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Kilonzo SB, Nkandala I, Rudovick L, Jaka HM, Mirambo MM, Mshana SE, Kajogoo VD, Shao ER. Prevalence of Hepatitis B Virus Infection in Tanzania: A Systematic Review and Meta-Analysis. J Trop Med 2024; 2024:4178240. [PMID: 38962495 PMCID: PMC11222000 DOI: 10.1155/2024/4178240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/19/2024] [Accepted: 05/20/2024] [Indexed: 07/05/2024] Open
Abstract
Methods We systematically searched the PubMed, Web of Science, African Journals Online, Embase, Cochrane Library, and Google Scholar databases for studies conducted up to March 1, 2023, that estimated the prevalence of HBV in Tanzania based on HBV surface antigen measurements. The DerSimonian-Laird random effects model was used to estimate the overall prevalence of HBV with 95% confidence intervals (CIs). Potential sources of heterogeneity were also investigated. Results Thirty-one studies with a total sample size of 37,988 were included in the meta-analysis. The overall average HBV prevalence estimate in Tanzania was 6.91% (95% CI = 5.18-8.86%). Subgroup analysis revealed the highest prevalence in the northern zone (9.32%, 95% CI; 2.24-20.36%), among the blood donors (18.72%, 95% CI: 17.43-20.05%) and among the community volunteers (8.76%, 95% CI: 4.55-14.15%). The lowest prevalence was observed in the lake zone at 4.66% (95% CI: 3.49-5.99) and in pregnant women at 4.72% (95% CI: 3.42-6.21). The overall between-study variability showed significant heterogeneity (I 2 = 97.41%, P < 0.001). Conclusions Our results showed that Tanzania is a country with moderately high HBV endemicity, with large interregional differences and significantly high numbers of HBV infections within the community. This underscores the need for immediate development of targeted prevention strategies and further epidemiological studies to better understand the pattern of the disease.
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Affiliation(s)
- Semvua B. Kilonzo
- Internal Medicine Department, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Igembe Nkandala
- Internal Medicine Department, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Ladius Rudovick
- Internal Medicine Department, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Hyasinta M. Jaka
- Internal Medicine Department, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Violet D. Kajogoo
- Department of Clinical Trials, Tanzania Diabetes Association, P.O. Box 65201, Dar es salaam, Tanzania
| | - Elichilia R. Shao
- Internal Medicine Department, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
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Langat B, Muge EK, Night D, Okoth F, Ochwedo KO, Songok EM. Sero-prevalence of hepatitis B virus and compliance with hepatitis B vaccination schedules among outpatient clinic attendees in Nairobi. PLoS One 2023; 18:e0281256. [PMID: 36730277 PMCID: PMC9894478 DOI: 10.1371/journal.pone.0281256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Hepatitis B is becoming a growing public health problem in Kenya. To combat the threat, HBV vaccination should be recommended, particularly for individuals who are not covered by the national immunization program. Vaccination provides sero-protection rates approaching 95% among healthy adults after completing the three-dose vaccination course, but decreases to 87% among those who receive only two doses, emphasizing the importance of completing the three-dose vaccination course. However, data on adult adherence to HBV multi-dose vaccines in Sub-Saharan Africa are limited, despite the fact that this information is critical for prevention. As a result, more research on HBV vaccine dose completion is required. The purpose of this study is to estimate the prevalence of hepatitis B virus infection among out-patient clinic attendees in Nairobi, Kenya, as well as to identify beneficiaries of free vaccination and barriers to completing the recommended vaccine doses. METHODS Between July 30th and September 30th, 2015, 2644 outpatient clinic attendees aged ≥ 4 were recruited from three hospitals in Nairobi County, Kenya: Mama Lucy, Riruta, and Loco. Self-administered questionnaires were used to collect socio-demographic information, and blood samples were tested for hepatitis B surface antigen (HBsAg) using the KEMRI HEPCELL Rapid® (Hepatitis B Detection kit) test kit. Individuals who tested negative for HBsAg were given a free course of three doses of HBV vaccine. The vaccination register provided information on the number of doses administered. RESULTS The average age of the study population was 31.4 years (range: 4-66), with females accounting for 59.2%. 1.82% (48/2644) of the participants tested positive for HBsAg. Among the 2596 individuals eligible for vaccination, 66% (1720/2596) received at least one dose, and 51.8% (1345/2596) received all three doses. Vaccination acceptance increased with age, with older patients more likely to return for subsequent dose (OR>1 for second and third dose). Unavailability and failure to contact client were cited as significant (p<0.0001) barrier to vaccination completion by 53.7% (666/1226, 95% CI 0.5-0.6) and 37% (454/1226, 95% CI 0.3-0.4) of respondents respectively. CONCLUSION The prevalence of HBV infection among outpatient clinic attendees highlights the importance of expanding HBV immunization programs in Kenya. However, given the low vaccination completion rate, there is a need for public awareness of the vaccine's importance in preventing HBV and HBV-related complications.
