Accelerating Hepatitis C virus elimination in Egypt by 2030: A national survey of communication for behavioral development as a modelling study

• DOI: 10.1371/journal.pone.0242257
• Publication Date: 2021-02-23T19:48:06Z
• Authors: Ammal M. Metwally; Dalia M. Elmosalami; Hazem Elhariri; Lobna A. El Etreby; Ahmed Aboulghate; Marwa M. El-Sonbaty; Amira Mohsen; Rehan M. Saleh; Ghada A. Abdel-Latif; Sahar Samy; Sherif E. El Deeb; Asmaa M. Fathy; Mohab M. Salah; Mohamed A. Abdel ...; Hanaa M. Imam; Nihad A. Ibrahim; Fatma A. Shaaban; Reham Y. Elamir; Mohamed Abdelrahman; Manal H. El-Sayed
• Keywords: Adult; Male; Adolescent; Epidemiology; Science; Hepacivirus; Biochemistry; Gene; Young Adult; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; Sociology; Risk Factors; Health Sciences; Humans; Psychology; Hepatitis E Infection and Treatment; Biology; Demography; Hepatology; Hepatitis B Infection and Treatment; Q; R; Age Factors; 1. No poverty; Middle Aged; HBV Infection; 16. Peace & justice; Hepatitis C; FOS: Sociology; 3. Good health; FOS: Psychology; Dominance (genetics); Cross-Sectional Studies; Environmental health; Socioeconomic Factors; Hepatitis C Infection and Treatment; Medicine; Egypt; Female; Research Article

Aim of the work This study aimed at assessing the dominance of risk practices associated with HCV endemicity in Egypt and detecting the behavioral development level concerning different aspects of HCV risk behaviors with respect to age and gender. The survey highlights the most cost-effective strategies that could accelerate HCV elimination in Egypt.

Subjects and methods A national household survey targeted 3780 individuals (age range: 10–85 years). The sample was a systematic probability proportionate to size from 6 governorates representing the six major subdivisions of Egypt. The indicators used for assessing the behavioral development level towards HCV included six domains: awareness (7 indicators), perceived risk (5 indicators), motivation with the intention to change (4 and 5 indicators for males and females respectively), trial, rejection or adoption (6 and 5 indicators for males and females respectively).

Results The study revealed that along the continuum of behavior development, the percentage of the participants who acquired half of the scores was as follows: 73.1% aware, 69.8% developed perceived risk, 80.6% motivated with only 28.9% adopting the recommended behaviors, 32% rejected them, 2.3% were in the trial stage versus 35.8% who did not try any. Adolescents had significantly lower levels of development for almost all domains when compared to adults. Statistical higher significance was detected in favor of adults, employees, married, Lower Egypt governorates, and university-educated participants (p<0.001) regarding awareness, perceived risk, and motivation scores. More than half of the participants incorrectly believed that contaminated food, sharing food utilities, contaminated water, mosquitoes, and schistosomiasis would lead to HCV transmission.

Conclusion Egypt would be closer to HCV elimination when cost-effective strategies are directed not towards creating awareness, perceived risk or motivation to change- (at an acceptable level)- but towards motivating adopting risk-reduction behaviors for HCV, tackling misconceptions and reinforcement of social support.