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Mukadi-Kakoni P, Munyeku-Bazitama Y, Kashitu-Mujinga G, Manwana-Pemba M, Zenga-Bibi N, Okitale-Talunda P, Mbelu-Kabongo C, Domai-Mbuyakala F, Pukuta-Simbu E, Mutantu-Nsele P, Kubo Y, Makiala-Mandanda S, Ahuka-Mundeke S, Ariyoshi K, Muyembe-Tamfum JJ. Revealing viral hepatitis epidemiology in the Democratic Republic of Congo: insights from yellow fever surveillance reanalysis. Trop Med Health 2025; 53:17. [PMID: 39910399 PMCID: PMC11800490 DOI: 10.1186/s41182-025-00687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2025] [Accepted: 01/16/2025] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND Yellow fever surveillance systems are designed to identify cases of acute febrile jaundice, a clinical syndrome used to monitor the emergence of yellow fever outbreaks. However, this syndrome has diverse etiologies, particularly viral hepatitis. This study investigates the seroepidemiology of viral hepatitis A (HAV), B (HBV), C (HCV), and E (HEV) among cases initially suspected to be yellow fever, aiming to elucidate the epidemiology of viral hepatitis in the Democratic Republic of Congo (DRC) and provide insights for improving public health interventions. METHODS A retrospective cross-sectional study was conducted using serum samples collected between 2017 and 2018 through national yellow fever surveillance in the DRC. Samples from individuals testing negative for yellow fever were tested for IgM antibodies against HAV, HBc, HCV, and HEV and HBs antigen using validated ELISA kits. Acute HBV infection was defined by both HBc IgM and HBs antigen positivity. Multivariable logistic regression was used to assess the association of demographic, geographic, and environmental factors with each hepatitis type. RESULTS Among 1239 participants (58.8% male; median age: 16 years), seroprevalence was 16.1, 11.2, 5.0, and 3.1% for HAV, HBV, HCV and HEV, respectively. HAV prevalence was highest in the youngest age group and rural residents. In contrast, the youngest group was most protected from HBV. HCV prevalence was highest in the oldest age groups. HEV exhibited higher prevalence during the dry season and in a humid subtropical climate. Several provinces were identified as hotspots of HAV, HCV and HEV. CONCLUSIONS Viral hepatitis is a major cause of acute febrile jaundice in the DRC with notable geographic and seasonal trends. National yellow fever surveillance is a valuable resource for understanding hepatitis epidemiology, though careful interpretation is necessary. Tailored interventions are required for mitigating the burden of viral hepatitis in each province.
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Affiliation(s)
- Patrick Mukadi-Kakoni
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Yannick Munyeku-Bazitama
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- Faculty of Medicine, University of Kikwit, Kikwit, Democratic Republic of the Congo
| | - Gracia Kashitu-Mujinga
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Niclette Zenga-Bibi
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Patient Okitale-Talunda
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Christelle Mbelu-Kabongo
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Fleurette Domai-Mbuyakala
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | | | - Pierre Mutantu-Nsele
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Yoshinao Kubo
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Sheila Makiala-Mandanda
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
| | - Jean-Jacques Muyembe-Tamfum
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
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Nimpa MM, Karemere H, Ngandu C, Mboussou FF, Danovaro-Holliday MC, Nkamba D, Fouda AB, Nguejio B, Kakozi S, Cikomola AMW, Mukendi JC, Mwamba D, Yapi MD, Riziki RB, Mwanga C, Otomba J, Nikiema JB, Hama Sambo B, Ishoso DK. Viral Hepatitis B and Its Implications for Public Health in DR Congo: A Systematic Review. Viruses 2024; 17:9. [PMID: 39861798 PMCID: PMC11768743 DOI: 10.3390/v17010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 12/18/2024] [Accepted: 12/19/2024] [Indexed: 01/27/2025] Open
Abstract
Background: The prevalence of hepatitis B virus infection remains high in the Democratic Republic of Congo (DRC), constituting a public health problem in view of the fatal complications it causes, notably cirrhosis and hepatocellular carcinoma. The aim of this study was to provide an overview of the situation of viral hepatitis B in the DRC and in particular its implications for public health. Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group guidelines. Google Scholar, PubMed, and ResearchGate were used as databases. The review essentially analyzed the viral hepatitis B (HBV) vaccination status of study subjects, diagnostic means, HBV genotypes in DR Congo, seroprevalence of HBV infection, subjects' level of knowledge and perceptions of HBV, co-infection/comorbidity with HBV infection, factors associated with HBV infection and public health issues raised by HBV infection. Results: The vast majority of studies (69%) were carried out to determine the seroprevalence of HBV infection. The Determine rapid test was the most widely used test (10 studies), sometimes combined with ELISA (3 studies) and polymerase chain reaction (PCR) (1 study, for genotyping). Some of the public health issues raised by hepatitis B virus infection were identified in the course of the included studies, in relation to co-infection, comorbidity, associated factors, and individuals' level of knowledge and perceptions of HBV. Certain factors were identified as being closely associated with HBV, notably healthcare professions (e.g., doctor, laboratory technician) and having several sexual partners. In terms of perception of HBV, the hepatitis B virus is recognized as dangerous, and the majority of people questioned in the various studies were aware that vaccination remains the most effective means of prevention. Conclusions: Hepatitis B is a highly contagious infectious disease present in the DRC, with a higher prevalence among healthcare professionals, sex workers, patients with certain diseases including HIV, and people with a history of blood transfusion. The surveillance system within the national blood transfusion program needs to be strengthened. Raising public awareness of the seriousness of viral hepatitis B, offering vaccination to at-risk populations, and systematically screening pregnant women and blood donors for HBV infection could help reduce the prevalence of viral hepatitis B.