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Affiliation(s)
- Benard Langat
- Department of Medical Biochemistry, University of Nairobi, Nairobi, Kenya
- * E-mail:
| | - Edward K. Muge
- Department of Medical Biochemistry, University of Nairobi, Nairobi, Kenya
| | - Doris Night
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Fredrick Okoth
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Kevin O. Ochwedo
- Faculty of Science and Technology, Department of Biology, University of Nairobi, Nairobi, Kenya
| | - Elijah M. Songok
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
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Afolabi IB, Aremu AB, Maidoki LA, Atulomah NO. Predictors of Hepatitis B Virus Infection Vaccine Hesitancy Among Pregnant Women Attending Antenatal Care at Lubaga Hospital, Kampala, Uganda. Int J Womens Health 2022; 14:1093-1104. [PMID: 35999868 PMCID: PMC9393032 DOI: 10.2147/ijwh.s378000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background While hepatitis B virus infection may be seen as a global threat within the medical and scientific community, primary prevention via vaccination remains the most effective approach towards breaking the chain of transmission of HBV infection. However, vaccination uptake in Uganda has been modest despite a very endemic national figure resulting from the vertical transmission of this infection. This study assessed the predictors of HBV vaccine hesitancy among pregnant women attending Antenatal clinic in Central Uganda. Methodology A hospital-based cross-sectional study employing a five-sectioned pretested interviewer-administered questionnaire was conducted to obtain data from 385 consenting pregnant women. Responses for the antecedent variables were transformed into weighted aggregate scores using SPSS version 26. Multivariable logistic regression analysis was employed to ascertain the predictors of HBV vaccine hesitancy with the cut-off for hypotheses set at 5% level of significance. Results The majority of the respondents (59%) were between the ages of 18 and 28 years. Women with secondary educational attainment were predominant (42.3%). The respondents had mean scores of 5.97±6.61, 17.10±18.31, and 12.39±13.37, respectively, computed for knowledge of HBV infection, perception, and behavioral skills towards HBV prevention. Regarding vaccine hesitancy, three-quarters of the women (74%) hesitated to uptake HBV vaccine. While negative significant associations exist between marital status (AOR = 0.47, 95% CI = 0.22-1.01), knowledge (AOR = 0.79, 95% CI = 0.70-0.89), behavioral skills (AOR = 0.88, 95% CI = 0.81-0.95) and vaccine hesitancy, level of education (AOR = 1.88, 95% CI = 1.08-3.27) and perception (AOR = 1.11, 95% CI = 1.05-1.18) on the other hand, positively predicted vaccine hesitancy. Conclusion The findings reported an extremely high degree of HBV vaccine hesitancy among the expectant mothers discovered to be linked with marital status, educational attainment, HBV-specific knowledge, perception and behavioral skills. This necessitates targeted health education for married women with lower educational attainment to improve their knowledge which will in turn shape their perception and behavioral skills towards satisfactory uptake of HBV vaccine.
