المهام

محمد خالد شمبش هو احد اعضاء هيئة التدريس بقسم طب الاسرة والمجتمع بكلية الطب البشري. يعمل السيد محمد خالد شمبش بجامعة طرابلس كـأستاذ منذ 2013-06-01 وله العديد من المنشورات العلمية في مجال تخصصه.

CURRICULUM VITAE . السيرة الداتيه.

  محمد خالد عبد العاطي شمبش

 قسم طب الاسرة والمجتمع

 كليت الطب البشري

Dr. Mohamed. Kaled. A.  Shambesh 

1. Professor in community & family Medicine 

department, Tripoli Medical Faculty, Libya (2013-2014) 

2. Head of community & family Medicine department, Tripoli Medical Faculty, Libya 

 (2013-2014)

3. Head of Research unit in The Libyan Board of Medical Specialties, Tripoli, Libya (from 

 2015 to 2020)

(M.B.B.Ch, MSc-UK, PhD-UK) 

Surname  Shambesh 

Previous names Mohammed   Kaled   A 

Current Address:  

Tripoli Medical University, Faculty of Medicine  Community & Family Medicine Department P.O.Box (13229)-Tripoli-Libya. 

Fax (0021821-4627765) 

Mobile: 0218-092 7380237 

E mail, mkshambesh@yahoo.com 

Nationality : Libyan with British citizenship. Passport 

No. 093151949 London 

Date of birth: 14 September 1962 

Marital Status: 

  Married with five children 

Study attainments: 

Basic Education: 

  1970-Primary school Tripoli. 

  1976-Preparatory school Tripoli. 

  1981-Secondary school Tripoli 

Medical  Education :  

   University-school of medicine-Tripoli   from November 1981 to January 1987. 

Qualification: 

1. M. B. B. Ch, January  1987 (Physician). 

2. MSc of Tropical Medicine, December 1991  (Liverpool school of Tropical Medicine, UK). 

3. PhD , 17 july 1997. PhD in Community medicine (Salford University & Liverpool school of Tropical Medicine, UK) 

UK-GMC registration:  Full registration No. 4592499. 

 Current appointments

Professor in community & family Medicine  department, Tripoli Medical Faculty, Libya

Professor and head of department of Community & Family  

Medline department, Medical Faculty, Tripoli University from 1/6/2006 and continue (2015) 

Working as  professor in this department engaged in teaching of medical students, postgraduate, demonstrators. Supervising researches of new doctors and postgraduate doctors doing Arab and Libyan boards, Masters in sciences and microbiology and also PhDs.. 

Also engaged in teaching and examinations of undergraduate & postgraduate in Tripoli, Misrata, Khmus, Zawia and Alarab medical faculty in Benghaz, Gerian and Sabha. 

Also engaged doing multiple methodology and nosocomial courses in Tripoli, Benghazi and Sabha. 

Head of Research Department  in The Libyan Board of Medical Specialties, Tripoli, Libya   (2015-2020)

In this department I was leading a research team in Tripoli, Benghazi, Misrata and Sabha conducting various methodology courses for doctors and specialists preparing them for the 

Libyan higher Board and to train the  research supervisors  also          leading the research activates in the community board.            Also I am supervising  research protocols and board  thesis to be authorized for the board office. Also I am supervising  different activates in this unit.                                                  

Specialist in Clinical Laboratory & hematology (University Hospitals Aintree, Fazakerley & Walton Hospitals, Liverpool. UK, from 5th September 1996 till may 2006. 

Clinical specialist in hematology in University Hospitals Aintree post conducting weekly myeloma clinics, general hematology clinics, anticoagulant clinics (new patients and follow ups) and hematology Day word responsibilities. Also doing bone Marrow aspiration & biopsies, vensections and giving chemotherapy for hematology patients like Lymphoma, Leukemia and myeloma. Some times as flexible post with extending hours when needed I am working In laboratory reporting blood films from all over the hospital, OPDs and GPs, reporting bone marrows and doing on calls 1 in 5 covering our hematology department (20 beds) and other departments for any hematology opinion, also engaged in teaching new doctors and medical students in clinical bed side and laboratory and also conducting various community/laboratory researches with help of public health department in Liverpool University specially in Tropical Medicine. 

Previous appointments:  

PhD in community medicine (January 1992-February 1996) 

During this period I engaged doing a PhD in Clinical laboratory in community based large scale study in UK shared African project. This project is shared project between Liverpool school of tropical Medicine and Manchester University. During this course I did a clinical and laboratory study (questionnaire-ultrasound-serology) where I examined 20,220 people by portable ultrasonography in 36 villages in North Africa (north Libya) for hydatid disease prevalence in a biggest questionnaire-ultrasound-serology survey in north Africa. Most of my time during this post I was keeping in touch with general medicine throughout my project, I was doing complete medical examinations for all my hydatid (liver, spleen, kidney, ovary, uterus and abdominal wall) and non-hydatid cases (gall stones, renal stones, hydronephrosis simple liver & kidney cysts, Ascities and pleural effusions etc.), investigating and screening them by X-rays, CAT scans and laboratory tests. I was following my patients during their investigation, before and after operations. I was treating some of my cases with Albendazole and following them every 2 months for one year looking for ultrasound cyst remission. Also I collected 15,000 blood samples from general public and tested them by ELISA and westren blotting serology in UK laboratories. I analyzed 20,220 questionnaire forms (each form contains 21 questions) with 1000 case's sheets (hydatid cases, simple kidney cysts, hydronephrosis and gall stone cases) (each form contains 40 questions) by hospital data analysis programmes (File maker Pro, Epi Info and Data Desk) to produce the statistical data needed for this survey. I published seven papers and I have 2 more papers in preparation for publication (see page 7), also I wrote especial chapter in hydatid disease in North Africa which published in USA in "compendium on cystic Echinococcosis" in July 1998. 

Master of Tropical Medicine (September 1990-September 1991) 

I took and passed the various courses in Master of Tropical Medicine in Liverpool school of Tropical Medicine-UK, during which I attended extensive laboratory courses in Medical Parasitology and Tropical Medicine, also did small clinical study in clinical laboratory & community Medicine (hydatid disease prevalence, pilot study) in North Africa where I examined 4103 people by ultrasonography in five big areas in North Africa (northwest Libya) and collected and tested 4103 blood samples, I analyzed 4103 questionnaire forms (each form contains 21 questions) with 112 case's sheets (hydatid cases, simple kidney cysts, hydronephrosis and gall stone cases) (each form contains 40 questions) by hospital data analysis programmes. This work was published in Annals of Tropical Medicine and Parasitology. 

