Risk factors for viral hepatitis C infection in Rwanda: Results from a Nationwide Screening Program

Abstract Background The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; however, this information is crucial to shaping the country’s public health approach to hepatitis C control. Methods A HCV screening campaign was conducted in the general population in 24 districts previously identified to have a high HCV disease burden at the time of sample collection, sociodemographic information and self-reported risk factors were collected. Bivariate and multivariate logistic regressions were conducted to assess risk factors independently associated with HCVAb seroprevalence. Results Out of a total of 326,263 individuals screened for HCVAb, 22183 (6.8%) were positive. In multivariate analysis, risk factors identified as statistically associated with HCVAb positivity include history of traditional operation or scarification (OR=1.091, 95% CI: 1.049-1.135), presence of viral hepatitis in the family (OR=1.268, 95% CI: 1.151-1.397), widowed or separated/divorced (OR=1.36, 95% CI: 1.257-1.471), South province (OR=1.978, 95% CI: 1.884-2.077) and age 65 years old and over (OR=4.857, 95% CI: 4.617-5.110). Ubudehe category 3 (OR=0.966, 95% CI: 0.927-1.008) and participants using RAMA insurance (OR=0.775, 95% CI: 0.704-0.854) had lower odds of HCV seropositivity. Conclusions Our findings provide important information for Rwanda’s strategy on prevention and case-finding. Future prevention interventions will aim to reduce transmission through targeted messaging around traditional healing practices and future case-finding will target individuals with a history of exposure or of older age.