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Affiliation(s)
- Ismail Bamidele Afolabi
- Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| | - Abdulmujeeb Babatunde Aremu
- Faculty of Health Sciences, Department of Human Anatomy, Islamic University in Uganda, Kampala Campus, Kampala, Uganda
| | - Lawal Abdurraheem Maidoki
- Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
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Shayo G, Makundi I, Luzzatto L. The prevalence of human immunodeficiency and of hepatitis B viral infections is not increased in patients with sickle cell disease in Tanzania. BMC Infect Dis 2021; 21:1028. [PMID: 34592961 PMCID: PMC8485526 DOI: 10.1186/s12879-021-06726-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tanzania ranks as the fourth country in the world with respect to the number of sickle cell disease (SCD) births; it is also endemic to the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). This study was done to determine the prevalence of HIV and HBV infections among SCD patients in Dar es Salaam, Tanzania. METHODS A multicenter hospital-based descriptive cross sectional study was carried out among participants aged ≥ 16 years with a proven diagnosis of SCD. Socio-demographic and clinical data were recorded. Blood samples were drawn for HIV and HBV diagnosis. All categorical variables were summarized into frequencies. RESULTS There were 185/325 (56.9 %) females. The mean age (SD) was 23.0 ± 7.5 years. The prevalence of HIV was 1.8 %; the prevalence of HBV was 1.2 %. CONCLUSIONS The prevalence of both HIV and HBV in SCD patients is no greater than in the general population of Dar es Salaam or Tanzania. For associations, a large study would be needed. From a detailed blood transfusion history of SCD patients we found no evidence that HIV or HBV infection was transmitted through blood transfusion.
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Affiliation(s)
- Grace Shayo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, Tanzania. .,Department of Internal Medicine, Muhimbili National Hospital, P.O.Box 65000, Dar es Salaam, Tanzania.
| | - Irene Makundi
- Department of Internal Medicine, Muhimbili National Hospital, P.O.Box 65000, Dar es Salaam, Tanzania
| | - Lucio Luzzatto
- Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, Tanzania
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Prevalence of Kaposi's sarcoma-associated herpesvirus and transfusion-transmissible infections in Tanzanian blood donors. Int J Infect Dis 2020; 95:204-209. [PMID: 32294540 DOI: 10.1016/j.ijid.2020.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Kaposi's sarcoma-associated herpesvirus (KSHV) is the causative agent for Kaposi's sarcoma (KS), one of the most common cancers in Tanzania. We have investigated KSHV prevalence and factors associated with KSHV infection in Tanzania. METHODS This is a cross-sectional study of voluntary blood-donors from Dar es Salaam, Tanzania. Plasma was screened for KSHV, HIV-1, HBV, HCV and Treponema pallidum (syphilis). Associations between KSHV sero-status and risk factors were analyzed. Odds ratios (OR) and 95% confidence intervals (CI) are reported to evaluate risk factors of KSHV infection. All tests were 2-tailed, and P-values <0.05 were considered statistically significant. RESULTS The overall KSHV seroprevalence was 56.9%. Significantly increased risk of KSHV infection was detected in persons from the Lake and Central Zones (OR=6.4, 95% CI=1.6-25.3, P=0.008 and OR=5.7, 95% CI=1.0-32.5, P=0.048 respectively). A trend toward increased risk of KSHV infection with HIV-1 co-infection was not significant (OR=2.8, 95% CI=1.0-8.0, P=0.06). Seroreactivity to T. pallidum was surprisingly high (14.9%). CONCLUSION The prevalence of KSHV infection and syphilis was high among Tanzanian blood-donors. The most common transfusion-transmissible infections did not associate with KSHV infection. Regions of focal KSHV infection need further investigation for underappreciated risk factors.
