Reasons for Unwillingness of Libyans to Donate Organs after Death

Introduction: Organ transplantation in Libya depends exclusively on donations from live relatives. This limitation increases mortality and prolongs the patients' suffering and waiting time. Objectives: The aims of this study were to explore willingness to donate organs after death and to identify the reasons for refusal. Methods: A population-based cross-sectional study was conducted from April to July 2008 on a cluster sample of 1652 persons (58males and 42females). The questionnaire included demographic information and mainly enquired about willingness to donate organs after death and the reasons for refusal when applicable. Results: About one-third (29.7) of participants were in favor of donating their organs after death; 60.1refused and 10.2were undecided. Willingness was significantly associated with being male; younger age; having a college or graduate degree; and being single (P 0.05 for all). Lack of adequate knowledge about the importance of deceased organ donation and uncertainty about its religious implications were the most predominant reasons for refusal (43.8and 39.5; respectively). Other reasons included ethical concerns about retrieving organs from dead bodies (37.9); preference for being buried intact (28); and uneasiness about the idea of cadaver manipulation (33). Conclusion: There were a considerable resistance to deceased organ donation; especially among females; those of older age; married people; and those with a low education level. The barriers to cadaveric donations were lack of adequate knowledge; unease about body manipulation; and concerns about religious implications. Public educational campaigns should be coordinated with religious leadership

Risk Factors and Genotypes of Hepatitis C Virus Infection in Libyan Patients

Background: The prevalence and incidence of HCV infection varies geographically due to exposure to different risk factors. Identification of HCV genotype is important to defining the epidemiology of the disease. The objective of this study was to describe genotype distribution and its relation to risk factors among HCV infected patients attending virology clinic of the Department of Infectious Diseases at the Tripoli Medical Centre. Methods: The medical records of 891 Libyan chronic HCV infected patients registered and followed up from January 2003 to January 2007 were reviewed. Data gathered includes patient/'s age, gender, risk factors and family history of HCV infection. Statistical analysis was performed using t, x2 and contingency coefficient tests. Results: The mean age was 40.22±13.09 years. Two thirds of patients were males. Normal alanine aminotransferase (ALT) at diagnosis was found in 62% of the patients. HCV RNA < 2 million copies at diagnosis was found among 54% of patients. HCV genotype 1 (G1) was the most frequent (30.9%), followed by G4 (29.2%). Genotype 2 affected 19.3% and G3 13.6%. No classification of HCV genotype was available for 2% of the patients. Many subtypes of HCV were detected with different frequencies (G1a and b, G2a, b, c and a/c, G3a and G4a and c/d). All genotypes of HCV were more common among males (P<0.001). Genotype 3 was the most frequent among male patients (88.6%). Regarding the risk factors, 33% of patients had a history of hospitalization and/or surgical procedures, and 22.7% had a history of blood transfusion. A past history of intravenous drug abuse (IVDA) was reported by 15% of the patients, and 15.9% reported a history of dental procedures. The relationship between the genotype of HCV and risk factors was statistically significant (P<0.001). No history of risky exposure was found among 10.8% of patients. Conclusion: Genotypes 1 and 4 were more predominant among HCV infected patients. Males were affected more than females and they presented themselves to the clinic at a younger age. The results of this study strongly suggest the need for implementing strict infection control measures in hospitals and dental clinics to reduce the nosocomial transmission of HCV, as well as measures to control the problem of intravenous drug users in the community