Farkhanda Ghafoor, Razak Chohan, Shahid Ghafoor.
Hepatitis B and C in Chakar district Muzafarabad following post earthquake events.
Pak J Med Res Jan ;47(3):58-61.

Background: Earthquake of year 2005, played havoc in many northern districts of Pakistan. Emergent measures to manage the injured and displaced people resulted in rise in many diseases. Hepatitis B and C viral infections were therefore studied in one of these areas to see the situation. Objective: To assess the HBsAg and Anti HCV in an earthquake hit survivors and identify some of the risk factors which could have contributed to their transmission. Setting: Union Council Chakar of district Muzafarabad was selected and subjects of all ages were interviewed for having undergone various high-risk procedures like surgery or blood transfusion in the post-disaster period. Methods: It was a case control study in which 220 cases were selected on the basis of having being exposed to injury, underwent some surgery or transfused blood after the disaster. Controls (n=1295) were selected from the same area who had not undergone any of the above procedures. All 1515 subjects were interviewed through a questionnaire and a 5ml blood sample was taken to check HBsAg and Anti HCV. Rapid method was used for testing in the field while ELISA was used later to confirm the results. Results: A total of 1515 cases were studied of which 220 (14.5%) were injured (group 1) and 1295 (85.5%) non injured (group 2). There were 89 males and 131 females in group 1 and 579 males and 716 females in groups 2. On rapid dry chemistry test in group 1; HBsAg was positive in 19 cases (12 males and 7 females) and anti HCV in 6 cases (3 males and 3 females). In group 2 HBsAg was positive in 6 cases (4 males and 2 females) and anti HCV positive in 3 cases (2 males and 1 female). Using ELISA kits in group 1, HBsAg was positive in 29 cases (18 males and 11 females) and anti HCV in 7 cases (4 males and 3 females). In group 2, HBsAg was positive in 13 cases (7 males and 6 females) and anti HCV in 4 cases (2 males and 2 females). Comparison of rapid test with ELISA showed that ELISA was much more sensitive in picking HBsAg cases than the rapid test where a substantial number could have been missed. For HCV results were comparable within the two diagnostic methods. Conclusions: Disaster planning should carefully select and implement preventive and curative needs for the communities against diseases like hepatitis B and C. Vaccination against hepatitis B should be undertaken in all high risk groups.

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