English Language course (April 1990-July 1990) 

English Language course was taken in UMIST University, Manchester. 

Senior House Officer Post in Intensive Therapy Unit (December 1989-February 1990) 

Senior House Officer in Intensive Therapy Unit Tripoli central hospital. During this post I became competent in the performance of a number of procedures including endotracheal intubation, tracheostomy, and dealing with various medical emergencies.  

Senior House Officer Post in general medicine (March 1988- November 1989) 

Senior  House  Officer in  general medicine, Tripoli central hospital, I performed 1:4 duties dealing with acute medical cases including day to day  care of the patients and taking part in the out patient clinics, during this post I rotated into the following subspecialties: Gastroenterology in which I have gained wide experience in upper G.I.endoscopy ,and I have attended various endoscopic procedures including sclerotherapy, oesophageal dilatation, and polypectomy, also I have dealt with  

different gastroenterological problems in the out patient clinics. Also I worked in 

Hematology, in which I dealt with various cases of blood disorders like leukemia, Lymphoma and varies types of anaemia (A plastic & others), also I worked in Respiratory medicine in which I was doing various respiratory testes and attending asthma clinic and I gained experience in mangement of other various medical problems like diabetes & other endocrine abnormalities and hypertension.  

House Officer post (March 1987-February 1988) 

Tripoli central hospital rotational internship, six months general medicine, general surgery and six months pediatric and gyneobstetric. 

The post of house officer in Libya is quite similar to the post of house officer in U.K, in which I was dealing with different medical cases including prescribing drugs and doing various medical and surgical procedures. 

Scientific Activities. 

During my career I attended and actively participated in various post graduate activities including weekly journal clubs, clinical case presentations and x-ray and ultrasonography meetings. 

Hobbies: 

I enjoy watching football, I am  an avid reader of literature and writing papers. 

Career Plans: 

I intend to contribute in teaching in medical schools in Arab world in my field specially in community & family medicine, research methodology and nosocomial 

medicine.  

Experience in: 

1. Experience in general Medicine: 

A. Experience in Care of inpatients. 

B. Experience in conducting various general Medical clinics. 

C. Experience in management of Medical emergencies. 

D. Experience in various Medical procedures like Bone             Marrows, venesections, Red cell mass and others. E. Experience in clinical hospital laboratories. 

2. Medical practice: 

Dealing with acute and cold medical cases.

3. Research 

In conducting medical field studies, community surveys, hospital medical studies and collecting & analyzing medical data,  conducting  research methodology Courses and nosocomial hospital acquired course. 

4. Laboratory 

In conducting various laboratory tests like ELISA, Westren plotting and antigen preparations, reporting peripheral blood films and bone marrows. 

5. Computer  

In data collections and analysis, statistical analysis, graphs designs and various diagram drawings. Some computer software used during my work; File Maker Pro as filing system (version 1.0 Bv2, 1991. USA), Data Desk programme (version 3.0, 1989. USA) with IBM & Macintosh computers, Epi Info program, version 6 (US Centers for Disease Control, Atlanta) with IPM computer, Microsoft Word 5.1 & 6 and word perfect-windows and SPSS. 

6. Teaching

Specially teaching students and newly graduated doctors in community medicine with special interest in research programs, also teaching and supervising postgraduate doing masters & PhDs. 

Publications 

Paper Publications (as a first main Author, Shambesh et al) 

1. Contaminations of blood donors by Hepatitis B Infection in North west Libya , BBTS Annual Conference, Harrogate Convention Centre UK.  2014 

2. Levels of C3 and C4 Complement in Libyans with Heart diseases, LMJ, 2014 V12,4.2013. 

3. The Demographic Features of Scabies in Misurata – Libya,   Tripolitana Medical Journal. V.2, No.1, 28-30.  (2013). 

4. Multidrug Resistant Bacteria in Wounds of Fighters of the Libyan Uprising, journal of infection, USA, 2011. 

5. Estimation of the Incidence of Pulmonary Tuberculosis in Northwestern Libya, , Ibnosina J Med,  2010. 

6. hepatitis among Libyans Using Anti-core,  THE LIBYAN JOURNAL OF Infectious Diseases, 2010. 

7. Eczema in Zlytin, Ibnosina J Med , 2008 

8. Rickets in Libya, Jamahiriya medical Journal, 2008. 

9. Hydatid disease review in Libya, Libyan Journal of Infectoius Disease, 2007. 

10. TB Burden IN Libya, In press, Libyan Journal of Infectoius Disease, 2007. 

11. Prevalence of human hydatid disease in north-western Libya: a crosssectional ultrasound survey. Annals of Tropical Medicine and Parasitology.1992, 68, No 4, 381-386, UK 

12. Immunoblot evaluation of the 100 and 130 KDa antigens in camel hydatid cyst fluid for the serodiagnosis of human cystic Echinococcosis in Libya. Transaction of the Royal Society of Tropical Medicine and Hygiene, 1995, 89, 

276-279, UK 

13. Immunoblot evaluation of IgG and IgG-subclass antibody response for immunodiagnosis of human alveolar Echinococcosis. Annals of Tropical 

Medicine and Parasitology. 1995, 89, No 5 123-131, UK 

14. IgG1 and IgG4 serum antibody responses in asymptomatic and advanced cystic Echinococcosis patients, Acta Tropica1997, 64 (1997), 53-63. UK 

15. Use of ultrasound and serology to investigate the prevalence of human cystic Echinococcosis.  In American. J. Tropical Med. & Hygiene. 2000, 60(3), 462-468, USA 

16. High prevalence of cystic hydatid disease in rural Libyan village. Annals of Tropical Medicine & Hygiene, 1998,  957-959. UK 

17. High prevalence of cystic hydatid disease in Africa. UK Parasitology, Congress, 1996, 96, paper No. 16. UK 

18. Assessments of the sensitivity and specificity of different Libyan B antigens for the diagnosis of field and surgical hydatid cases and factors affecting human serology positivity  

