Annexure

Annexure 1

Fig. 1 Population attributable risk rate and 95% confidence interval for various modifiable factors for hepatitis B virus

Fig. 2 Population attributable risk rate and 95% confidence interval for various modifiable factors for hepatitis C virus

Annexure 2

Systematic review of the occurrence of risk factors for hepatitis B virus and hepatitis C virus from South Asia

Author / Year / Country / Prevalence HBV / Prevalence HCV / Prevalence of risk factors in HBV positive / Prevalence of risk factor in HCV positive
Ahmed[9] / 2011 / Pakistan / NA / 5.5 / NA / Needle stick injury = 13.6%
Therapeutic injections = 99.1%
Dental procedure= 40.0%
Tattooing = 13.6%
Shared razor = 6.4%
Ear piercing = 51.8%
Nose piercing = 50.0%
Injecting drug use = 4.0 %
Bari[30] / 2001 / Pakistan / NA / NA
Occasional facial shaves from barbers = 50.0%
Daily facial shaves from barber = 19.6%
Reuse of blade by barber = 22.5%
Armpit shave from barber = 48.2%
More than 10 injections in the past 10 years= 42.9%
Tattoos = 8.9%
Ghias [34] / 2009 / Pakistan / NA / NA / NA
Dental surgery =34.88%
Tattooing =11.4%
Body piercing =33.8%
Injecting drug use =1.4%
Contact with blood and needle =11.0%
Sharing syringes =1.8%
Sharing tooth brush =1.8%
Sharing razor =6.4%
Barber shaves= 63.7%
Jafri / 2006 / Pakistan / 1.8 / 1.6 / >5 injections in the last year =46.8% / >5 injections in the last year =38.9%
Use of needle and syringes= 67.7% / Not using new needle and syringe =49.1%
Visit to barber shop =72.3 % / Visit to barber shop =81.8%
Cuts at barber shop =23.4% / Cuts at barber shop =15.6%
Piercings =33.8% / Piercings =34.6%
Usman[35] / 2002 / Pakistan / NA / NA / >1 injections= 53.7%
Dental treatment =6.0%
Facial shave from barber =47.6%
Armpit shave from barber =33.3%
Ear piercing =1.5%
IV drug use =3.0%
Open syringes =10.4%
Accidental cuts at barber shops =28.57%
Luby [24] / 1997 / Pakistan / NA / 6.5 / NA
Shave by barber at least once a month =80%
Sharing toothbrush =9%
Tattooing in last 2 years =7%
Body piercing in last 2 years =7%
Dental work =33%
Blood or needle exposure =7%
Masood[36] / 2005 / Pakistan / 6.5 / 11.5
Frequent injections =96% / Frequent injections =95.4%
Dental procedures =44% / Dental procedures =54.5%
Tattooing =36% / Tattooing =31.8%
Body piercings =52% / Body piercings =50%
Regular barber visits =56% / Regular barber visits =56.8%
>4 therapeutic injections last year =81.8%
Qureshi [10] / 2010 / Pakistan / 2.5 / 4.8 / >10 injections =3.2% / >10 injections =8.3%
Reused syringes= 3.0% / Reused syringes =6.8%
Barber shaves =4.1% / Barber shaves= 9.8%
Sharing toothbrush =4.2% / Sharing toothbrush =8.4%
Tattooing/acupuncture =3.5% / Tattooing/acupuncture =8.3%
Piercings(only females)= 2.3% / Piercings (only females) =5.8%
Surgery= 3.1% / Surgery =10.1%
Chowdhury[37] / 2005 / India / 2.97 / NA / Less than 10 years education =98.35% / NA
Use of glass injection syringes =85.61%
Tattooing =0.21%
Dental therapy =0.28%
Shaving by community barber =70.98%
Chowdhury [21] / 2003 / India / NA / 0.87 / NA / Less than 10 years education =61.54%
Glass syringes use =80.76%
Shaving by community barber =45.45%
Tattooing =7.70%
Dental therapy =11.54%
Jagannathan [38] / 2010 / India / 0.94 / NA
Dental procedure= 29.6%
Needle stick injuries= 4.2%
Body piercing =11.3%
Tattooing= 4.2%
Kumar[39] / 2007 / India / NA / 1.03 / NA / Blood transfusion =4.8%
Acupuncture or tattooing =4.8%
Surgery =11.9%
Thakral[40] / 2006 / India / NA / 0.44 / NA
Multiple drug injections =19.4%
Tattooing, piercings =12.9%
Acupuncture =9.7%
Sharing of shaving kits =32%
IV drug abuse =6.5%
Needle stick injury =6.5%
Karim / 2009 / Bangladesh / 0 / 0.88
Shaving/haircut at barber =33%
Ear piercing =33.33%
Body piercing =33.34%
Ashraf [41] / 2010 / Bangladesh / 29 / 0.2 / Previous surgery= 25.9%
Circumcision =84.1%
Needle stick injuries =5.1%
Body piercing (in females only) =96%
Shaving by community barber =72.4%
Gibney [42] / 2001 / Bangladesh / 5.9 / <1
Therapeutic injections= 9.1% / Therapeutic injections =55.8%
>10 injections in the past year =33.2%
Dental procedure =25.4%
Piercing (only females) =98.6%
Sharing tooth brush =1.1%
Shaving by barber =99.2%
>10 injections in the past year =86.4%
Mahtab[43] / 2008 / Bangladesh / NA / 0.88 / NA
Shaving from barber =33.34%
Body piercing =33.34%
Circumcision =33.34%
Shirin [44] / 2000 / Bangladesh / 6.2 / NA / Sharing of needles =9.6% / Sharing of needles =38.5%
History of exposure =4.5% / History of exposure =25%
>1 year injectable drug use =9.7% / >1 year injectable drug use =36%
Hajiani [45] / 2006 / Iran / Transfusions =52%
IV drug abuse =14.5%
Extra marital sexual contact =2.4%
Tattooing =3.6%
Jahani[46] / 2003 / Iran / 5.9 / NA / Blood transfusion =3.2% / NA
Tattooing =8.9%
Merat [47] / 2009 / Iran / Blood transfusion =5% / Blood transfusion =17%
Non intravenous drug abuse =1% / Non IV drug abuse =18%
Surgery =3.1% / Surgery =16%
Tattooing =41 % / Tattooing =18%
Zamani(48) / 2007 / Iran / NA / 52 / NA / >10 years intravenous drug abuse =63.5%
Sharing needles =53.5%
Tattoo =58.3%
Shahnaz Sali(49) / 2005 / Iran / Tattooing =8.8%
Intravenous drug abuse =4.2%
Dental work =33.2%
Needle stick injury =1.4%
Nasir / 2010 / Afghanistan / 5.8 / 36 / Aspirating and reinjection blood =69.4% / Aspirating and reinjection blood =80.7%
Sharing injecting equipment= 25% / Sharing injecting equipment =35.4%
Sharing needles =37.1% / Sharing needles =35.6%
Therapeutic injections =22.2% / Therapeutic injections =15.2%
Myo / Myanmar / NA / 0.93
Body piercing =0.31%
Tattooing =0.98%

Annexure 3

Flow diagram showing review process from January 1997 to January 2012