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Makuza JD, Rwema JOT, Ntihabose CK, Dushimiyimana D, Umutesi J, Nisingizwe MP, Serumondo J, Semakula M, Riedel DJ, Nsanzimana S. Prevalence of hepatitis B surface antigen (HBsAg) positivity and its associated factors in Rwanda. BMC Infect Dis 2019; 19:381. [PMID: 31053097 PMCID: PMC6499977 DOI: 10.1186/s12879-019-4013-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/23/2019] [Indexed: 02/07/2023] Open
Abstract
Background The epidemiology of hepatitis B virus (HBV) infection in the general population in Rwanda is not well known. This study examined the prevalence of HBV surface antigen (HBsAg) positivity and associated risk factors among people aged 25 years and over in an organized national screening campaign. Methods This is a cross-sectional study using data from a nationwide HBV screening campaign organized by the Rwanda Biomedical Centre from March to October 2018. This campaign targeted individuals aged > 25 years old from 24 of 30 districts of Rwanda. Sensitization was done through multimedia announcements, community health workers and local church leaders. During the campaign, a structured interview was administered by trained healthcare workers to collect information on socio-demographic, clinical and behavioral characteristics of participants; HBV screening was performed with HBsAg using enzyme-linked immunosorbent assays (ELISA) testing. Bivariate and multivariate logistic regressions were used to assess factors associated with HBsAg positivity in the screened participants. Results A total of 327,360 individuals were screened during the campaign. Overall 12,865(3.9%) were HBsAg positive. The highest prevalence (4.2%) was found in the 35–44-year-old group, but the difference from other groups was not significant (Odds Ratio [OR = 1.057, 95% Confidence Interval(CI) (0.904–1.235)]. Being male [OR = 1.348, 95% CI (1.30,1.40)]; being single [OR = 1.092, 95% CI (1.10–1.16)] compared to married; a previous positive TB screening test [OR = 2.352, 95% CI (1.63–3.39)]; history of surgical operation [OR = 1.082, 95% CI (1.00,1.17)]; exposure to traditional operational practices and scarification [OR = 1.187, 95% CI (1.13, 1.24)]; and having a person in the family with viral hepatitis [OR = 1.367, 95% CI (1.21, 1.53)] were significantly associated with HBV infection. Conclusions These data provide the first national estimate of the prevalence of HBsAg seropositivity and its associated factors in Rwanda. The study identified people with the highest risk of HBV infection who should be the priority of future prevention efforts in Rwanda and in similar settings. Electronic supplementary material The online version of this article (10.1186/s12879-019-4013-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | - Justine Umutesi
- IHDPC Department, Rwanda Biomedical Center, Po Box 7162, Kigali, Rwanda
| | - Marie Paul Nisingizwe
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Janvier Serumondo
- IHDPC Department, Rwanda Biomedical Center, Po Box 7162, Kigali, Rwanda
| | - Muhamed Semakula
- IHDPC Department, Rwanda Biomedical Center, Po Box 7162, Kigali, Rwanda
| | - David J Riedel
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Sabin Nsanzimana
- IHDPC Department, Rwanda Biomedical Center, Po Box 7162, Kigali, Rwanda
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Hepatitis B Virus Infection in Tanzania: Current Status and Challenges. J Trop Med 2018; 2018:4239646. [PMID: 29666656 PMCID: PMC5831599 DOI: 10.1155/2018/4239646] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/18/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022] Open
Abstract
Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention.
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Mazigo HD, Kepha S, Kaatano GM, Kinung'hi SM. Co-infection of Schistosoma mansoni/hepatitis C virus and their associated factors among adult individuals living in fishing villages, north-western Tanzania. BMC Infect Dis 2017; 17:668. [PMID: 29017483 PMCID: PMC5635496 DOI: 10.1186/s12879-017-2780-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/29/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Schistosoma mansoni and Hepatitis C virus (HCV) are co-existence in sub-Saharan Africa and co-infection is common among humans population. The immunological responses characterized with Th2-immune responses for S. mansoni and Th1-immune responses for HCV are responsible for development hepatic morbidities in infected individuals. However, the co-occurrences of S. mansoni and HCV infection, their related ultrasound detectable morbidities and associated risk factors at community levels have not been examined in fishing communities, north-western Tanzania. In this context, the present study covers that gap. METHODS A cross-sectional study was conducted among 1924 asymptomatic individuals aged 15-55 years in four fishing villages (Igombe, Igalagala, Sangabuye and Kayenze) of Northwestern Tanzania. A single stool sample was collected from each study participants and examined for S. mansoni eggs using Kato Katz technique. Hepatitis C surface antigen (HCVsAg) was determined from a finger prick blood sample using a rapid test. RESULTS Overall, 51.8% (997/1924; 95%CI: 49.6-54.1) of the study participants were infected with S. mansoni and had a mean intensity of 223.7epg (95%; 202.4-247.1). Of the study participants, 90 (4.7%) were infected with hepatitis C virus (HCV). Overall, 2. 