Abstract: SA-PO992
Viral Hepatitis Infections in Hemodialysis Facilities in a Non-Government Controlled Area in Syria
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Sekkarie, Mohamed A., Nephrology and Hypertension Associates, Bluefield, West Virginia, United States
- Alashawi, Hani Subhi, WHO, Gaziantep, Turkey
- Karah, Nabil, Umea University, Umea, Sweden
- Abbara, Aula, Impeiral college London, London, United Kingdom
Background
The prevalence of hepatitis C infections in the Syrian end stage renal disease (ESRD) population has been reported to be around 15% or less in both goverment controlled areas and host countries of Syrian refugees . The prevalence of this condition in non-government controlled areas, known to have limited resources for healthcare delivery and quality control, is unknown.
Methods
In January of 2019 we conducted a cross sectional survey of all dialysis facilities operating in a non-government controlled area in Northwestern Syria. Collected information included sources of funding of operations, available resources, patients demographics and testing of patients and staff for hepatitis C and HIV antibodies, hepatitis B surface antigen (Hep B SAg), and recent history of blood transfusion. The study was conducted by the WHO and non-government organizations (NGO's)
Results
All 20 dialysis facilities identified in the area participated in the study. Funds for operation were provided by 11 different charitable NGO's for 17 of these centers, the other three were funded by a local health directorate (n= 2) and the Turkish goverment (n=1). The area had two nephrologists and most facilities were covered by internists. Two facilites had no physician coverage. Some facilities had telenephrology care from US nephrologists. There was no regulatory body to supervise the operation of the facilities.
Among 598 patients hepatitis C virus antibodies were present in 300 ( 50% ) varying between 5 and 84% per facility. Hep B SAg was + in 32 patients ( 5%). One patient was HIV +. Among 148 staff members the prevalence of hepatitis C antibody was 3% and hepatitis B surface antigen 5%. The median time on dialysis for the hepatitis C positive patients was 3 years versus 2 years for the hepatitis C negative patients ( P < .01). No funding is currently available to confirm the diagnosis by nucleic acid testing or for treatment.
Conclusion
Hepatitis C prevalence in this non-government area of Syria seems to be much higher compared to published data on patients in the government areas and countries hosting Syrian refugees. Limited resources and inadequate regulatory environment are contributing to this problem. Educating staff about infection control methods, and their reinforcement are of high priority. NGO's and renal societies should collaborate on this effort.
Funding
- Private Foundation Support