TY - JOUR
T1 - Prevalence, trends, and distribution of hepatitis C virus among the general population in sub-Saharan Africa: A systematic review and meta-analysis
AU - the DESTINE NIHR Global Health Research Group
AU - Kassa, Getahun Molla
AU - Walker, Josephine G.
AU - Alamneh, Tesfa Sewunet
AU - Tamiru, Melaku Tileku
AU - Bivegete, Sandra
AU - Adane, Aynishet
AU - Amogne, Wondwossen
AU - Dillon, John F.
AU - Vickerman, Peter
AU - Dagne, Emebet
AU - Yesuf, Elias Ali
AU - Hickman, Matthew
AU - French, Clare E.
AU - Lim, Aaron G.
AU - Dillon, John F.
AU - Amogne, Wondwossen
AU - Vickerman, Peter
AU - Hickman, Matthew
AU - Paltiel, Ora
AU - Wolday, Dawit
AU - Adane, Aynishet
AU - Abdella, Saro
AU - Abay, Zenahbezu
AU - Hailu, Workagegnehu
AU - Awoke, Tadesse
AU - Dagne, Emebet
AU - Yesuf, Elias Ali
AU - Walker, Josephine G.
AU - Lim, Aaron G.
AU - French, Clare E.
AU - Mulu, Andaragachew
AU - Tamiru, Melaku Tileku
AU - Weldemariam, Atsbeha Gebreegziabxier
AU - Cabral, Christie
AU - Baissa, Obsie
AU - Speakman, Elizabeth
AU - Radley, Andrew
AU - Malaguti, Amy
AU - Inglis, Sarah K.
AU - Yohannes, Meseret
AU - Taddele, Bruktait
AU - Abraha, Hagos
AU - Erkie, Mengistu
AU - Alamneh, Tesfa Sewunet
AU - Kassa, Getahun Molla
N1 - Publisher Copyright:
© 2024 The Author(s). Liver International published by John Wiley & Sons Ltd.
PY - 2024/9/13
Y1 - 2024/9/13
N2 - Background and Aims: Although the evidence is uncertain, existing estimates for hepatitis C virus (HCV) in sub-Saharan Africa (SSA) indicate a high burden. We estimated HCV seroprevalence and viraemic prevalence among the general population in SSA. Methods: We searched Medline, Embase, Web of Science, APA PsycINFO, and World Health Organization Africa Index Medicus for community-based studies. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool, and heterogeneity using the index of heterogeneity (I2). Two approaches were deployed. First, we used random-effects meta-analysis to pool prevalence. Second, to derive representative estimates, we weighted each country's HCV seroprevalence using 2021 United Nations country population sizes. Results: We synthesized 130 studies. Overall, SSA HCV seroprevalence from the random-effects model was 4.17% (95% confidence interval [CI]: 3.71–4.66, I2 = 99.30%). There were no differences between males (4.31%) and females (4.03%). Seroprevalence was 2.25%, 3.31%, and 16.23% for ages ≤20, 21–64, and ≥65 years, respectively, and was higher in rural (6.63%) versus urban (2.93%). There was indication of decrement overtime from 5.74% to 4.35% to 3.03% in the years 1984–2000, 2001–2014, and 2015–2023, respectively. The weighted overall SSA HCV seroprevalence was estimated to be 2.30% (95% CI: 1.59–3.00) with regional variation: Africa-Southern (.79%), Africa-Central (1.47%), Africa-Eastern (2.71%), and Africa-Western (2.88%). HCV viremia among HCV seropositives was 54.77% (95% CI: 47.80–61.66). Conclusions: HCV seroprevalence in SSA remains high. Populations aged ≥65 years, rural communities, Africa-Western, and some countries in Africa-Central and Africa-Eastern appear disproportionately affected. These results underline the need for governmental commitment to achieve the 2030 global HCV elimination targets.
AB - Background and Aims: Although the evidence is uncertain, existing estimates for hepatitis C virus (HCV) in sub-Saharan Africa (SSA) indicate a high burden. We estimated HCV seroprevalence and viraemic prevalence among the general population in SSA. Methods: We searched Medline, Embase, Web of Science, APA PsycINFO, and World Health Organization Africa Index Medicus for community-based studies. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool, and heterogeneity using the index of heterogeneity (I2). Two approaches were deployed. First, we used random-effects meta-analysis to pool prevalence. Second, to derive representative estimates, we weighted each country's HCV seroprevalence using 2021 United Nations country population sizes. Results: We synthesized 130 studies. Overall, SSA HCV seroprevalence from the random-effects model was 4.17% (95% confidence interval [CI]: 3.71–4.66, I2 = 99.30%). There were no differences between males (4.31%) and females (4.03%). Seroprevalence was 2.25%, 3.31%, and 16.23% for ages ≤20, 21–64, and ≥65 years, respectively, and was higher in rural (6.63%) versus urban (2.93%). There was indication of decrement overtime from 5.74% to 4.35% to 3.03% in the years 1984–2000, 2001–2014, and 2015–2023, respectively. The weighted overall SSA HCV seroprevalence was estimated to be 2.30% (95% CI: 1.59–3.00) with regional variation: Africa-Southern (.79%), Africa-Central (1.47%), Africa-Eastern (2.71%), and Africa-Western (2.88%). HCV viremia among HCV seropositives was 54.77% (95% CI: 47.80–61.66). Conclusions: HCV seroprevalence in SSA remains high. Populations aged ≥65 years, rural communities, Africa-Western, and some countries in Africa-Central and Africa-Eastern appear disproportionately affected. These results underline the need for governmental commitment to achieve the 2030 global HCV elimination targets.
KW - general population
KW - HCV
KW - seroprevalence
KW - SSA
KW - viraemic prevalence
U2 - 10.1111/liv.16102
DO - 10.1111/liv.16102
M3 - Article
C2 - 39268900
AN - SCOPUS:85204079126
SN - 1478-3223
VL - 44
SP - 3238
EP - 3249
JO - Liver International
JF - Liver International
IS - 12
ER -
SDG 3 Good Health and Well-being