Annals of Tropical Medicine and Parasitology. 2002 OCT. UK 

19. Classification of field hydatid cysts by ultrasonography and serology,

  Lancet, 2002, July, UK 

20. Community Based Study of Cerebrovascular Risk Factors in Tripoli-Libya (North Africa). Journal of Scientific Research & Reports 6(6): 451-460, 2015; Article no.JSRR.2015.169 ISSN: 2320-0227 

21. Stroke Risk Classification by Use of the CHADS2 Score in Community Population in Absence of Atrial Fibrillation. Journal of Scientific Research & 

Reports 7(5): 348-358, 2015; Article no.JSRR.2015.216 ISSN: 2320-0227 

22. Anti-HBc and HBV-DNA among Blood Donors in North Africa; Western Libya. International Blood Research & Reviews 3(4): 152-159, 2015, Article no.IBRR.2015.017. ISSN: 2321–7219 

23. CHADS2 Stroke Risk Stratification in Atrial Fibrillation Patients; 

Community Based Comparison Study.  Journal of Scientific Research & Reports 7(4): 266-275, 2015; Article no.JSRR.2015.208. ISSN: 2320-0227 

24. Congestive Heart Failure among the Libyan  Population (North Africa); A 

Community Based Survey of Risk Factors and Complication. Cardiology and Angiology: An International Journal 4(2): 51-60, 

2015Article.no.CA.2015.027. ISSN: 2347-520X. 

25. Diabetes Mellitus and Cerebrovascular Accident among North African Population (Libya) Community Based Survey.  International Journal of 

TROPICAL DISEASE & Health. 10(2): 1-9, 2015, Article no.IJTDH.19028 

ISSN: 2278–1005 

26. Role of Hypertension as a Major Risk Factor of Stroke in Africa; Libya: Community Based Survey. British Journal of Medicine & Medical Research 

9(5): 1-11, 2015, Article no.BJMMR.18897 .ISSN: 2231-0614. 

27. Levels of C3 and C4 complement in Libyans with Heart Diseases. Ali  Daeki, Mohamed Kaled Shambesh, Tarek AF, Kalifa Ghenghesh. 

LMJ.V12,4.2013. 

28. The demographic features of Scabies in Misurata-Libya.tripolitana Medical Journal. V.2, No.1, 28-30. 

Book Chapters (Shambesh et al) 

1. Medical Aspects of human cystic Echinococcosis in north Africa compendium on cystic Echinococcosis, June, 1997, Professor F.L. Andersen 

597 WIDB-BYU, Provo, pages: 223-244. USA 

2. Medical Aspects of human cystic Echinococcosis in north Africa Hydatid diseases in Libya 2002 Dr. M K Shambesh and Dr A M Gusbi First, In Libya, 2002. 

Thesis  

1. Hydatid disease prevalence in Northwest Libya (pilot study). Master of 

Tropical medicine, Dec. 1991 Liverpool School of Tropical Medicine , 

UK 

2. Use of ultrasonography and serology to investigate the prevalence of 

Hydatid disease in human in North Libya, PhD Feb. 1996, Manchester, University, UK 

Referees: 

1. Professor Philip.S.Craig 

Biological Sciences Department,  

Salford Uuniversity, Peel Building,  

Salford, Greater Manchester,  

M5 4WT. UK 

Tel: 0161 295 5488,  

 Fax: 0161 295 5210. 

2. Professor Calum. N .L. Macpherson, DIC, PhD. Director of Research, Windward Islands Research & Education Foundation. 

St. George's University School of Medicine, P.O. Box 7, St. George, Grenada. 

Tel: 809 444 3997, Fax: 809 444 2823. and visiting lecturer in Liverpool school of  Tropical Medicine. 

3. Professor. Mohamed M Baccush, 

University, Faculty of Medicine  Community & Family Department P.O.Box (13229)-Tripoli-Libya. 

Fax (4627765) 

4. Dr. Omar Ibrahim Abusnena, 

University, Faculty of Medicine  Community & Family Department P.O.Box (13229)-Tripoli-Libya. 

Fax (4627765) 

المسيرة المهنية

من محاضر الى استاد

رائيس قسم طب الاسرة والمجتمع لمدة 10 سنوات.

منسق الدراسة والامتحانات بالقسم 

منسق اطباء الامتياز بالقسم

منسق التدريب للقبول الكندى

عصو لجنة الكورونا بالجامعة

عضو لجنة الكورونا بالكلية 

عضو اللحنة الإستشارية العلياء للكورونا فى ليبيا 

رئيس فريق متابعة الاجراءات الاحترازية بوزارة التعليم 

باحت معتمد لدى هيئة أبحاث العلوم الطبيعية والتكنولوجيا

 ممتحن خارجى للدرسات العلياء بالحامعات الليبية 

ممتحن بكليات الطب بالدولة

Head of Research Department  in The Libyan Board of Medical Specialties, Tripoli, Libya   (2015-2020

الاهتمامات البحثية

الامراض السارية والبحوت الطبيه

medicine Tropical

 Tropical diseases 

Zoonisis

 None Communicable  

 communicable  disease 

  Blood diseases   

Publications 

Paper Publications (as a first main Author, Shambesh et al)  

1. Contaminations of blood donors by Hepatitis B Infection in North west Libya , BBTS Annual Conference, Harrogate Convention Centre UK.  2014 

2. Levels of C3 and C4 Complement in Libyans with Heart diseases, LMJ, 2014 V12,4.2013. 

3. The Demographic Features of Scabies in Misurata – Libya,   Tripolitana Medical Journal. V.2, No.1, 28-30.  (2013). 

4. Multidrug Resistant Bacteria in Wounds of Fighters of the Libyan Uprising, journal of infection, USA, 2011. 

5. Estimation of the Incidence of Pulmonary Tuberculosis in Northwestern Libya, , Ibnosina J Med,  2010. 

6. hepatitis among Libyans Using Anti-core,  THE LIBYAN JOURNAL OF Infectious Diseases, 2010. 

