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Bloodborne Diseases among Barbers in Makkah during Hajj, 1419H.

Introduction

Head shaving has been expected to be an important potential means of transmission of communicable blood-borne disease (BBD) such as hepatitis B, hepatitis C and human immune-deficiency virus. The malpractice's of barbers could make head-shaving during Hajj an optimum focal setting for worldwide spread of serious BBDs, since some barbers have history of infectious diseases, particularly in some Islamic countries with relatively high prevalence rates of (HBV) and (HCV) such as Pakistan, Nigeria, and Egypt. However, previous studies lacked laboratory components that document the prevalence of these BBD among Hajjees or barbers. The objectives of this study were to determine the prevalence of Hepatitis and human immune-deficiency virus (HIV) among barbers and to study some personal characteristics associated with (BBD).

Methodology

The study design was a cross-sectional study. The selected barbers were recruited from barbers working at head-shaving sites Jamarat. There are three collections for head shaving, each having more than 200-barber chairs. A random group of barbers were selected from each site, and their consent was obtained to draw intravenous blood. 158 blood specimens were collected, and sera were tested for the presence of markers for (HBV), (HCV), and (HIV).

Results

The studied sample was 158 barbers, the mean age was 29.6 ± 8.2 years and they were from eight different nationalities; the majority 72 (45.6%) were from Myanmar, 28 (17.7%) from Egypt and 22 (13.9%) were from Bangladesh. About two-thirds of the barbers were seasonal and work during Hajj season only (N = 101, 63.9%), and the professional licensed barbers were 57 (36.1%). Most of the barbers worked during the previous Hajj seasons for a median of 2-5 years. More than four fifths 128(81%) reported that no diseases transmittable by head shaving. Laboratory tests revealed that 7 (4.4%) barbers tested positive for HbsAg, 16 (10.1%) barbers for HCV, and one barber (0.6%) for HBeAg. None of the barbers tested positive for HIV, anti-HTLV 1&2, anti-HbsAg or Anti-HBc IgM. Around one third of Egyptian barbers tested positive for HCV, and one sixth (15%) of Pakistani barbers, but none of the barbers from Bangladesh. HCV was relatively higher among barbers who had been practicing head shaving at least in one previous Hajj season.

Conclusion

This study reports the prevalence of HBV, HCV and HIV among barbers serving Hajjees during the Hajj season for the first time. Head shaving has been reported to be an occupational risk factor for BBD among barbers. Barbers and Hajjees are at risk to acquire a BBD especially if they have a cut wound. The prevalence of BBD among barbers was high and was associated with nationality, residency status, original jobs and the number of years of practice as a seasonal barber during the Hajj season. Strict supervision, screening and licensing of barbers is needed to make sure that at least those working at areas supervised by the government are free from any BBD. Control measures have to be integrated with self-supervision by Hajjees themselves and barbers through intensified health educational programs.