Prevalence of hepatitis C virus infection and evaluation of a health education program in El-Ghar village in Zagazig, Egypt

Hepatitis C virus [HCV] is an emerging global epidemic, some nations have been more drastically affected than others. Egypt reports the highest incidence in the world, with a prevalence rate of over 20% [global average 3%]. Despite the alarming prevalence of the disease in the country, awareness of the disease is still low. The objectives of this study were: 1-to estimate the prevalence of hepatitis C seropositivity among the study group. 2-to study some risk factors with hepatitis C, 3-to assess the effect of the health education on the knowledge and concepts about hepatitis C. This study is a combined cross sectional and an interventional educational community-based study. It was carried out at El-Ghar village in Zagazig district from November 2006 to January 2007. A multistage systematic sample included 304 households above 12 years of age, using a predesigned questionnaire for assessing some potential risk factors [medical and lifestyle behavior] and another questionnaire to assess the effect of health education on knowledge and attitude toward Hepatitis C problem. In addition, samples were collected to assess the seropositivity of HCV among the studied group. The results showed that the prevalence of seropositivity of HCV among the sample was 10.9%. The seropositivity of HCV was higher among males than females and increased sharply with age from 3.6% in those below 20 years old to 30.9% in older age [40 years or more]. Those who were illiterate and farmers had a significantly higher prevalence. According to the logistic regression model, the significant predictors of HCV infection were previous infection with schistsomiasis, those who have positive medical history, followed by those shaving at the community barber, above 40 years and male sex. A highly significant improvement in knowledge in all aspects of HCV infection and also the attitude toward HCV problem [p < 0.000] was revealed. Conclusion and recommendations: Hepatitis C is a health problem in rural areas in Zagazig district. Health education program successfully improved knowledge and attitude toward this problem. The following is recommended: 1- Introduction of health education programs about HCV infection into the established health services 2-Surviellance activities to monitor the disease trend

value of granulocyte elastase versus ascitic fluid polymorphnuclear cell count in diagnosis of spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis [SBP] is one of the most common complications attending the onset of ascites in patients with liver cirrhosis. Granulocyte elastase [GE] is the powerful proteolytic enzyme that is released by PMNs when degranulated in infectious processes. The aim of this study was to measure GE in ascitic fluid and plasma of cirrhotic patients with SBP comparing them with the standard test in diagnosis of SBP; ascitic fluid polymorphonucleocytic count [PMN count]. Eighty five cirrhotic patients with ascites were included in the study 35 of them have SBP [ascitic PMN> 250/mm[3] and/or ascitic ascitic white blood cell count> 500/mm[3] with or without positive culture], the other 50 didn't have SBP at the time of diagnosis. GE level in the ascitic fluid and plasma was measured. Infectious group further divided into two groups according to the result of ascitic fluid culture; poitive culture spontaneous bacterial peritonitis [CP-SBP] group [contained 25 patients] and negative culture spontaneous bacterial peritonitis [CN-SBP] group [contained 10 patients]. The result showed that there was significant difference between SBP subgroups [CP-SBP and CN-SBP] in one hand and cirrhotic group without SBP in the other hand as regard the ascitic fluid WBC count [p<0.01], PMN count/mm[3] [p<0.01], and highly significant difference as regard GE micro g/ml [p<0.0001], meanwhile there was no significant difference as regard ascitic fluid protein. After treatment of the infectious group; there was statistically significant change in plasma GE [p<0.01] and highly significant difference Was recorded in ascitic fluid GE [p<0.001]. Also there was significant drop for raised serum creatinine after treatment [p<0.01]. These findings suggest that GE in the ascitic fluid is highly valuable than the ascitic fluid PMN in the diagnosis of SBP. In addition more valuable for follow up response to treatment. Lastly GE level either in plasma or ascitic fluid could be responsible for deterioration of renal function and raised creatinine level in patients with SBP