7. Eczema in Zlytin, Ibnosina J Med , 2008 

8. Rickets in Libya, Jamahiriya medical Journal, 2008. 

9. Hydatid disease review in Libya, Libyan Journal of Infectoius Disease, 2007. 

10. TB Burden IN Libya, In press, Libyan Journal of Infectoius Disease, 2007. 

11. Prevalence of human hydatid disease in north-western Libya: a crosssectional ultrasound survey. Annals of Tropical Medicine and Parasitology.1992, 68, No 4, 381-386, UK 

12. Immunoblot evaluation of the 100 and 130 KDa antigens in camel hydatid cyst fluid for the serodiagnosis of human cystic Echinococcosis in Libya. Transaction of the Royal Society of Tropical Medicine and Hygiene, 1995, 89, 

276-279, UK 

13. Immunoblot evaluation of IgG and IgG-subclass antibody response for immunodiagnosis of human alveolar Echinococcosis. Annals of Tropical 

Medicine and Parasitology. 1995, 89, No 5 123-131, UK 

14. IgG1 and IgG4 serum antibody responses in asymptomatic and advanced cystic Echinococcosis patients, Acta Tropica1997, 64 (1997), 53-63. UK 

15. Use of ultrasound and serology to investigate the prevalence of human cystic Echinococcosis.  In American. J. Tropical Med. & Hygiene. 2000, 60(3), 462-468, USA 

16. High prevalence of cystic hydatid disease in rural Libyan village. Annals of Tropical Medicine & Hygiene, 1998,  957-959. UK 

17. High prevalence of cystic hydatid disease in Africa. UK Parasitology, Congress, 1996, 96, paper No. 16. UK 

18. Assessments of the sensitivity and specificity of different Libyan B antigens for the diagnosis of field and surgical hydatid cases and factors affecting human serology positivity  

Annals of Tropical Medicine and Parasitology. 2002 OCT. UK 

19. Classification of field hydatid cysts by ultrasonography and serology,

  Lancet, 2002, July, UK 

20. Community Based Study of Cerebrovascular Risk Factors in Tripoli-Libya (North Africa). Journal of Scientific Research & Reports 6(6): 451-460, 2015; Article no.JSRR.2015.169 ISSN: 2320-0227 

21. Stroke Risk Classification by Use of the CHADS2 Score in Community Population in Absence of Atrial Fibrillation. Journal of Scientific Research & 

Reports 7(5): 348-358, 2015; Article no.JSRR.2015.216 ISSN: 2320-0227 

22. Anti-HBc and HBV-DNA among Blood Donors in North Africa; Western Libya. International Blood Research & Reviews 3(4): 152-159, 2015, Article no.IBRR.2015.017. ISSN: 2321–7219 

23. CHADS2 Stroke Risk Stratification in Atrial Fibrillation Patients; 

Community Based Comparison Study.  Journal of Scientific Research & Reports 7(4): 266-275, 2015; Article no.JSRR.2015.208. ISSN: 2320-0227 

24. Congestive Heart Failure among the Libyan  Population (North Africa); A 

Community Based Survey of Risk Factors and Complication. Cardiology and Angiology: An International Journal 4(2): 51-60, 

2015Article.no.CA.2015.027. ISSN: 2347-520X. 

25. Diabetes Mellitus and Cerebrovascular Accident among North African Population (Libya) Community Based Survey.  International Journal of 

TROPICAL DISEASE & Health. 10(2): 1-9, 2015, Article no.IJTDH.19028 

ISSN: 2278–1005 

26. Role of Hypertension as a Major Risk Factor of Stroke in Africa; Libya: Community Based Survey. British Journal of Medicine & Medical Research 

9(5): 1-11, 2015, Article no.BJMMR.18897 .ISSN: 2231-0614. 

27. Levels of C3 and C4 complement in Libyans with Heart Diseases. Ali  Daeki, Mohamed Kaled Shambesh, Tarek AF, Kalifa Ghenghesh. 

LMJ.V12,4.2013. 

28. The demographic features of Scabies in Misurata-Libya.tripolitana Medical Journal. V.2, No.1, 28-30. 

Book Chapters (Shambesh et al) 

1. Medical Aspects of human cystic Echinococcosis in north Africa compendium on cystic Echinococcosis, June, 1997, Professor F.L. Andersen 

597 WIDB-BYU, Provo, pages: 223-244. USA 

2. Medical Aspects of human cystic Echinococcosis in north Africa Hydatid diseases in Libya 2002 Dr. M K Shambesh and Dr A M Gusbi First, In Libya, 2002. 

Thesis  

1. Hydatid disease prevalence in Northwest Libya (pilot study). Master of 

Tropical medicine, Dec. 1991 Liverpool School of Tropical Medicine , 

UK 

2. Use of ultrasonography and serology to investigate the prevalence of 

Hydatid disease in human in North Libya, PhD Feb. 1996, Manchester, University, 

 Paper...

Prevalence a of anti-HBc in Blood Donors in Libya, and its 

Value in prevention of HBV infection

A Submitted Study Financed and Supervised by The Authority for natural Science Research and Technology 

Year

2018

By:

1. Mohamed Kaled A Shambesh,

2. Ezzadin A Franka

وزارة التعليم

هيئة أبحاث العلوم الطبيعية والتكنولوجيا

انتشار مجموع الأجسام المضادة ِللُب فيروس الإلتهاب الكبدي البائي في المتبرعين بالدم بليبيا،

وأهميته فى منع عدوى الإلتهاب الكبدي الفيروسي "بى"

دراسة مقدمة بدعم ومتابعة من هيئة 

العلوم الطبيعية والتكنولوجيا 

السنة

2018

إعداد:

أ. د. محمد خالد عبدالعاطي شمبش

أ. د. عزالدين العارف فرانكة.

الخلاصة

مقدمة : على الرغم من توفر وحساسية الاختبار المصلى للأنتجين السطحي لفيروس الإلتهاب الكبدي "بى" (HBsAg) في فحص الدم للمتبرعين بالدم ، غيرأن منع الخطر المتبقي لانتقال عدوي هذا الفيروس عن طريق التبرع بالدم غالباً ما يعتمد أيضا على فحص دم المتبرعين لوجود الأجسام المضادة للّب البروتيني لهذا الفيروس (anti-HBc)لاكتشاف المتبرعين في مرحلة النافذة (Window period)عند الإصابة بهذا المرض، و أنه في العديد من الحالات يكون هو المؤشر الوحيد للإصابة، في الحالات التي يتدنى فيها مستوى الأنتجين السطحي للفيروس إلى حد لا يمكن الكشف عنه وخاصة في الحالات المزمنة،  وهذا ما تم إثباتة أكثر بعد تطور تقنية مضاعفة الحمض النووي الـ (DNA) و المعروفة اختصاراً بالـ (PCR)، حيث إن العديد من الدراسات وجدت مابين 0 إلى 39 % من المتبرعين بالدم الذين لا يوجد لديهم الأنتجين السطحي لفيروس الإلتهاب الكبدي "بى " ويوجد لديهم مجموع الأجسام المضادة للب هذا الفيروس يحملون الحمض النووي لهذا الفيروس ومن الممكن أن يشكلون خطر نقل العدوى بعد التبرع بالدم.

