West Africa is one of the global regions most highly affected by the hepatitis C virus (HCV), according to a new study published in Clinical Infectious Diseases. Health experts warn hep C is getting too little attention compared to other diseases in the region, Science Daily reports.

Researchers estimate that more than 180 million people around the world have HCV, compared to 34 million people living with HIV/AIDS and approximately 30,000 who have had Ebola.

In developed countries, hep C is most often transmitted through intravenous drug use. Researchers believe that in West Africa traditional cultural practices—such as tribal scarring, home birthing and traditional circumcision procedures—are leading to the high rate of new HCV cases.

In particular, researchers conducted a small study at a blood bank in a teaching hospital in Ghana, where the association with cultural practices was found. The researchers are now planning a study to test more than 5,000 people in Ghana for HCV. Their goal is to better understand which populations are most affected by hep C and how to identify the next steps for intervention and prevention in the region.

The initial study was conducted by HepNet, an international group of physicians and scientists from Loyola University in Chicago, the Komfo Anokye Teaching Hospital in Ghana, the U.S. Centers for Disease Control and Prevention and Johns Hopkins University.