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Affiliation(s)
- Marcellin Mengouo Nimpa
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Hermès Karemere
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu 11103, Democratic Republic of the Congo;
| | - Christian Ngandu
- National Institute of Public Health, Kinshasa 01206, Democratic Republic of the Congo; (C.N.); (D.M.)
| | - Franck-Fortune Mboussou
- World Health Organization African Regional Office, Brazzaville P.O. Box 06, Congo; (F.-F.M.); (A.B.F.)
| | - M. Carolina Danovaro-Holliday
- Immunization, Analytics and Insights (IAI), Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization (WHO), 1211 Geneva, Switzerland;
| | - Dalau Nkamba
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa 01206, Democratic Republic of the Congo;
| | - André Bita Fouda
- World Health Organization African Regional Office, Brazzaville P.O. Box 06, Congo; (F.-F.M.); (A.B.F.)
| | - Bienvenu Nguejio
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Sifa Kakozi
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Aimé Mwana-Wabene Cikomola
- Expanded Program of Immunization, Kinshasa 01206, Democratic Republic of the Congo; (A.M.-W.C.); (J.-C.M.)
| | - Jean-Crispin Mukendi
- Expanded Program of Immunization, Kinshasa 01206, Democratic Republic of the Congo; (A.M.-W.C.); (J.-C.M.)
| | - Dieudonné Mwamba
- National Institute of Public Health, Kinshasa 01206, Democratic Republic of the Congo; (C.N.); (D.M.)
| | - Moise Désiré Yapi
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Richard Bahizire Riziki
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
- Higher Institute of Medical Techniques of Nyangezi, Public Health Section, Sud-Kivu 11213, Democratic Republic of the Congo
| | - Cedric Mwanga
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - John Otomba
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Jean Baptiste Nikiema
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Boureima Hama Sambo
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
| | - Daniel Katuashi Ishoso
- World Health Organization (WHO) Country Office, Kinshasa 01206, Democratic Republic of the Congo; (M.M.N.); (B.N.); (S.K.); (M.D.Y.); (R.B.R.); (C.M.); (J.O.); (J.B.N.); (B.H.S.)
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa 01206, Democratic Republic of the Congo;
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Kafeero HM, Ndagire D, Ocama P, Kato CD, Wampande E, Walusansa A, Kajumbula H, Kateete D, Ssenku JE, Sendagire H. Mapping hepatitis B virus genotypes on the African continent from 1997 to 2021: a systematic review with meta-analysis. Sci Rep 2023; 13:5723. [PMID: 37029173 PMCID: PMC10082212 DOI: 10.1038/s41598-023-32865-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
Hepatitis B virus (HBV) has ten genotypes (A-J) and over 40 sub-genotypes based on the divergence of ≥ 8% and 4 to < 8% in the complete genome respectively. These genotypes and sub-genotypes influence the disease prognosis, response to therapy and route of viral transmission. Besides, infection with mixed genotypes and recombinant genotypes has also been reported. This study aimed at mapping the de novo genotypes and correlate them with the immigration trends in order to inform future research on the underlying reasons for the relative distribution of HBV genotypes from a large sample size pooled from many primary studies. Data was extracted from 59 full research articles obtained from Scopus, PubMed, EMBASE, Willy library, African Journal Online (AJOL) and Google Scholar. Studies that investigated the genotypes, sub-genotypes, mixed genotypes and recombinant were included. The Z-test and regression were used for the analysis. The study protocol is registered with PROSPERO under the registration number CRD42022300220. Overall, genotype E had the highest pooled prevalence significantly higher than all the other genotypes (P < 0.001). By region, genotype A posted the highest pooled prevalence in eastern and southern Africa, E in west Africa and D in north Africa (P < 0.0001). Regarding the emerging genotypes B and C on the African continent, genotype B was significantly higher in south Africa than C (P < 0.001). In contrast, genotype C was significantly higher in east Africa than west Africa (P < 0.0001). The A1 and D/E were the most diverse sub-genotypes and genotype mixtures respectively. Finally, we observed a general progressive decrease in the prevalence of predominant genotypes but a progressive increase in the less dominant by region. Historical and recent continental and intercontinental migrations can provide a plausible explanation for the HBV genotype distribution pattern on the African continent.