أهداف الدراسة:  الهدف الرئيسي لهده الدراسة هو معرفة مدى انتشار مجموع الأجسام المضادة للب فيروس الإلتهاب الكبدي " بى" في المتبرعين بالدم، ومدى إمكانية إدخال هذا الاختبار ضمن الاختبارات الروتينية لفحص الدم للمتبرعين.

الطريقة:  2735 عينة مصل أخذت من متبرعي بالدم في شمال ليبيا الذين ارتادوا مصارف الدم للتبرع، حيث تم قياس مجموع الأجسام المضادة للب الفيروس الكبدي " بى"، والعينات الموجبة تم قياس الأجسام المضادة للأنتجين السطحي  (anti-HBs)، وكل العينات الموجبة لمجموع الأجسام المضادة للب الفيروس الكبدي "بى" مع أو بدون الأجسام المضادة للأنتجين السطحي  تم اختبارها بواسطة ( (PCR للبحث عن الحمض النووي للفيروس الكبدي " بى".

النتائج: كان معدل انتشار مجموع الأجسام المضادة للب فيروس الإلتهاب الكبدي "بى" في هذه المجموعة هو (215 عينة- 8.3% )، وكان هناك عدد 18  عينة موجبة للأجسام المضادة للب فيروس الإلتهاب الكبدي "بى"  تحتوي على الحمض النووي لفيروس الإلتهاب الكبدي "بى"  (1%). 

الاستنتاج: اختبار مجموع الأجسام المضادة للب فيروس الإلتهاب الكبدي "بى" يجب أن يتم إدخاله من ضمن الاختبارات الروتينية لفحص دم المتبرعين علي الأقل للمتبرعين للمرة الأولي و إبعاد أي عينات دم تحتوى على هذه الأجسام، و استخدام اختبار الأجسام المضادة للأنتجين السطحي واختبار الحمض النووي لهذا الفيروس بواسطة (PCR) له فائدة في تتبع الحالات التي لديها مجموع الأجسام المضادة للب هذا الفيروس.

Summary

Background: There is a potential risk of infection with hepatitis B virus despite of the availability of a sensitive screening assay for detection of hepatitis B virus surface antigen(HBsAg), prevention of residual risk of transfusion transmission Hepatitis B Virus (HBV) infection is mostly relied on serological screening of blood donors for antibody to hepatitis B core antigen (anti-HBc), to detect donors in window period in HBV infection, and in many cases anti-HBc is the only serological marker when HBsAg fall to the level that can not be detected especially in chronic cases.  This has been improved further by detecting the viral DNA in samples that were positive for anti-HBc but negative for HBsAg. Many studies found that between 0 to 39% HBsAg negative and anti-HBc positive blood donors have DNA to HBV and may be potential source of post-transfusion hepatitis B (PTHB).  

Objectives: The aim of the present study was to assess the frequency of positive anti hepatitis B core (anti-HBc) and evaluate whether anti-HBc could be adopted as a screening assay for blood donation.

Material and Methods: 

Study design: The study was a Cross sectional study. Area: North of Libya  (west, middle & east). Tim: three years.  Ethical Consideration: The study protocol was reviewed and approved by the Ethical Committees of National Authority for Scientific Research (NASR) of  Libya. All participants endorsed a written informed consent form. Study population sample size: A total of  2735 blood samples were obtained from healthy blood donors. The donors were interviewed and medically using anonymous. Serological Analysis: All blood samples which gave a negative results for HBsAge were simultaneously tested for anti- HBc.  Real-time PCR: DNA fragment detected using the COBAS® AmpliPrep/COBAS® TaqMan® HBV Test, v2.0 system (analysis conducted in France by Taqman Roche, Cerba. Data statistical analysis:  was done using Version 19-24, SPSS Inc. USA. Data was calculated and described by A chi-, T and P value for significance.

Results: General Results: From the sample of 2735, 218 (8.3%) were total anti-HBc positive. Of the 215 anti-HBc positive samples, 18 (8.3%) tested positive for HBV-DNA by PCR (Polymerase chain reaction). The frequency of anti-HBc positive cases among the voluntary donors was 44.6%, and among the replacement donors was 55.4% (p

Frequency of Hepatitis B Core Antibody and Hepatitis B Virus 

DNA among Apparently Healthy Male Blood Donors in Eastern Libya

Mohamed K. Shambesh1,2, Ezzadin A Franka1,2, Amal R. Agila3, Faisal F. Ismail2,3

1Department of Community Medicine, Faculty of Medicine, University of Tripoli, Tripoli, 2National Centre for Disease Control, 3Department of Laboratory, Faculty of Medical Technology, University of Tobruk, Tobruk, Libya

Abstract

Original Article

Background/Objectives: Hepatitis B virus (HBV) infection represents one of the most serious blood transfusion-transmitted viral infections. By implementation of the hepatitis B surface antigen (HBsAg) screening assay, blood banks in Libya have been considerably increased blood transfusion safety in term of protecting against the transmission of HBV infection. However, several studies demonstrated that donors who are HBsAg negative and hepatitis B core antibody (anti-HBc) positive maybe a potential source for posttransfusion hepatitis B. The aim of this study is to determine the presence of anti-HBc and HBV DNA (hepatitis B viral DNA) in healthy HBsAg-negative blood donors in eastern Libya (Tobruk region). Materials and Methods: A total of 500 serum samples were tested for HBsAg and obtained from healthy blood donors in blood bank unit in Tobruk Medical Center. All donors were tested for anti-HBc, using commercial ELISA and microwell methods (MBS-SRL, Milano, Italy). The reactive samples were further tested for the presence of HBV DNA using polymerase chain reaction (PCR). Results:   In this study, the seroprevalence rate of anti-HBc sample was 54 (10.8%) among donors.  The majority of anti-HBc-positive cases (52 of 54) were in the age group of 20–49 years. Of the 54 anti-HBc-positive samples, 4 (7.4%) were tested positive for HBV DNA by PCR. Conclusion: Among all the samples, the rate of anti-HBc was 10.8%. This finding is comparable to a previous study performed in northwestern Libya. The present study estimated the expected exclusion rate of anti-HBc-positive donated blood that would be an important factor to consider before adopting anti-HBc testing in addition to HBsAg testing as a mandatory screening test to further enhance transfusion safety. Keywords: Blood donors, eastern Libya, hepatitis B virus, hepatitis B core antibody

