Hepatitis C virus infection is a major public health problem that mainly affects the liver, causing liver cirrhosis, hepatocellular carcinoma, and liver failure, if it was untreated or treated late in patients with kidney transplantation and hemodialysis patients leading to a serious problem in this population. The aim of this study to determine the infection rate and genotypes of the hepatitis C virus among hemodialysis patients in Diyala governorate-Iraq. A cross-sectional study was performed on hemodialysis patients who were admitted to the Baqubah Teaching Hospital - Ibin Sina Dialysis Center and Khanaqin General Hospital, during the period from 16th September 2020 until 16th December 2020. Plasma was separated from 5 ml of a blood sample obtained from 306 hemodialysis patients (177 were males and 129 were females), their ages ranged from 10-85 years, then use for serological and molecular detection after RNA extraction from those HCV antibody seropositive hemodialysis patients. Furthermore, genotyping of the hepatitis C virus -RNA positive samples was done by one step using the real-time polymerase chain reaction technique. The results showed the infection rate of HCV in hemodialysis patients in Diyala governorate was 7.8% (24 out of 306), no significant differences were noticed between males and females, the age between 61-70 years old were more susceptible to infection with highly significant differences (P=0.0087), the blood transfusion was most risk factors to infection with highly significant differences (P=0.0054). Genotyping was performed in all patients who were HCV-RNA positive. Genotypes 4, 1a, 1b, and 2 were found in (33.33%), (29.2%), (29.2%), and (8.3%) respectively. This study concluded the infection of HCV among hemodialysis patients in the Diyala governorate was moderate and genotype 4 was more predominant followed by genotype 1 (a, b) and more common in treated patients, no significant differences were noticed between males and females, the ages between 61-70 years were most susceptible to infection, and blood transfusion is the most risk factors for transmission of infection in this population

Topics
Teaching, Hemodialysis, Blood compatibility, Dialysis, Diseases and conditions, Organs, Polymerase chain reactions, Antibody, Ribonucleic acid, Genotypes
1.
I.
 
Elghitany
 “
Hepatitis C virus infection in Egypt: current situation and future perspective
”.
JHIPH
Vol.
49
No.
1
pp
1
–
9
. (Egyptian Journals, Egypt,
2019
)
Google Scholar
 
2.
Organization WH. Hepatitis C
.
World Health Organization
(
WHO
, 27 July
2020
).
3.
J.
 
Schmelzer
,
E.
 
Dugan
,
S.
 
Blach
,
S.
 
Coleman
,
Z.
 
Cai
, and
M.D.
 
Paola
, “
Global prevalence of hepatitis C virus in children in 2018: a modeling study
”,
Lancet. Gastroenterol. Hepatol
Vol.
5
No.
4
pp
374
–
92
. (Elsevier, Netherlands,
2020
)
https://doi.org/10.1016/S2468-1253(19)30385-1
Google Scholar
 
4.
Organization WH. Hepatitis B
 https://www. who. int/news-room/fact-sheets/detail/hepatitis-b. Accessed July.
2019
; Published July 18, 2019
5.
M.T.
 
Catanese
,
K.
 
Uryu
,
M.
 
Kopp
,
T.J.
 
Edwards
,
L.
 
Andrus
, and
W.J.
 
Rice
 “
Ultrastructural analysis of hepatitis C virus particles
”,
Proc. Natl. Acad. Sci.
Vol.
110
No.
23
pp
9505
–
9510
. (Proceedings of the National Academy of Sciences, U.S.A.,
2013
)
https://doi.org/10.1073/pnas.1307527110
Google Scholar
 
6.
S.M.
 
Borgia
,
C.
 
Hedskog
,
B.
 
Parhy
,
R.H.
 
Hyland
,
L.M.
 
Stamm
, and
D.M.
 
Brainard
, “
Identification of a novel hepatitis C virus genotype from Punjab, India: expanding classification of hepatitis C virus into 8 genotypes
”.
Int J Infect Dis
Vol.
218
No.
11
pp
1722
–
1729
. (Oxford Academic, USA,
2018
)
https://doi.org/10.1093/infdis/jiy401
Google Scholar
 
7.
S.
 
Ashkani-Esfahani
,
S.M.
 
Alavian
, and
M.
 
