Hepatitis B and C infection in first- time blood donors in Karachi - a possible subgroup for sentinel surveillance

Hepatitis B virus [HBV] and C virus [HCV] are major public health concerns in Pakistan. We conducted a baseline analysis of first- time replacement blood donors at the blood bank of Jinnah Postgraduate Medical Centre in the year 2000 with the view to developing low- cost sentinel surveillance for these infections. Among 7325 such donors, 264 [3.6%] were positive for anti- HCV and 344 [4.7%] for HBsAg. HCV seroprevalence was significantly positively associated with age and lower education. Those speaking Sindhi or other minor languages had a significantly higher prevalence of HBV infection. Blood bank data could provide reliable information to monitor trends in prevalence of these infections

Survey and surveillance development in settings with low human immunodeficiency virus prevalence

In most countries, during the early phases of a human immunodeficiency virus epidemic, independently initiated surveys of perceived high-risk groups tend to precede the development of formal surveillance systems. Unfortunately, in low-prevalence settings, small sample sizes produce unreliable estimates of prevalence and trends, with an inevitable tendency towards positive results. In our study, we present sample size calculations and typical samples used in actual surveys, with Pakistan as our example. More useful data on risk behaviour and potential for spread can be derived from the study of commoner sexually transmitted diseases and associated risk behaviours, including assessments of knowledge, attitudes, beliefs and practices