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Seroprevalence of HEV infection and risk factors among Sudanese pregnant women in Khartoum state

Nadir Musa khalil Abuzeid


Background: Hepatitis E virus (HEV), a single-stranded, positive-sense RNA virus is responsible for acute Hepatitis E epidemics in many developing countries. HEV infection in pregnant women is more common and fatal in the third trimester. The incidence of acute viral hepatitis E is known for being the cause of major outbreaks of waterborne hepatitis in Africa. Traditional sanitation and water supplying systems are one of the most important factors for the virus transmission.                                                                                                                   

 Objectives: our aims were to confirm the incidence of Hepatitis E virus among pregnant women attending Khartoum teaching hospitals and to detect the association of abortion in women with HEV infection, the relative risk factors and clinical symptoms.

Methods: Ninety-three pregnant women were enrolled in this study. Enzyme linked immunoassay (ELISA) was performed to determine the presence of anti-HEV IgG during the period from March to May 2015.

The results: HEV IgG antibodies were detected in 61.2% (57/93) of the women under study. The highest percentages were recorded in third trimesters of pregnancies 62.5% (34/57). HEV is associated with high rates of spontaneous abortion, we found about 36.8% (21/57) of HEV positive patients abortive with odd ratio above 1 which means that HEV is considered as risk factor for abortion among pregnant women. While other risk factors include water system supplies, age groups (26-45), rural residence, history of blood transfusion and travelling out of Sudan were 71.9% (41/54), 54.4% (31/57), 50.9% (29/57), 12.3% (7/57) and 5.3% (3/57) respectively. The symptoms were variable with no significant interpretations.

Conclusion: In this study, we found a high frequency of anti-HEV IgG among Sudanese pregnant women in Khartoum which is endemic in Sudanese habitant original root that had never travelled out of the country. Also the present study indicated that one of the highest risk factor is water hygiene cautions. HEV positive patient's symptoms are not reliable for HEV diagnosis which needs more sensitive and specific diagnostic tools to confirm the result.

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