{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:50:24Z","timestamp":1789905024088,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,6,7]],"date-time":"2017-06-07T00:00:00Z","timestamp":1496793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Viral hepatitis is a major public health challenge in Egypt but little is known about the epidemiology of the hepatitis B virus (<jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>) infection, its geographical distribution, or risk factors for infection in the Egyptian context. This study addresses this deficit using data from a nationally representative survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional analysis of data gathered from men and women aged 15\u201059 in the Egypt Health Issues Survey (<jats:styled-content style=\"fixed-case\">EHIS<\/jats:styled-content>) 2015, including logistic regression to evaluate the contribution of different factors to risk of <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> infection. This was supplemented by spatial analysis of the distribution of acute or chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> infection at governorate level, and the ecological relationship between <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Population <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> prevalence was 1.4% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.2\u20101.6), with a <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> co\u2010infection rate of 0.06%. Spatial analysis showed localisation of <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> infected individuals primarily to urban areas of Upper Egypt (in contrast to <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> for which prevalence is highest in rural Lower Egypt), and those in early middle age (Adjusted Odds Ratio [<jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content>] 3.32, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.66\u20106.63). <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> positive status among other household members emerged as a powerful driver of infection risk in this analysis (<jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content>=10.75, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 4.98\u201023.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Spatial distribution of <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> infection in Egypt differs markedly from <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> and co\u2010infection rates are low. Within\u2010household transmissions appear to be particularly important in explaining the persistence of <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> infection in the general population. Prevention strategies should focus on urban Upper Egypt, and particularly those households with documented cases of infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13469","type":"journal-article","created":{"date-parts":[[2017,5,8]],"date-time":"2017-05-08T15:26:49Z","timestamp":1494257209000},"page":"1814-1822","source":"Crossref","is-referenced-by-count":31,"title":["Hepatitis B in Egypt: A cross\u2010sectional analysis of prevalence and risk factors for active infection from a nationwide survey"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-7337","authenticated-orcid":false,"given":"Sharif A.","family":"Ismail","sequence":"first","affiliation":[{"name":"Department of Primary Care and Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego F.","family":"Cuadros","sequence":"additional","affiliation":[{"name":"Department of Geography and Geographic Information Science University of Cincinnati  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Benova","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1476-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13186"},{"key":"e_1_2_10_4_1","volume-title":"Egypt Health Issues Survey 2015","author":"EZA","year":"2015"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61412-X"},{"key":"e_1_2_10_6_1","volume-title":"Egyptian National Control Strategy for Viral Hepatitis, 2008\u201012","author":"MoHP","year":"2008"},{"key":"e_1_2_10_7_1","volume-title":"Plan of Action for the Prevention, Care and 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