Determining the true prevalence rate of Hepatitis-C in Pakistan
Hafiz Anwar Ahmad, Sadaf Aslam, Luma Akil, Jibran Hussain, Imtiaz Rabbani
Abstract
Background
Hepatitis-C is a serious public health concern in Pakistan, with an average prevalence rate of 8.7 per cent, has been reported.
Aims
The objectives of this study are multifold: to comprehensively review the published reports, determine positive predictive value (PPV) of Hepatitis-C using Bayes’ Theorem and to perform meta-analysis using both raw prevalence rates and PPV rates.
Methods
Using available search engines and databases, a comprehensive literature search was performed on Hepatitis-C in Pakistan. Positive predictive values for the reported prevalence rates were calculated using Bayes’ Theorem.
Results
Average PPV value found to be 33 per cent of the prevalence rate indicating that even after high prevalence reports, the chance of actual disease is still low to moderate, necessitating further confirmatory diagnosis. This discrepancy may be attributed to several factors, including the highly varying rates of prevalence; and test sensitivity and test specificity.
Conclusion
Random samples from various geographical locations and population segments are required to determine a realistic Hepatitis-C prevalence in Pakistan; in the absence of such representative samples, novel analytical and modeling approaches may offer a viable alternative to determine the actual prevalence rate and help devise better public health policy to combat the disease.
Full Text:
Hepatitis-C is a serious public health concern in Pakistan, with an average prevalence rate of 8.7 per cent, has been reported.
Aims
The objectives of this study are multifold: to comprehensively review the published reports, determine positive predictive value (PPV) of Hepatitis-C using Bayes’ Theorem and to perform meta-analysis using both raw prevalence rates and PPV rates.
Methods
Using available search engines and databases, a comprehensive literature search was performed on Hepatitis-C in Pakistan. Positive predictive values for the reported prevalence rates were calculated using Bayes’ Theorem.
Results
Average PPV value found to be 33 per cent of the prevalence rate indicating that even after high prevalence reports, the chance of actual disease is still low to moderate, necessitating further confirmatory diagnosis. This discrepancy may be attributed to several factors, including the highly varying rates of prevalence; and test sensitivity and test specificity.
Conclusion
Random samples from various geographical locations and population segments are required to determine a realistic Hepatitis-C prevalence in Pakistan; in the absence of such representative samples, novel analytical and modeling approaches may offer a viable alternative to determine the actual prevalence rate and help devise better public health policy to combat the disease.
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