IntRoductIon

Hepatitis B virus (HBV) infection remains a global important health problem. It is responsible for a significant number of deaths due to HBV infection-related complications.[1] It is estimated that there are approximately 257 million HBV carriers in the world, of whom 887,000 die annually from HBV infection-related liver diseases.[2] Large efforts have been made in recent decades to prevent incidence of HBV infection. Perhaps, the most important steps have been the implementation of HBV global vaccination programs to all antibody (anti-HBc), and more recently implementing nucleic acid testing (NAT) in many developed countries.[4]

In Libya, the carrier state of the disease among the general population was found 2.2%,[5] which considered an area of low-intermediate endemicity (2%–7%) for HBV infection as classified by the WHO.[6] Several preventive measures have been implemented over the past three decades in the country; such as introducing the free mandatory vaccination program in late 1990s to all newborns as well as to high-risk groups; in addition, implementing HBsAg serological testing to 

newborns and to high-risk groups in several countries, in addition to developing more efficacious treatments to treat Address for correspondence: Dr. Faisal F. Ismail, 

Department of Laboratory, Faculty of Medical Technology, University of 

its chronic status,[3] in addition to screening blood and other Tobruk, Tobruk, Libya. blood derivatives for the presence of HBV infection markers E‑mail: faisal.ismail@tu.edu.ly

such as hepatitis B surface antigen (HBsAg), hepatitis B core  

Access this article online

Quick Response Code:

  Website:  

www.ljmsonline.com

DOI:  

10.4103/LJMS.LJMS_47_17

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. 

For reprints contact: reprints@medknow.com

How to cite this article: Shambesh MK, Franka EA, Agila AR, Ismail FF. Frequency of Hepatitis B core antibody and Hepatitis B Virus DNA among apparently healthy male blood donors in Eastern Libya. Libyan J Med Sci 2018;2:12-5.

12 © 2018 Libyan Journal of Medical Sciences | Published by Wolters Kluwer - Medknow

blood donors in 1980s;[7] in addition, screening for HBsAg is obligatory to all individuals as a part of their preemployment and premarital medical checkup.[8,9]

Many studies[10-14] emphasized on the importance of implementing anti-HBc with HBsAg to increase blood safety[15] and showed that a percentage of blood donors who are found negative for HBsAg and positive for anti-HBc may carry circulating hepatitis B viral DNA (HBV DNA) and may be a potential source of posttransfusion hepatitis B, yet blood donation centers in Libya are relying on HBsAg as the only screening assay for detection of HBV infection. In this regard, several studies were performed in the last few years to estimate the percentage of anti-HBc seroprevalence in blood donors in the country and also to estimate the chronic carrier state among blood donors who found to be negative for the presence of HBsAg and positive for anti-HBc by screening anti-HBc blood units using the polymerase chain reaction (PCR) and found that the frequency of anti-HBc in blood donors ranges from 3.9% to 15.6% in different parts of the country.[10-14]

This study was conducted to determine the seroprevalence of anti-HBc in healthy HBsAg-negative blood donors in eastern Libya (Tobruk area), to estimate the exclusion rate of the anti-HBc-positive donated blood. This would be an important factor for the health authorities to consider before adopting anti-HBc testing in addition to HBsAg testing as a mandatory screening test to increase transfusion safety until considering introducing an advanced testing system for HBV, such as NAT.

mateRIals and methods

Study population

A total of 500 HBsAg-negative blood samples were prospectively obtained from healthy male blood donors who attended Tobruk hospital blood bank unit between October 22, 2016, and January 30, 2017. All blood donor samples were collected in 5 ml blunt tube and left for 15 min until the serum separated and then centrifuged for 5 min at 3000 RPM. The sera transferred to other tubes and kept frozen at −20 until transferred to National Centre for Disease Control, Tobruk branch.

Tobruk city is the capital of Butnan province of Libya, which is located on the Libyan’s eastern Mediterranean coast, sharing around 140 km long Mediterranean coastline, and it has international border with Egypt in the east. Tobruk hospital blood bank unit serves neighboring cities as well as Tobruk. All donors were examined as per blood bank’s standard operating procedure.

Ethical consideration

The study protocol was approved by the Ethics Committee of the Scientific Research in Tobruk University. All male blood donors were informed about the research, and written consent was obtained from each donor to collect an anonymous serum sample to be used in this study. Donors’ data such as age, address, and donation history were obtained. Donors were classified as replacement donors and voluntary donors; replacement donors who donated blood to their relatives and friends and voluntary donors who voluntarily donated their blood.

Serological assays

All mandatory viral screening tests for blood-transmitted infections, i.e. HBsAg, anti-HCV, anti-HIV and VDRL for screening of syphilis were performed in the Tobruk Medical Center's blood bank as part of routine mandatory screening tests using commercially available ELISA (Dialab, Microwell method, GmbH) and for the VDRL by hemagglutination assay (Plasmatec Laboratory Products Limited, UK). All blood samples were simultaneously tested for anti-HBc using ELISA microwell methods (MBS-SRL, Milano, Italy). The sera were transferred frozen to the medical laboratory of National Centre for Disease Control, Tobruk, where anti-HBc analysis was performed. All reactive samples were further confirmed in duplicate.

Real‑time polymerase chain reaction

All 54 anti-HBc-reactive samples were further analyzed by real-time PCR for the presence of HBV viral genome; 500 µL of each sample was extracted and amplified and target HBV genome fragment detected using the COBAS® AmpliPrep/COBAS® TaqMan® HBV Test, version 2.0 system (analysis conducted in France by Taqman Roche, Cerba). The test procedure was carried out according to the manufacturer’s instructions. The sensitivity of the real-time PCR used is 20 IU/mL; the conversion factor is 1 IU = 5.82 copies.

