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

• Main Authors: Jean Damascene Makuza, Carol Y. Liu, Corneille Killy Ntihabose, Donatha Dushimiyimana, Sabine Umuraza, Marie Paul Nisingizwe, Justine Umutesi, Janvier Serumondo, Soline Dusabeyesu Mugeni, Muhamed Semakula, Neil Gupta, Margaret Hellard, Sabin Nsanzimana
• Format: Article
• Language: English
• Published: BMC 2019-08-01
• Series: BMC Infectious Diseases
• Subjects: Viral hepatitis C; Risk factors; Rwanda
• Online Access: http://link.springer.com/article/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.