Salehi-Marzijarani
 “
Prevalence of hepatitis C virus infection among hemodialysis patients in the Middle-East: A systematic review and meta-analysis
”.
World. J. Gastroenterol.
Vol.
23
No.
1
pp
151
–
166
. (PMC US National Library of Medicine National Institutes of Health,
USA
,
2017
)
https://doi.org/10.3748/wjg.v23.i1.151
Google Scholar
 
8.
N.
 
Coppola
,
L.
 
Alessio
,
L.
 
Onorato
,
C.
 
Sagnelli
,
M.
 
Macera
, and
E.
 
Sagnelli
, “
Epidemiology and management of hepatitis C virus infections in immigrant populations
”,
Infect. Dis. Poverty
Vol.
8
No.
1
pp
1
–
10
. (BMC, United Kingdom, 2019)
9.
L.
 
Kuna
,
J.
 
Jakab
,
R.
 
Smolic
,
G.Y.
 
Wu
, and
M.
 
Smolic
. “HCV extrahepatic manifestations”.
J Clin Transl Hepatol
. Vol.
7
No.
2
pp
172
-
182
. (
BMC
,
United Kingdom
,
2019
).
Google Scholar
 
10.
D.A.
 
Goodkin
,
B.
 
Bieber
,
B.
 
Gillespie
,
B.M.
 
Robinson
, and
M.
 
Jadoul
 “
Hepatitis C infection is very rarely treated among hemodialysis patients
”.
Clin. J. Am. Soc. Nephrol.
Vol.
38
No.
5
pp
405
–
412
. (ASN, USA,2013)
11.
A.
 
Sultana
,
A.N.M.S.
 
Islam
,
C.R.
 
Mittra
,
S.
 
Khatun
, and
A.K.
 
Saha
. “
Management of Hemodialysis Unit for Care Receivers in a Specialized Hospital. Bangladesh
”
J Infect Dis.
Vol.
7
No.
2
:
84
–
89
. (Bangladesh Journals Online, Bangladesh,
2020
)
Google Scholar
 
12.
Y.
 
Mehmood
,
U.
 
Ashraf
, and
I.
 
Ali
, “
Hemodialysis acute intradialytic complication found on maintenance hemodialysis in patients at a public hospital, Lahore
,
Prof Med J.
Vol.
26
No.
1
pp
45
–
50
. (EBSCO, USA
2019
).
Google Scholar
 
13.
S.H.
 
Abbasi
,
R.A.
 
Aftab
, and
S.S.
 
Chua
 “
Risk factors associated with nosocomial infections among end-stage renal disease patients undergoing hemodialysis: A systematic review
”.
PLoS One
Vol.
15
No.
6
pp
1
–
18
. (PLoS One, USA,
2020
).
https://doi.org/10.1371/journal.pone.0234376
Google Scholar
 
14.
H.
 
Park
,
C.
 
Chen
,
W.
 
Wang
,
L.
 
Henry
,
R.L.
 
Cook
, and
D.R.
 
Nelson
. “Chronic hepatitis C virus (
HCV) increases the risk of chronic kidney disease (CKD) while effective HCV treatment decreases the incidence of CKD”
 
Hepatol
. Vol.
67
No
2
pp
492
–
504
. (American Association for the Study of Liver Diseases, USA,
2018
).
Google Scholar
 
15.
F.
 
Fabrizi
,
G.
 
Lunghi
,
S.V.
 
Ganeshan
,
P.
 
Martin
, and
P.
 
Messa
, “
Hepatitis C virus infection and the dialysis patient
”,
Semin. Dial.
Vol.
20
No.
5
pp
416
–
422
. (Europe PMC, United Kingdom,
2007
)
https://doi.org/10.1111/j.1525-139X.2007.00311.x
Google Scholar
 
16.
A.
 
Covic
,
D.
 
Abramowicz
,
A.
 
Bruchfeld
,
G.
 
Leroux-Roels
,
D.
 
Samuel
, and
W.
 
Van Biesen
, “
Endorsement of the kidney disease improving global outcomes (KDIGO) hepatitis C guidelines: A European renal best practice (ERBP) position statement
”,
Nephrol. Dial. Trans.
Vol.
24
No.
3
pp
719
–
727
. (Oxford Academic, USA,
2009
)
https://doi.org/10.1093/ndt/gfn608
Google Scholar
 
17.
C.
 
Liu
, and
J.
 