Statistical data analysis

Data analysis was performed using SPSS computer software (Version 19, SPSS Inc., Chicago, IL, USA). The contributing blood donors were divided into groups according to their age. Chi-square test was used to highlight if there are no statistical significance differences between variables. In all tests, α < 0.05 was regarded statistically significant. All confidence intervals were calculated at the 95% level of statistical significance.

Results

Libyan Journal of Medical Sciences ¦ Volume 2 ¦ Issue 1 ¦ January-March 2018 13

The study was performed on 500 donor males aged from 17 to 68 years. The donors were divided into age groups, as shown in Figure 1. The donors had not been previously tested for anti-HBc. Of the total 500 male donors, only 182 (36.4%) were voluntary donors who had donated more than once before, and 318 (63.6%) were family or friend replacement donors. All blood samples were negative to other mandatory tests for blood-transmitted infections (HBsAg, anti-HCV, anti-HIV, and syphilis). Of 500 male blood donors, 54 (10.8%) samples were positive results for anti-HBc. The distribution of anti-Hbc antibody positivity was nearly similar among the voluntary donors (n = 20, 10.9%) and the family replacement donors (n = 34, 10.6%). The majority of anti-HBc-positive samples were found in the age group of 20–49 years with a concentration in the age group of 30–39 years (43.2%) [Table 1].

Table 1: Screened age groups by total amount listed anti‑hepatitis B core positive

Age groups Anti‑HBc‑positive cases among whole samples Number of donors screened (%)

10-19 0 12 (0.000)

20-29 10 193 (0.052)

30-39 26 192 (0.135)

40-49 16 85 (0.188)

>50 2 18 (0.111)

Total 54 500 (0.108)

Anti-HBc: Hepatitis B core antibody

250 200 150 100 500 12 193  192  85  18

< 20 20 - 29 30 - 39 Donors Age Group 40 - 49 > 50

Figure 1: Donors’ number among different age groups

Four samples were found to be seropositive for occult HBV infection. This figure represents 0.8% of the whole sample and 7.4% of the anti-HBc-positive samples. The positive PCR samples were found 25, 28, 39, and 54 IU, respectively. All the positive PCR samples were from 30 to >50 years’ age groups, and three cases were from the voluntary donor group and one case from the replacement donor group.

The rate of anti-HBc-positive exclusion was estimated that approximately 11 blood units would be excluded from every 100 donated units if anti-HBc testing was to be adopted. Moreover, the study estimates that 8 donated units per 1000 donated units may be potentially infected with HBV.

dIscussIon

Currently, the only serological screening assay for HBV infection in Libyan blood banks is HBsAg.[5] The present research tested 500 healthy male blood donors in East Libya (Tobruk region) by detecting another serological marker for HBV infection known as total (IgG and IgM) anti-HBc antibodies which was found to be positive 54 (10.8%) blood donors. This percentage is similar to that found in two previous studies conducted by the authors. The first study was performed in 2014 (500 blood donors) from Tripoli region, anti-HBc percentage was found (9.8%),[12] and the second study was performed in 2015 (1256 donors) in the northwestern region of Libya (including Tripoli and its surroundings), anti-HBc frequency was found in 10.5%.[13] However, our finding was considerably low compared with another study done on 200 blood donors in Tripoli Central Hospital blood bank in 2009;[10,11] this difference in “frequency” could be due to the small sample size. In contrast, the rate of anti-HBc in the present study is high compared to that found in a study in 2015 (979 blood donors) in middle northern region of Libya (Misurata and their neighboring cities).[14] This “variation” in anti-HBc rates between the two studies could be related to the fact that there could be small difference in endemic rates of chronic HBV carrier between the two regions,[5] and another possibility is that most of blood donated in Misurata study was classified as family types, which usually had lower levels of HBV infectivity.[14]

The prevalence of anti-HBc also has been reported from countries neighboring Libya, Egypt (7.8% and 10.9% in two different studies).[16,17] Although the North African countries show high prevalence in anti-HBc rate, in Europe, the rate of anti-HBc shows lower levels, varying between 0.07% in the UK, 1.5% in Germany,[18] and 4.9% in Italy.[19] In the Middle East, the prevalence of anti-HBc among blood donors has been found to be higher, 17% in Kuwait[20] and 15.3% in Saudi Arabia.[21] In countries elsewhere, the prevalence varies between 6.5% in Iran[22] and a very high prevalence (42%) in Sudan.[23] These variations of anti-HBc levels between different countries were related to the different levels of HBV infections being endemic as classified by the WHO; Libya was classified in the intermediate level of the endemic range (Europe was classified with low levels of being endemic while Asian countries and some African countries were classified with high levels).[6]

The frequency of HBV DNA among anti-HBc-positive donors was 7.4%. This frequency is higher than a previous pilot study conducted by the authors in Tripoli region (3%)[10,11] and less than another study performed by the authors in Northern Libya (10.5%).[13] Furthermore, this percentage is higher compared with the DNA-positive sample that found in another study by the same authors in North Middle Libya.[14] In comparison, in this study, the frequency of HBV DNA in anti-HBc-positive donors is low compared with that found in Egypt (11.54%).[16] However, it is roughly similar to that reported in another study in Egypt (6.25%),[17] is higher than that reported in Italy (4.86%),[19] and is also lower than that found in Iran (12.2%).[22] These differences could be related to the endemicity of HBV infection among different countries.

This study estimates that about 108 blood donors would be excluded from every 1000 donated persons, if anti-HBc testing were adopted, and approximately 8 donors per 1000 donated persons may possibly be infected with HBV.

conclusIon

14 Libyan Journal of Medical Sciences ¦ Volume 2 ¦ Issue 1 ¦ January-March 2018

This study reports a prevalence rate of anti-HBc (10.8%) in eastern region of the Libya, which is comparable to other studies performed in the west of the country and high compared to one study performed in the north middle of the country. 

The present study estimated that the expected exclusion rate of anti-HBc-positive donated blood which approximately 11 blood donors would be excluded from every 100 donated persons, if anti-HBc testing was to be adopted in addition to HBsAg as a mandatory screening test to further enhance transfusion safety. Furthermore, the implementation of anti-HBc testing would help to find more chronic HBV carriers; this may allow early access to therapy and therefore prevent the complications of HBV infection.

Acknowledgment

The authors would like to thank all the blood bank staffs in 

Tobruk Medical Center and all medical laboratory staffs at NCDC, Tobruk, for their assistance in performing serological analysis. A special thanks to the National Authority for Scientific Research (NASR), Libya, for supporting this research.

