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 Table of Contents  
LETTER TO EDITOR
Year : 2018  |  Volume : 2  |  Issue : 4  |  Page : 156-157

Seroprevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infections among individuals attending tobruk medical center, Tobruk, Eastern Libya: Declining trends after 2011


1 Department of Laboratory, Faculty of Medical Technology, University of Tobruk; National Center for Disease Control, Tobruk, Libya
2 National Center for Disease Control, Tobruk, Libya

Date of Web Publication17-Jan-2019

Correspondence Address:
Dr. Faisal F Ismail
University of Tobruk, Tobruk
Libya
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/LJMS.LJMS_18_18

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How to cite this article:
Ismail FF, Yousif AF. Seroprevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infections among individuals attending tobruk medical center, Tobruk, Eastern Libya: Declining trends after 2011. Libyan J Med Sci 2018;2:156-7

How to cite this URL:
Ismail FF, Yousif AF. Seroprevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infections among individuals attending tobruk medical center, Tobruk, Eastern Libya: Declining trends after 2011. Libyan J Med Sci [serial online] 2018 [cited 2019 Feb 19];2:156-7. Available from: http://www.ljmsonline.com/text.asp?2018/2/4/156/250300



Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are blood-transmitted viral infections which are causing significant concern globally and alarmingly so in Libya. In Libya, the impact of these viral infections is not only limited to the health complications they cause but also extends to the heavy psychological and social burdens they place on affected individuals. These three major blood-transmitted pathogens remain a main health concern for both health workers and patients in health-care settings worldwide.[1] In Libya, this concern is growing, especially as health screening services, policies, and financial resources have been inadequate since the revolution of 2011. In addition, due to weak border control, the waves of illegal immigrants have infiltrated the country from areas where these blood-transmitted viral infections are endemic who may be a potential source of the infection during their stay in Libya, especially in health-care settings.

The prevalence rate of these viral infections in the general population in Libya is HBV infection 2.2%, HCV infection 1.3%, and HIV infection 0.13%.[2] In recent decades, considerable efforts have been made by the country's health authorities to prevent the incidence of these pathogens both in health-care settings and in the community, such as by implementing universal standard precautions in health service providing centers. These measures include obliging all patients to undergo preintervention screening for HBV, HCV, and HIV as a routine investigation, and the implementation of HBV national vaccination programs for all new-born babies and high-risk groups, such as health-care workers.[3]

Additional preventative measures include the provision of more efficacious treatments for the infections of these pathogens, and sensitive screening tests to check all blood units for the presence of hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV before blood donation to prevent the transmissions of these pathogens by blood and blood derivatives. However, in this respect, some studies have recommended additional screening for the antibodies of the total hepatitis B core antigen (anti-HBc) in addition to HBsAg, in order to further enhance the blood donation safety by protecting against transmission of the HBV infection.[4],[5],[6],[7] Furthermore, screening for these blood-transmitted pathogens is obligatory for all immigrants and other individuals as part of their preemployment and premarital medical check-up.[8]

It is essential that up-to-date studies are conducted on the epidemiology of HBV, HCV, and HIV in health-care centers, in order to raise the awareness and promote the development of appropriate policies to prevent the transmission of these pathogens in health-care settings in the region.

The authors conducted a retrospective analysis of the blood sample records taken from the individuals attending Tobruk Medical Center, for various medical and surgical conditions between January 2003 and December 2016. Over the period of 14 years, out of 343,833-blood sample records, 971-blood sample records were found to be positive for one of the three viral infections using commercially available enzyme-linked immunosorbent assays. The percentage of HBsAg in these positive samples was 33%, anti-HCV was 60.7%, and anti-HIV was 6.4%.

Steadily declining trends of seroprevalence of these three viral infections were observed over the last 6 years from 2011 to 2016 (P < 0.001). The average annual seroprevalence rate of these three viral infections declined significantly from an average of 98 people infected per year during 2003-2010 to an average incidence of 31 individuals per year during 2011–2016. This decline may be due to the deterioration of health screening services (i.e., lack of financial resources required for providing laboratory screening tests to all individuals who will have invasive medical intervention) and preventive policies.

In conclusion, the authors recommend that stricter standard precautions should be used for the care of all patients in hospitals, regardless of their presumed infection status, in addition, surveillance of occupationally acquired HBV, HCV, and HIV infections, and review of the efficiency of preventive measures in health-care-providing centers, should be performed regularly. Moreover, public health authorities are advised to regularly update the practice guidelines for the optimal management of the infected individuals.

Acknowledgments

The authors would like to thank all staff of the Public Health Department of Tobruk Medical Center for their assistance.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Beltrami EM, Williams IT, Shapiro CN, Chamberland ME. Risk and management of blood-borne infections in health care workers. Clin Microbiol Rev 2000;13:385-407.  Back to cited text no. 1
    
2.
Elzouki AN, Smeo MN, Sammud M, Elahmer O, Daw M, Furarah A, et al. Prevalence of hepatitis B and C virus infections and their related risk factors in Libya: A national seroepidemiological survey. East Mediterr Health J 2013;19:589-99.  Back to cited text no. 2
    
3.
Elzouki AN. Hepatitis B infection in Libya: The magnitude of the problem. Libyan J Infect Dis 2008;2:20-5.  Back to cited text no. 3
    
4.
Ismail F, Shambesh M, Aboutwerat A, Elbackush M. Serological and molecular characterization of total hepatitis B core antibodies in blood donors in Tripoli, Libya. Libyan J Infect Dis 2010;4:31-7.  Back to cited text no. 4
    
5.
Shambesh MK, Franka EA, Ismail FF, Gebril NM, Azabi KA, Amar F. Anti-HBc and HBV-DNA among blood donors in North Africa; Western Libya. Int Blood Res Rev 2015;3:152-9.  Back to cited text no. 5
    
6.
Shambesh MK, Franka EA, Ismail FF, Elosta MA. Occult hepatitis B virus Infection among blood donors; North Middle Libya. Int Blood Res Rev 2016;6:2321-7219.  Back to cited text no. 6
    
7.
Shambesh M, Franka E, Agila A, Ismail F. Frequency of hepatitis B core antibody and hepatitis B virus DNA among apparently healthy male blood donors in Eastern Libya. Libyan J Med Sci 2018;2:12-5.  Back to cited text no. 7
  [Full text]  
8.
Ismail F, Farag A, Ilah MA. Occurrence of hepatitis B, hepatitis C and HIV infections among individuals undergoing preemployment and premarital medical examination in mediterranean Port city Tobruk, Libya. Int Blood Res Rev 2016;6:2321-7219.  Back to cited text no. 8
    




 

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