Kao
, “
Treatment of hepatitis C virus infection in patients with end-stage renal disease
”,
J. Gastroenterol. Hepatol.
Vol.
26
No.
2
pp
228
–
239
. (Wiley Online Library, USA,
2011
).
https://doi.org/10.1111/j.1440-1746.2010.06488.x
Google Scholar
 
18.
A.M.
 
Muhrath
, and
A.K.
 
Leelo
, “
Detection of seropositive anti-hepatitis C Virus (HCV) antibody in hemodialysis patients in AL-Diwaniyah City, Iraq
”,
J. Pharm. Sci. Res.
Vol.
10
No.
11
pp
2735
–
2737
. (Journal of pharmaceutical sciences, India, 2018)
19.
N.A.
 
Jasim
, and
H.A.
 
Athbi
, “
Prevalence and Risk Factors for Hepatitis C and B Viruses Infection among Hemodialysis Patients in Holy Karbala, Iraq
”,
Kufa. J. Nur. Sci.
Vol.
5
No.
3
pp
24
–
33
. (Iraqi academic scientific journals, Iraq,
2015
)
Google Scholar
 
20.
H.Y.A.
 
Sinjari
, and
K.A.
 
Bakr
, “
Prevalence and Risk Factors of Hepatitis B and C Virus Infections Among Patients Undergoing Hemodialysis in Kurdistan, Iraq
”
Hepat. Month.
Vol.
18
No.
5
pp
e11776
. (Kowsar, Iran,
2018
)
Google Scholar
 
21.
M.A.
 
Abdilazeem
, and
N.A.
 
Nasir
, “
Prevalence of Viral Hepatitis B, C, and Human Immunodeficiency Virus among End-Stage Renal Disease Patients on Hemodialysis
”,
Iraqi Acad. Sci. J
Vol.
18
No.
2
pp
76
–
86
. (Iraqi academic scientific journals, Iraq,
2019
).
Google Scholar
 
22.
G.S.H.
 
Al-Taan
,
M.D.
 
Khalid
, “
Prevalence of Hepatitis B Virus in Hemodialysis Patients Infected with Hepatitis C Virus in Mosul District/Iraq
”,
American Sci. Res. J. Eng. Technol. Sci.
Vol.
63
No.
1
pp
1
–
6
. (American Scientific Research Journal for Engineering, Technology, and Sciences, USA,
2020
)
Google Scholar
 
23.
H.A.A.
 
Khudhair
,
A.A.H.
 
Albakaa
, and
K.R.
 
Hussein
, “Detection of the Prevalence of Hepatitis C Virus among Iraqi People”.
bioRxiv
. (
Cold Spring Harbor Laboratory
,
USA
,
2020
).
Google Scholar
 
24.
S.
 
Mahmoudvand
,
S.
 
Shokri
,
A.
 
Azaran
,
S.S.
 
Seyedian
,
M.
 
Makvandi
, and
H.
 
Mirzaei
, “Seronegative Occult Hepatitis C Infection among Hemodialysis Patients: A Prevalence Study”,
Ther. Apher. Dial
. (
Wiley Online Library
,
USA
,
2020
)
Google Scholar
 
25.
A.
 
Alduraywish
,
M.
 
Ragheb
,
I.
 
Taher
,
N.
 
Louis
,
K.
 
Aldossari
, and
R.
 
Kishk
, “
Prevalence, risk factors and impact of occult HCV infection on liver morbidity among hemodialysis patients: a hospital-based cross-sectional study
”,
Scandinavian. J. Gastroenterol.
Vol.
55
No.
8
pp
963
–
969
. (Taylor and Francis online, England,
2020
).
Google Scholar
 
26.
N.
 
Çelik
,
O.
 
Çelik
,
C.
 
Sevinç
, and
O.
 
Ünal
, “
Hepatitis C prevalence in hemodialysis patients and the results of new antiviral therapy
”,
Turk. J. Nephrol.
Vol.
28
No.
2
pp
103
–
108
. (Turkish Journal for Nephrology, Turkey,
2019
).
Google Scholar
 
27.
S.
 
Mhalla
,
R.
 
Hammoud
,
A.
 
Frih
,
Y.
 
Kadri
,
A.
 
El-Argoubi
, and
M.
 