Financial support and sponsorship

This work was financially supported by the National Authority for Scientific Research (NASR), Libya.

Conflicts of interest

There are no conflicts of interest.

RefeRences

1. Ly KN, Xing J, Klevens R, Jiles RB, Ward JW, Holmberg SD. The increasing burden of mortality from viral hepatitis in the united states between 1999 and 2007. Annals Intern Med2012;156:271-8.

2. Avalaible from: http://www.who.int/mediacentre/factsheets/fs204/en/ Af. [Last accessed on 2017 May 20].

3. Rajbhandari R, Chung RT. Treatment of hepatitis B: A concise review. Clin Transl Gastroenterol 2016;7:e190.

4. Roth WK, Busch MP, Schuller A, Ismay S, Cheng A, Seed CR, et al. International survey on NAT testing of blood donations: Expanding implementation and yield from 1999 to 2009. Vox Sang 2012;102:82-90.

5. Elzouki AN, Smeo MN, Sammud M, Elahmer O, Daw M, Furarah A, et al. Prevalence of hepatitis B and C virus infections and their related risk factors in libya: A national seroepidemiological survey. East Mediterr Health J 2013;19:589-99.

6. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11:97-107.

7. Elzouki AN. Hepatitis B infection in Libya: The magnitude of the problem. Libyan J Infect Dis 2008;2:20-5.

8. Ismail F, Farag A, Ilah MA. Occurrence of hepatitis B, hepatitis C and HIV infections among individuals undergoing preemployment and premarital medical examination in mediterranean Port City Tobruk, Libya. Int Blood Res Rev 2016;6:2321-7219.

9. Alsharif F, Ismail F, Ilah A. Incidence of HBV Infections Detected During Pre-Employment Checkup in Tripoli, Libya. The 2nd Medical Research Conference. Tripoli: Tripoli University; 2017.

10. Ismail F, Shambesh M, Aboutwerat A, Elbackush M. Serological and molecular characterization of total hepatitis B core antibodies in blood donors in Tripoli, Libya. Libyan J Infect Dis 2010;4:p. 31-7.

11. Ismail F, Shambesh M, Aboutwerat A, Elnifro E. Serological and Molecular Characterization of Total Hepatitis B Core Antibodies in Blood Donors in Tripoli, Libya. 2nd Infectious and Endemic Diseases Scientific Conference 2009. “Abstract” OR-HEP 03. p. 45.

12. Shambesh MK, Franka E, Ismail F, Gebril N, Azabi K. Significance of Screening Anti-hbc Among Libyan Blood Donor: A Preliminary Study. 32nd BBTS Annual Conference. Harrogate. UK: Transfusion Medicine; 2014. p. 64-5.

13. Shambesh MK, Franka EA, Ismail FF, Gebril NM, Azabi KA, Amar F. Anti-HBc and HBV-DNA among blood donors in North Africa; Western Libya. Int Blood Res Rev 2015;3:2321-7219.

14. Shambesh MK, Franka EA, Ismail FF, Elosta MA. Occult hepatitis B virus infection among blood donors; north middle Libya. Int Blood Res Rev 2016;6:2321-7219.

15. Hanson MR, Polesky HF. Evaluation of routine anti-HBc screening of volunteer blood donors: A questionable surrogate test for non-A, non-B hepatitis. Transfusion 1987;27:107-8.

16. El-Zayadi AR, Ibrahim E, Badran H, Saeid A, Moneib N, Shemis M, et al. Anti-HBc screening in Egyptian blood donors reduces the risk of hepatitis B virus transmission. Transfus Med 2008;18:55-61.

17. Antar W, El-Shokry MH, Abd El Hamid WA, Helmy MF. Significance of detecting anti-HBc among egyptian male blood donors negative for HBsAg. Transfus Med 2010;20:409-13.

18. Candotti D, Allain JP. Transfusion-transmitted hepatitis B virus infection. J Hepatol 2009;51:798-809.

19. Manzini P, Girotto M, Borsotti R, Giachino O, Guaschino R, Lanteri M, et al. Italian blood donors with anti-HBc and occult hepatitis B virus infection. Haematologica 2007;92:1664-70.

20. Ameen R, Sanad N, Al-Shemmari S, Siddique I, Chowdhury RI, Al-Hamdan S, et al. Prevalence of viral markers among first-time arab blood donors in kuwait. Transfusion 2005;45:1973-80.

21. Bashawri LA, Fawaz NA, Ahmad MS, Qadi AA, Almawi WY. Prevalence of seromarkers of HBV and HCV among blood donors in eastern saudi arabia, 1998-2001. Clin Lab Haematol 2004;26:225-8.

22. Behzad-Behbahani A, Mafi-Nejad A, Tabei SZ, Lankarani KB, Torab A, Moaddeb A, et al. Anti-HBc & HBV-DNA detection in blood donors negative for hepatitis B virus surface antigen in reducing risk of transfusion associated HBV infection. Indian J Med Res 2006;123:37-42.

23. Abd El Kader Mahmoud O, Abd El Rahim Ghazal A, 

El Sayed Metwally D, Elnour AM, Yousif GE. Detection of occult hepatitis B virus infection among blood donors in sudan. J Egypt Public Health Assoc 2013;88:14-8.

Libyan Journal of Medical Science ¦ Volume 2 ¦ Issue 1 ¦ January-March 2018 19

النشاطات الخارجية

مستشار لوزارة التعلبم والمركز الوطنى للأمراض.

باحت لدى هيئة أبحاث العلوم الطبيعية والتكنولوجيا.

عضو اللحنة الإستشارية العلياء للكورونا فى ليبيا 

رئيس فريق متابعة الاجراءات الاحترازية بوزارة التعليم 

ممتحن معتمد لدى هيئة أبحاث العلوم الطبيعية والتكنولوجيا

 ممتحن خارجى للدرسات العلياء بالحامعات الليبية 

ممتحن بكليات الطب بالدولة

محكم للمجلات الطببة فى science domain

محكم للترقيات العلمية بالجامعات بالدولة

رئيس فسم البحوت بمجلس التخصصات الطبية 

منسق البحوت بمجلس طب المجتمع

Head of Research Department  in The Libyan Board of Medical Specialties, Tripoli, Libya   (2015-2020