Risk factors for viral hepatitis C infection in Rwanda: results from a nationwide screening program

BMC Infect Dis. 2019 Aug 5;19(1):688. doi: 10.1186/s12879-019-4322-7.

Abstract

Background: The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; however, this information is crucial to shaping the country's public health approach to hepatitis C control.

Methods: A HCV screening campaign was conducted in the general population in 24 districts previously identified to have a high HCV disease burden. At the time of sample collection, sociodemographic information and self-reported risk factors were collected. Bivariate and multivariate logistic regressions were conducted to assess risk factors independently associated with hepatitis C antibodies (HCVAb) seroprevalence.

Results: Out of a total of 326,263 individuals screened for HCVAb, 22,183 (6.8%) were positive. In multivariate analysis, risk factors identified as statistically associated with HCVAb Seroprevalence include history of traditional operation or scarification (OR = 1.09, 95% CI: 1.05-1.14), presence of viral hepatitis in the family (OR = 1.27, 95% CI: 1.15-1.40), widowed or separated/divorced (OR = 1.36, 95% CI: 1.26-1.47), Southern province (OR = 1.98, 95% CI: 1.88-2.08) and aged 65 years and older (OR = 4.86, 95% CI: 4.62-5.11). Ubudehe category 3 (OR = 0.97, 95% CI: 0.93-1.01) and participants using RAMA (Health insurances for employees of public and private sectors) insurance (OR = 0.76, 95% CI: 0.70-0.85) had lower odds of HCV seroprevalence.

Conclusions: Our findings provide important information for Rwanda's strategy on prevention and case-finding. Future prevention interventions should aim to reduce transmission through targeted messaging around traditional healing practices and case-finding targeting individuals with a history of exposure or advanced age.

Keywords: Risk factors; Rwanda; Viral hepatitis C.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Hepatitis C / epidemiology*
  • Hepatitis C Antibodies / blood
  • Hepatitis C Antibodies / immunology
  • Humans
  • Logistic Models
  • Male
  • Mass Screening
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • Rwanda / epidemiology
  • Seroepidemiologic Studies

Substances

  • Hepatitis C Antibodies