Elmay
, “
Prevalence and risk factors of hepatitis B and C among hemodialysis patients in Tunisia
”,
Med. Mal. Infect.
Vol.
48
No.
3
pp
175
–
179
. (Elsevier, Netherlands,
2018
)
Google Scholar
 
28.
S.H.
 
Hanash
,
H.A.
 
Al-Shamahy
, and
M.H.S.
 
Bamshmous
, “
prevalence and genotyping of hepatitis C virus in hemodialysis patients and evaluation of HCV-core antigen test in screening patients for dialysis in Sana’a city–Yemen
”,
Universal. J. Pharm. Res.
Vol.
4
No.
2
pp
14
–
8
. (Universal Journal of Pharmaceutical Research, India,
2019
)
Google Scholar
 
29.
H.A.
 
Abdulwahab
,
R.
 
Al-Juboori
,
R.
 
Hamad
,
M.
 
Taqi
,
J.
 
Mahaan
, and
M.T.
 
Abd
, “
Seroprevalence of Hepatitis B & C Virus and Associated Risk Factors in Hemodialysis Units in Al-Anbar Province
”.
J. Global. Sci. Res.
Vol.
6
No.
1
pp
1051
–
1068
. (Journal of Global Scientific Research, USA,
2021
)
Google Scholar
 
30.
W.H.K.
 
Al-Muramdy
, “
Prevalence Rate of Hepatitis C virus (HCV) and Hepatitis B virus (HBV) Infection in Iraqi Patients on Hemodialysis: Cross-Sectional Study
”.
Medico-legal Update
Vol.
20
No.
3
pp
123
–
128
. (Medico-Legal Update, India,
2020
)
Google Scholar
 
31.
N.
 
Hussein
,
E.S.
 
Al-Obeidy
,
I.
 
Naqid
,
K.H.
 
Abd
, and
S.
 
Abdulrahman
, “
The Distributions of HCV Genotypes in Hemodialysis Patients in Iraq
”,
Iran. J. Med. Microbiol.
Vol.
13
No.
4
pp
279
–
283
. (Iranian Journal of Medical Microbiology, Iran,
2019
)
Google Scholar
 
32.
Z.S.M.
 
Saleem
,
I. A.
 
Naqid
,
N.R.
 
Hussein
,
S.J.
 
Mohammad
,
J.S.
 
Noaman
, and
R.S.
 
Haji
, “
The Prevalence of Hepatitis B and C Virus in Patients With End-Stage Kidney Disease on Regular Hemodialysis in Duhok, Iraq: A Brief Report
”.
Avicenna J. Clin. Microbiol. Infect.
Vol.
7
No.
1
pp
31
–
33
. (Clinical microbiology and infection, Iran,
2020
)
Google Scholar
 
33.
G.E.
 
Karlidag
,
M.
 
Kucuksu
, and
M.
 
Demir
, “
HBsAg EİHH. HBsAg, Anti-HBs, Anti-HCV, and HIV Seroprevalence in Hemodialysis Patients in Elazığ Province
”,
Viral. Hepatol. J.
Vol.
24
pp
53
–
56
. (Viral Hepatitis Journal, United Kingdom, 2018)
34.
N.
 
Ataei
,
M.
 
Hosseini
,
M.
 
Yousefifard
,
A.
 
Oraii
,
F.
 
Ataei
, and
A.
 
Abbasi
, “
Seroprevalence of hepatitis B and C virus infection in children with chronic kidney diseases; a historical cohort study
”
Int. J. Ped.
Vol.
6
No.
1
pp
6911
–
6917
. (e prints repository software, UK,
2018
)
Google Scholar
 
35.
A.K.
 
Kheirabad
,
F.
 
Bahri
,
M.
 
Kargar
, and
I.
 
Ghasemzadeh
, “
Hepatitis C and G Virus infection prevalence among hemodialysis patients and associated risk factors in the Hormozgan province of southern Iran
”,
Hepat. Month.
Vol.
16
No.
10
pp
e40375
. (PMC US National Library of Medicine National Institutes of Health, USA,
2016
)
Google Scholar
 
36.
N.
 
Fahmi
,
Z.
 
Farooq
,
W.F.
 
Hassan
, and
A.
 
Ahmed
, “Prevalence of Viral Hepatitis (
B and C) in Pediatric Hemodialysis Centers in Baghdad
”,
Iraqi Acad. Sci. J
. Vol.
17
No.
4
pp
366
–
372
. (Iraqi academic scientific journals, Iraq,
2018
).
Google Scholar
 
37.
M.E.
 
Ibrahim
, and
M.A.
 
