in GOOD HEALTH Mixed
in GOOD HEALTH Mixed Bag: Chaldeans fare better than Arabs in hepatitis study BY JEREMY HULL There was good news and bad news for Chaldeans in a recent study on the Hepatitis C virus (HCV), an incurable liver disease that is spread through contact with blood. While their rate of the disease is slightly higher than the national average, Chaldeans are infected in much lower numbers than their Arab counterparts in Metro Detroit. While more than 5 percent of Metro Detroit’s Arab population is infected with HCV, Chaldeans are at 2 percent. The national average is 1.6 percent. Conducted in May by the Arab American & Chaldean Council (ACC) along with Roche Pharmaceuticals, William Beaumont Hospital’s Gastroenterology and Hepatology Department and Family Medicine and Public Health Sciences at Wayne State University, the “HCV Public Awareness & Education Project” tested 484 people in Macomb, Oakland and Wayne Counties throughout a 12- month period. The study’s results, published in the journal “Gastroenterology,” revealed that 26 people tested positive for the virus, or 5.4 percent — triple the national average of 1.6 percent. According to the ACC’s Monty Fakhouri, an estimated 156,000 to 260,000 Arabs and Chaldeans in the United States are infected with HCV. He noted that while it was startling to see high rates in such a small sampling, the study’s authors were also troubled by how unaware people were of their condition. “Most of these people had the virus and did not even know it,” he said. While the prevalence of HCV among Chaldeans was relatively low at 2 percent, the ACC’s Dr. Evone Barkho cautions against dropping one’s guard against the virus. In 1999, the World Health Organization estimated that 170 million individuals were chronically infected with HCV worldwide, with at least 21.3 million HCV carriers in Eastern Mediterranean countries alone. “I believe the rates [of HCV] are higher in Iraq because of the sanitation and lack of healthcare,” said Barkho. “I am Chaldean and I came from Iraq. I practiced medicine there and I saw how blood was contaminated from using the same syringes.” The majority who tested positive for HCV in the ACC study were Arabic females, between the ages of 40-59, had less than a high school education and no health insurance. All of the study participants were immigrants who had lived in the United States less than seven years, with nearly half being non-English speakers. Lacking the ability to communicate effectively, said Fakhouri, further exacerbates the ability of new immigrants to get tested for HCV and seek treatment for the virus. “That so many of them are immigrants and newcomers, they are confined and limited to speaking Arabic,” he said. The study was able to attract such a large segment of metro Detroit’s Chaldean and Arab population because it was heavily advertised through fliers, brochures, websites and SYMPTOMS OF HEPATITIS C • 80 percent of people have no signs or symptoms • Jaundice, fatigue, dark urine, abdominal pain, loss of appetite, nausea LONG-TERM EFFECTS • Chronic infection: 55-85 percent of infected persons • Chronic liver disease: 70 percent of chronically infected persons • Deaths from chronic liver disease: 1-5 percent of infected persons may die • Leading indication for liver transplant SOURCE: NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD AND TB PREVENTION e-mail links. Barkho, however, is worried about the next step for many who tested positive. “Reaching people to test was so easy,” she said, “but because a lot of people don’t have medical insurance, they are scared of what to do next for treatment.” Among the ethnic groups who tested positive, the greatest majority were Egyptian males, which could be attributed to parenteral antischistosomal therapy, a treatment to combat a blood parasite that was given to many Egyptians from the 1920s to 1980s using unsterilized needles and syringes. Another significant factor, Fakhouri said, may involve a traditional tattoo given to specific members of the Egyptian population. “The Egyptian Coptic people all tend to receive a tattoo in the shape of a cross, and that becomes the most likely mode of contaminated blood transmission,” he said. “Everything boils down to the proper sterilization of needles.” In addition to using contaminated needles for medication injection or substance abuse, the study noted other risk factors for HCV, including shared personal hygiene such as two people using the same toothbrush or razor blade, as well as relying on folk remedies or untrained medical personnel to assist with healthcare procedures like circumcision or child delivery. Fakhouri said that the large frequency of HCV among a small ethnic population calls for a wider scope. “We want to use this as a stepping stone for a much larger health education campaign and to include physicians,” he said. “It would give us an absolute certainty of the prevalence of the population.” To learn more about HCV testing or treatment and to receive bilingual assistance, contact the ACC at (248)559-1990, or visit the Hepatitis Foundation International at http://www.hepfi.org. 44 CHALDEAN NEWS AUGUST 2007
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