OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017

Objective: An outbreak investigation team was deputed to assess the magnitude of disease, to evaluate risk factors and recommend control measures. Study Design: Case control study. Place and Duration of Study: Boy’s Training Center Karachi, from 4th Apr to 28th Apr 2017. Material and Method...

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Autores principales:	Rabia Subuktageen, Naila Azam, Muhammad Wasif Malik, Rana Jawad Asghar
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2019
Materias:	acute viral hepatitis e cross contamination water contamination Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9af318d432a64ef7af7f9aca566cf775
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spelling	oai:doaj.org-article:9af318d432a64ef7af7f9aca566cf7752021-11-11T03:35:18ZOUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 20170030-96482411-8842https://doaj.org/article/9af318d432a64ef7af7f9aca566cf7752019-08-01T00:00:00Zhttps://www.pafmj.org/index.php/PAFMJ/article/view/3201/2310https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: An outbreak investigation team was deputed to assess the magnitude of disease, to evaluate risk factors and recommend control measures. Study Design: Case control study. Place and Duration of Study: Boy’s Training Center Karachi, from 4th Apr to 28th Apr 2017. Material and Methods: On 30th March 2017, 30 suspected cases of acute viral hepatitis were reported. Active case search carried out and hospitals record reviewed. Age and gender matched controls (1:1) taken. Case definition was “Sudden onset of jaundice PLUS presence of Hepatitis E IgM on ELISA in a resident of Boys vocational training center from 9th March to 12th May 2017”. Total 79 blood samples collected for hepatitis screening and 5 water samples collected for microbiological/physiochemical testing. Descriptive analysis was carried out,frequencies/ attack rates were determined and odds ratios were calculated at 95% confidence interval and p<0.05. Results: Total 79 cases were identified (49 active search). All male with mean age of 22 ± 4.6 years. Overall attack rate was 9% and most affected age-group was 20-29 years (AR: 11%). Significant risk factors were consumption of raw vegetables (OR: 5.39, 95% CI: 2.37-12.25) and use of tap water (OR: 2.28, 95%CI: 1.14-4.58). While hand washing (OR: 0.37, 95%CI: 0.18-0.81) and use of filtered water (OR: 0.008, 95% CI: 0.002-0.029) found protective. Total 76 (96.2%) blood samples were positive for Hepatitis E IgM while 4 (80%) water samples had coliform organisms. Environmental assessment revealed rusty and broken water pipelines running parallel to sewage line. No water decontamination and overcrowding in living areas observed. Conclusion: Cross contamination between water and sewage lines was probable source of outbreak. It was recommended to replaced old pipelines, filter/decontaminate drinking water and more rooms should be constructed to avoid overcrowding.Rabia SubuktageenNaila AzamMuhammad Wasif MalikRana Jawad AsgharArmy Medical College Rawalpindiarticleacute viral hepatitis ecross contaminationwater contaminationMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 69, Iss 4, Pp 789-794 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute viral hepatitis e cross contamination water contamination Medicine R Medicine (General) R5-920
spellingShingle	acute viral hepatitis e cross contamination water contamination Medicine R Medicine (General) R5-920 Rabia Subuktageen Naila Azam Muhammad Wasif Malik Rana Jawad Asghar OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017
description	Objective: An outbreak investigation team was deputed to assess the magnitude of disease, to evaluate risk factors and recommend control measures. Study Design: Case control study. Place and Duration of Study: Boy’s Training Center Karachi, from 4th Apr to 28th Apr 2017. Material and Methods: On 30th March 2017, 30 suspected cases of acute viral hepatitis were reported. Active case search carried out and hospitals record reviewed. Age and gender matched controls (1:1) taken. Case definition was “Sudden onset of jaundice PLUS presence of Hepatitis E IgM on ELISA in a resident of Boys vocational training center from 9th March to 12th May 2017”. Total 79 blood samples collected for hepatitis screening and 5 water samples collected for microbiological/physiochemical testing. Descriptive analysis was carried out,frequencies/ attack rates were determined and odds ratios were calculated at 95% confidence interval and p<0.05. Results: Total 79 cases were identified (49 active search). All male with mean age of 22 ± 4.6 years. Overall attack rate was 9% and most affected age-group was 20-29 years (AR: 11%). Significant risk factors were consumption of raw vegetables (OR: 5.39, 95% CI: 2.37-12.25) and use of tap water (OR: 2.28, 95%CI: 1.14-4.58). While hand washing (OR: 0.37, 95%CI: 0.18-0.81) and use of filtered water (OR: 0.008, 95% CI: 0.002-0.029) found protective. Total 76 (96.2%) blood samples were positive for Hepatitis E IgM while 4 (80%) water samples had coliform organisms. Environmental assessment revealed rusty and broken water pipelines running parallel to sewage line. No water decontamination and overcrowding in living areas observed. Conclusion: Cross contamination between water and sewage lines was probable source of outbreak. It was recommended to replaced old pipelines, filter/decontaminate drinking water and more rooms should be constructed to avoid overcrowding.
format	article
author	Rabia Subuktageen Naila Azam Muhammad Wasif Malik Rana Jawad Asghar
author_facet	Rabia Subuktageen Naila Azam Muhammad Wasif Malik Rana Jawad Asghar
author_sort	Rabia Subuktageen
title	OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017
title_short	OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017
title_full	OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017
title_fullStr	OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017
title_full_unstemmed	OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017
title_sort	outbreak investigation of hepatitis-e at a boy’s training center, karachi pakistan from march-april 2017
publisher	Army Medical College Rawalpindi
publishDate	2019
url	https://doaj.org/article/9af318d432a64ef7af7f9aca566cf775
work_keys_str_mv	AT rabiasubuktageen outbreakinvestigationofhepatitiseataboystrainingcenterkarachipakistanfrommarchapril2017 AT nailaazam outbreakinvestigationofhepatitiseataboystrainingcenterkarachipakistanfrommarchapril2017 AT muhammadwasifmalik outbreakinvestigationofhepatitiseataboystrainingcenterkarachipakistanfrommarchapril2017 AT ranajawadasghar outbreakinvestigationofhepatitiseataboystrainingcenterkarachipakistanfrommarchapril2017
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OUTBREAK INVESTIGATION OF HEPATITIS-E AT A BOY’S TRAINING CENTER, KARACHI PAKISTAN FROM MARCH-APRIL 2017

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