Elawady
, “
Hepatitis C Virus Seroconversion Among Hemodialysis Patients and the Role of Hepatitis C Virus Positive Patient’s Isolation in Benha, Egypt
”
Clin. Med. Res.
Vol.
6
No.
2
pp
31
–
36
. (Science Publishing Group, Pakistan,
2017
).
Google Scholar
 
38.
Z.A.A.T.
 
Al-Khafajy
,
Q.I.K.
 
Al-Hussein
,
H.M.H.
 
AL-Abed
, and
A.A.
 
Al-Zeyadi
, “
Prevalence of Hepatitis C among Patients Undergoing Hemodialysis in Dialysis Center in Al-Najaf Al-Ashraf Governorate
”.
India. J. Pub. Health. Res. Dev.
Vol.
11
No.
4
pp
1791
–
1795
. (EBSCO, USA,
2020
)
Google Scholar
 
39.
E.E.
 
McClelland
, and
J.M.
 
Smith
, “
Gender-specific differences in the immune response to infection
”.
Archiv. Immunol. Ther. Exper.
 
59
(
3
) pp
203
–
213
. (Springer Nature, Switzerland AG,
2011
)
Google Scholar
 
40.
A.
 
Ruggieri
,
M.C.
 
Gagliardi
, and
S.
 
Anticoli
, “
Sex-dependent outcome of hepatitis B and C viruses infections: synergy of sex hormones and immune responses?
”
Front. Immunol.
Vol.
9
No.
2302
pp
1
–
7
. (Frontiers in Immunology,
2018
)
Google Scholar
 
41.
E.
 
Villa
,
A.
 
Karampatou
,
C.
 
Cammà
,
A.
 
Di Leo
,
M.
 
Luongo
, and
A.
 
Ferrari
, “
Early menopause is associated with lack of response to antiviral therapy in women with chronic hepatitis C
”,
Gastroenterol.
Vol.
140
No.
3
pp
818
–
829
. (Elsevier, Netherlands,
2011
)
Google Scholar
 
42.
A.
 
Khan
,
A.
 
Nadir
,
M.H.
 
Mushtaq
,
K.
 
Junaid
,
A.M.
 
Khan
, and
H.
 
Ali
, “
Molecular epidemiology and genotype distribution of hepatitis C in Pakistan; a multicenter cross-sectional study
”,
Infec. Genet. Evol.
Vol.
84
pp
1
–
5
. (Elsevier, Netherlands,
2020
)
Google Scholar
 
43.
H.Y.
 
Fadhil
,
R.J.
 
Khalaf
, and
M.J.A.
 
Al-Kareem
, “
Investigation of viral hepatitis spread with hemodialysis patients
”,
Biochem. Cell. Archives.
Vol.
19
No.
1
pp
1729
–
1735
. (Biochemical and Cellular Archive, India,
2019
)
Google Scholar
 
44.
M.M.
 
Almezgagi
,
W.H.
 
Edrees
,
W.A.
 
Al-Shehari
,
K.
 
Al-Moyed
,
R.S.
 
Al-Khwlany
, and
A.B.
 
Abbas
, “Prevalence of hepatitis B virus and hepatitis C virus and associated risk factors among hemodialysis patients in Ibb city-Yemen”,
PSM Microbiol
. Vol.
5
No.
2
pp
32
–
40
. (PSM Microbiology,
Switzerland AG
,
2020
).
Google Scholar
 
45.
I.A.
 
Nwannadi
,
O.
 
Alao
, and
L.
 
Shoaga
, “
Hepatitis C among blood donors in teaching hospital in North Central Nigeria
”,
J. Den. Med. Sci.
Vol.
13
pp
20
–
23
. (Journal of Dental and Medical Sciences, Thailand,
2014
)
Google Scholar
 
46.
R.
 
Rezzani
,
L.
 
Nardo
,
G.
 
Favero
,
M.
 
Peroni
, and
L.F.
 
Rodella
, “
Thymus and aging: a morphological, radiological, and functional overview
”,
AGE.
Vol.
36
pp
313
–
351
. (Springer Nature, Switzerland AG,
2014
)
Google Scholar
 
47.
E.A.M.
 
Abdalla
,
K.M.A.
 
