Epidemiological insights on the association between female genital mutilation and Hepatitis C Infection in Egypt: An Examination using Demographic and Health Survey data of Egypt, 2008

Purpose: Egypt has the highest prevalence of chronic Hepatitis C virus (HCV) infections and also a high prevalence of female genital mutilation (FGM). The high prevalence chronic hepatitis C has been attributed to HCV transmission by contaminated injections for the control of schistosomiasis. HCV infection has not been well studied in the context of female genital mutilation (FGM). We sought to identify associations between FGM and HCV using the Egypt Demographic and Health Survey (EDHS), 2008. Methods: FGM was chosen as the main independent variable of interest. Other independent variables such as age, education, marital status, residence, beliefs associated with FGM, history of blood transfusion, surgery, sharing needles, and history of schistosomiasis were included in the analysis. Throughout the analysis, HCV infection was used as the main dependent variable. Results: Univariate analysis of FGM and HCV showed a statistically significant association with a Prevalence Odds Ratio of 4.82 (2.91 -7.96), after adjusting for age and schistosomiasis injection, the association between FGM and HCV remained statistically significant with an odds of 2.98 (1.76 – 5.05)Among the category for FGM performer and association with HCV infection, the OR was 4.28 (2.31 – 7.91) when the FGM was performed by a ghagaria, 3.68 (2.76 4.90) when the FGM was performed by daya, and 3.30 (1.81 -5.88) when the FGM was performed by a barber. Among other independent variables, a lack of education, rural residence, and having religious precepts for FGM had statistically increased odds of association with HCV infection. Conclusion: There is a statistically significant association between FGM and HCV infection. There are increased odds of HCV when the FGM is performed by providers other than doctors. Participants from a rural residence and who those who did not have any education were at increased odds of HCV. Subjects who believed in religious precepts for FGM and also who answered that FGM can continue had increased odds of association with HCV infections. Epidemiological insights on the association between female genital mutilation and Hepatitis C Infection in Egypt: An Examination using Demographic and Health Survey data of Egypt, 2008. Submitted to Georgia State University as a partial fulfillment for the Degree of Masters in Public Health Shameem Fathima Jabbar, MBBS. Thesis chair: Ike Solomon Okosun, MS, MPH, PhD, FRSPH, FTOS