients were operated on for cataract surgery at eye camps. Mean age of patients was 60 years, 191 (43.70%) were male and 246 (56.29%) female. Out of them 108 patients were found to be positive for Hepatitis B and C (24.7%,) antibody. Hepatitis B accounted for 19 cases (4.34%) and Hepatitis C for 89 cases (20.36%). Conclusion: The prevalence rate of Hepatitis B and C antibody in our population is alarming, not only for the general population but also for the general health care personals. Steps need to be taken to abort this preventable disease. iral hepatitis is a major health problem effecting approximately two billion people worldwide. The hepatitis B virus (HBV) has infected more than two billion people and 350 million people are carrier of the virus, each year approximately one million people die from hepatitis B, makes it one of the major causes of morbidity and mortality1. Hepatitis C virus (HCV) infection is increasing even more rapidly and has occurred in endemic situation in most parts of the world, with a prevalence of about 3% world wide2. Hepatitis C virus infection progresses slowly and carries high risk of chronic liver disease (70-80%) and later liver malignancy3. The prevalence of Hepatitis B and C is also increasing in our country4. Doctors, especially surgeons, and the paramedical staff have a high occupational risk of acquiring HBV and HCV infection from the infected patients. Approximately 500,000 percutaneous blood exposures occur among hospital based health care workers in the United States each year. Surgeons and operation room personnel have the high risk of occupational exposure5. With such a high figure, rate of trans- mission in the highly developed country like USA little is known about the rate of risk in our part of the world. Due to this concern, this study was carried out to evaluate the presence of hepatitis B and C infection in patients admitted for surgery at eye camps. MATERIALS AND METHODS The observational study was carried out at the eye camps of Baloo-Ja-Kuba and Kumb Nawabshah in the V 28 district Shaheed Benazeerabad and Khairpur organized by the Department of Ophthalmology PMC Nawabshah from December 2008 to Feb 2010. During this period 437 patients undergoing eye surgery were evaluated for hepatitis B and C antibody. After history, examination and investigations patients were screened for HBV and HCV with chromatography (kit) method. The details were recorded on proforma and data was compiled and analyzed for age and sex mean values. Special emphasis was put on age, sex, occupation. All patients of either sex who were operated as elective cases were included in the study. RESULTS In this study 437 patients who underwent eye surgery at eye camps were screened for HBV and HCV. There `were 191 (43.70%) male and 246 (56.29%) female patients. Mean age of these patients was 60 years. The range of age was 40 to 80 years (Table 1). All the patients belonged to rural areas. Total 108 patients were found positive for hepatitis B and C. Amongst them 19 were positive for hepatitis B (4.34%) and 89 for hepatitis C (20.36%) (Table 2). Hepatitis B was found in 11 (57.89%) male and 08 (42.10%) female patients. Hepatitis C was predominant in females 57 (64.04%) while it was found in 32 (35.94%) male patients. Both hepatitis B and C were found in 108 (24.7.%) patients. Amongst them 43 (39.81%) were male and 65 (60.18%) were females (Table 2). DISCUSSION The incidence of hepatitis B and C has achieved endemic situation in many countries of the world, especially in underdeveloped countries. Pakistan is no exception as the disease has been recorded to an alarming level in most parts of the country especially in the rural areas, as can be seen from Tables 1 and 2. In Pakistan a large proportion of the population is already infected with hepatitis B and C with the prevalence of 10% for hepatitis B and 4-7% for hepatitis C. In certain parts especially in the rural areas the percentage of infected individuals is significantly higher than the above quoted figures6,7. The transmission of virus is through the blood and secretions. Most common source of spread of these infections is through the use of unsterilized syringes or instruments especially dental instruments or unchecked blood transfusion. Other factors involved in the spread of infection are persons who have their armpits or face shaved by street barber or those involved in sexual abuse8,9,10. In this study 4.34% patients had hepatitis B and 20.36% patients had hepatitis C. According to Cloud Hay and his colleagues11 the prevalence of hepatitis C was 11.26% which is lower to our study. Ali and his associates12 reported 5.1% patients suffering from hepatitis C in their study at Gadap area. The carrier state of HBs Ag is around 10% in different segments of Pakistani people7 which is higher than our study. In a study by Sheikh and his colleagues13 carrier state of HBs Ag was found to be 2.8 %. Weis and his co- workers14 reported 35% cases of HCV and 4% cases of HBV in their study of patients operated at John Hopkins. Table 1: Patients data Number of Patients 437 Age Group 40- 80 years Mean Age 60 years. Male 191 (43.70%) Female 246 (56.29%) Table 2: HBV and HCV Positive Total Patients Screened 437 Patients positive for both Hepatitis B and C. 108(24.7) HBV Positive 19 (4.34%) HCV Positive 89 (20.36%) Male 43 (39.81%) Female 65 (60.19%) CONCLUSION With such a rate of HBV and HCV as reported in our study suggests screening of all the patients who are selected for surgery. At the same time the print and electronic media is required to making the public aware about the methods of the spread of disease to prevent further transmission. It is the prime duty of doctors and paramedical staff to counsel the patients and use ethical practice. 29 Author’s affiliation Dr. Khan Mohammad Nangrejo Department of Ophthalmology Peoples Medical College Nawabshah Dr Manzoor Ahmed Qureshi Department of Ophthalmology Peoples Medical College Nawabshah Dr. Amjad Ali Sahto Department of Ophthalmology Peoples Medical College Nawabshah Dr. Shahid Jamal Siddiqui Department of Ophthalmology Peoples Medical College Nawabshah REFERENCE 1. Kane M. Global program for control of hepatitis B infection, vaccine. 1995; 47-9. 2. Dubois F, Desenclos JC, Merriote N. Gondean A, and the collaboration study group. Hepatitis C in a French population – based surgery, 1994. Sero prevalence surgery of viremia, genotype distribution and prognostic risk factors. Hepatol. 1997; 25; 1490-6. 3. Supsa VE, Hadjipashali E, Hatzakis A. 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