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Clustering of hepatitis C virus antibody positivity within households and communities in Punjab, India

  • A. Trickey (a1) (a2), A. Sood (a3), V. Midha (a3), W. Thompson (a4), C. Vellozzi (a4), S. Shadaker (a4), V. Surlikar (a5), S. Kanchi (a5), P. Vickerman (a1) (a2), M. T. May (a1) (a2) and F. Averhoff (a4)...

Abstract

To better understand hepatitis C virus (HCV) epidemiology in Punjab state, India, we estimated the distribution of HCV antibody positivity (anti-HCV+) using a 2013–2014 HCV household seroprevalence survey. Household anti-HCV+ clustering was investigated (a) by individual-level multivariable logistic regression, and (b) comparing the observed frequency of households with multiple anti-HCV+ persons against the expected, simulated frequency assuming anti-HCV+ persons are randomly distributed. Village/ward-level clustering was investigated similarly. We estimated household-level associations between exposures and the number of anti-HCV+ members in a household (N = 1593 households) using multivariable ordered logistic regression. Anti-HCV+ prevalence was 3.6% (95% confidence interval 3.0–4.2%). Individual-level regression (N = 5543 participants) found an odds ratio of 3.19 (2.25–4.50) for someone being anti-HCV+ if another household member was anti-HCV+. Thirty households surveyed had ⩾2 anti-HCV+ members, whereas 0/1000 (P < 0.001) simulations had ⩾30 such households. Excess village-level clustering was evident: 10 villages had ⩾6 anti-HCV+ members, occurring in 31/1000 simulations (P = 0.031). The household-level model indicated the number of household members, living in southern Punjab, lower socio-economic score, and a higher proportion having ever used opium/bhuki were associated with a household's number of anti-HCV+ members. Anti-HCV+ clusters within households and villages in Punjab, India. These data should be used to inform screening efforts.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: A. Trickey, E-mail: adam.trickey@bristol.ac.uk

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Clustering of hepatitis C virus antibody positivity within households and communities in Punjab, India

  • A. Trickey (a1) (a2), A. Sood (a3), V. Midha (a3), W. Thompson (a4), C. Vellozzi (a4), S. Shadaker (a4), V. Surlikar (a5), S. Kanchi (a5), P. Vickerman (a1) (a2), M. T. May (a1) (a2) and F. Averhoff (a4)...

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