Shaban
, and
I.M.
 
Elkhidir
, “
Prevalence and Risk Factors of HCV Infection among Haemodialysis Patients at Dialysis Centers in Khartoum State-Sudan
”,
J. Den. Med. Sci.
Vol.
16
No.
3
pp
83
–
88
. (Journal of Dental and Medical Sciences, Thailand,
2017
)
Google Scholar
 
48.
A.M.
 
Abdullah
,
A.R.
 
Hardan
, and
I.I.
 
Latif
, “
Genotyping of hepatitis C virus isolate from Iraqi hemodialysis patients by reverse transcription-PCR and one step nested RT-PCR
”,
DJM
, Vol.
3
No.
1
pp
9
–
18
. (Diyala Journal of Medicine, Iraq,
2012
)
Google Scholar
 
49.
A.W.A.R.
 
Alshaikhly
,
Z.A.
 
Musa
,
B.J.
 
Qasim
, H.F., and
W.J.
 
Mohammed
, “
The Distribution of Hepatitis C Virus Genotypes, Viral Load and Antibody Titer among Iraqi Chronic Hepatitis Patients
”,
Medico-Legal Update
Vol.
20
No.
1
pp
1143
–
1147
. (Medico-Legal Update India,
2020
)
Google Scholar
 
50.
M.A.
 
Daw
, “Prevalence of Hepatitis C Virus and Genotypes distribution within The Eastern Mediterranean countries of Lebanon, Syria and Palestinian Territories,
Department of Medical Microbiology &Immunology, (Faculty of Medicine
,
The University of Tripoli
,
Libia
.
51.
M.
 
Sallam
,
R.
 
Batarseh
,
A.
 
Natsheh
,
J.
 
Abbadi
,
E.
 
Al-Fraihat
, and
D.
 
Kaddomi
, “
An update on hepatitis C virus genotype distribution in Jordan: a 12-year retrospective study from a tertiary care teaching hospital in Amman
”.
BMC Infect. Dis.
Vol.
20
No.
1
pp
1
–
11
. (Springer Nature, Switzerland AG,
2020
).
Google Scholar
 
52.
S.P.
 
Kouyoumjian
,
H.
 
Chemaitelly
, and
L.J.
 
Abu-Raddad
, “
Characterizing hepatitis C virus epidemiology in Egypt: systematic reviews, meta-analyses, and meta-regression
”.
Sci. Rep.
Vol.
8
No.
1
pp
1
–
17
. (Springer Nature, Switzerland AG,
2018
).
Google Scholar
 
53.
M.
 
Harfouche
,
H.
 
Chemaitelly
,
S.
 
Mahmud
,
K.
 
Chaabna
,
S.P.
 
Kouyoumjian
, and
Z.
 
Al Kanaani
, “
Epidemiology of hepatitis C virus among hemodialysis patients in the Middle East and North Africa: systematic syntheses, meta-analyses, and meta-regression
”.
Epidemiol. Infect.
Vol.
145
No.
15
pp
3243
–
3263
. (Cambridge University \ Cambridge Core, United Kingdom,
2017
)
Google Scholar
 
54.
S.A.
 
Alhajim
, “
Assessment of the quality of life in patients on hemodialysis in Iraq
”,
Mediterr. Health J.
(Eastern Mediterranean Health Journal, WHO, Egypt, 2017) Vol.
23
No.
12
pp
815
–
820
55.
P.
 
Ebrahimzadeh
,
M.
 
Haghshenas
, and
F.
 
Babamahmoodi
, “
The prevalence of hepatitis C virus genotypes in Mazandaran province, Iran
”,
Jundishapur. J. Microbiol.
Vol.
10
No.
4
pp
1
-
6
. (ProQuest, USA,
2017
)
Google Scholar
 
56.
K.
 
Darahasa
, and
S.A.
 
Moqueeth
, “
Genotyping and prevalence of hepatitis c virus in dialysis patients in Gandhi general hospital-A tertiary care center
”,
Int. J. Med. Microbiol. Tropical Dis.
Vol.
4
No.
2
pp
80
–
87
. (International Journal of Medical Microbiology and Tropical Diseases, India,
2018
)
Google Scholar
 
This content is only available via PDF.
© 2022 Author(s).
2022
Author(s)
You do not currently have access to this content.