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Affiliation(s)
- Hussein Mukasa Kafeero
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda.
| | - Dorothy Ndagire
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Ponsiano Ocama
- Department of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Charles Drago Kato
- Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Eddie Wampande
- Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Abdul Walusansa
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda
| | - Henry Kajumbula
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - David Kateete
- Department of Molecular Biology and Immunology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Jamilu E Ssenku
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Hakim Sendagire
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda
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Thompson P, Parr JB, Holzmayer V, Carrel M, Tshefu A, Mwandagalirwa K, Muwonga J, Welo PO, Fwamba F, Kuhns M, Jhaveri R, Meshnick SR, Cloherty G. Seroepidemiology of Hepatitis B in the Democratic Republic of the Congo. Am J Trop Med Hyg 2020; 101:226-229. [PMID: 31074406 DOI: 10.4269/ajtmh.18-0883] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Hepatitis B virus (HBV) is endemic throughout Africa, but its prevalence in the Democratic Republic of the Congo (DRC) is incompletely understood. We used dried blood spot (DBS) samples from the 2013 to 2014 Demographic and Health Survey in the DRC to measure the prevalence of HBV using the Abbott ARCHITECT HBV surface antigen (HBsAg) qualitative assay. We then attempted to sequence and genotype HBsAg-positive samples. The weighted national prevalence of HBV was 3.3% (95% CI: 1.8-4.7%), with a prevalence of 2.2% (95% CI: 0.3-4.1%) among children. Hepatitis B virus cases occurred countrywide and across age strata. Genotype E predominated (60%), and we found a unique cluster of genotype A isolates (30%). In conclusion, DBS-based HBsAg testing from a nationally representative survey found that HBV is common and widely distributed among Congolese adults and children. The distribution of cases across ages suggests ongoing transmission and underscores the need for additional interventions to prevent HBV infection.
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Affiliation(s)
- Peyton Thompson
- Division of Infectious Diseases, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina
| | - Jonathan B Parr
- Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | | | - Margaret Carrel
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City, Iowa
| | - Antoinette Tshefu
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | | | - Jérémie Muwonga
- National AIDS Control Program, Kinshasa, Democratic Republic of the Congo
| | - Placide O Welo
- National AIDS Control Program, Kinshasa, Democratic Republic of the Congo
| | - Franck Fwamba
- National AIDS Control Program, Kinshasa, Democratic Republic of the Congo
| | - Mary Kuhns
- Abbott Laboratories, Abbott Park, Illinois
| | - Ravi Jhaveri
- Division of Infectious Diseases, Department of Pediatrics, Northwestern University, Evanston, Illinois
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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Highly sensitive chemiluminescent aptasensor for detecting HBV infection based on rapid magnetic separation and double-functionalized gold nanoparticles. Sci Rep 2018; 8:9444. [PMID: 29930331 PMCID: PMC6013465 DOI: 10.1038/s41598-018-27792-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/08/2018] [Indexed: 01/05/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a major global public health problem and one of the leading causes of chronic liver disease. HBsAg is the first serological marker to appear in the blood and is the most important marker of HBV infection. Detection of HBsAg in serum samples is commonly carried out using an immunoassay such as an enzyme-linked immunosorbent assay (ELISA), which is complex to perform, time-consuming, and unsatisfactory for testing sensitivity. Therefore, new methods for highly sensitive detection of HBV infection are urgently needed. Aptamers are specific recognition molecules with high affinity and specificity toward their targets. Biosensors that employ aptamers as biorecognition elements are known as aptasensors. In this study, we select an HBsAg-specific aptamer and use it to develop a new chemiluminescent aptasensor based on rapid magnetic separation and double-functionalized gold nanoparticles. This sensor enables rapid magnetic separation and highly sensitive detection of HBsAg in HBV-positive serum. The detection limit of this HBsAg-detecting chemiluminescent aptasensor is as low as 0.05 ng/mL, which is much lower than the 0.5 ng/mL limit of a typical ELISA used in hospitals. Furthermore, this aptasensor works well and is highly specific to HBV infection.
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