4% (47/1924) of the study participants were co-infected with S. mansoni and hepatitis C virus. Among the co-infected individuals, 42.6%, 70.2% and 19.1% had splenomegaly, hepatomegaly and periportal fibrosis (PPF). Factors associated with S. mansoni/HCV co-infection were being aged 26-35 years (aRR = 2.67, 95%CI: 1.03-6.93, P < 0.04), 46-55 years (aRR = 2.89, 95%CI: 1.10-7.57, P < 0.03) and having marked hepatomegaly (aRR = 2.32, 95%CI: 1.09-4.9, P < 0.03). CONCLUSION In this setting, S. mansoni and Hepatitis C are co-endemic and a proportion of individuals were co-infected. Hepatosplenic morbidities characterized with hepatomegaly, splenomegaly, hepatosplenomegaly and PPF were observed in co-infected individuals. These results highlight the need for integrated interventions measures against parasitic and viral diseases.
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Affiliation(s)
- Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
| | | | - Godfrey M Kaatano
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Safari M Kinung'hi
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
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Mueller A, Stoetter L, Kalluvya S, Stich A, Majinge C, Weissbrich B, Kasang C. Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania. BMC Infect Dis 2015; 15:386. [PMID: 26399765 PMCID: PMC4581415 DOI: 10.1186/s12879-015-1129-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 09/18/2015] [Indexed: 02/06/2023] Open
Abstract
Background Sub-Saharan Africa has a high prevalence of hepatitis B virus (HBV) infections. Health care workers (HCWs) are at high risk of contracting HBV infection through their occupation. Vaccination of HCWs against HBV is standard practice in many countries, but is often not implemented in resource-poor settings. We aimed with this cross-sectional study to determine HBV prevalence, HCW vaccination status, and the risk factors for HCWs contracting HBV infection in Tanzania. Methods We enrolled 600 HCWs from a tertiary Tanzanian hospital. Their demographics, medical histories, HBV vaccination details and risk factors for contracting blood-borne infections were collected using a standardized questionnaire. Serum samples were tested for HBV and hepatitis C virus (HCV) markers by ELISA techniques, PCR and an anti-HBs rapid test. HCWs were divided in two subgroups: those at risk of contracting HBV (rHCW 79.2 %) via exposure to potentially infectious materials, and those considered not at risk of contracting HBV (nrHCW, 20.8 %). Results The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0 % (42/598). Chronic HBV infection was found in 7.4 % of rHCW versus 5.6 % of nrHCW (p-value = 0.484). HCWs susceptible to HBV (HBsAg-, anti-HBc-, anti-HBs-) comprised 31.3 %. HBV immunity achieved either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) comprised 36.5 % and 20.2 %, respectively. 4.8 % of participants had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-). Only 77.1 % of HCWs who received a full vaccination course had an anti-HBs titer >10 ml/U. An anti-HBs point-of-care test was 80.7 % sensitive and 96.9 % specific. There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***). HCV prevalence was low (HCV antibodies 1.2 % and HCV-RNA 0.3 %). Conclusions Chronic HBV infection is common among Tanzanian HCWs. One third of HCWs were susceptible to HBV infection, highlighting the need for vaccination. Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.
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Affiliation(s)
- A Mueller
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany.
| | - L Stoetter
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany.
| | - S Kalluvya
- Bugando Medical Centre, P.O. Box 1370, Mwanza, United Republic of Tanzania. .,CUHAS, P.O. Box 1370, Mwanza, United Republic of Tanzania.
| | - A Stich
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany.
| | - C Majinge
- Bugando Medical Centre, P.O. Box 1370, Mwanza, United Republic of Tanzania.
| | - B Weissbrich
- Institute of Virology and Immunobiology, University of Wuerzburg, Versbacher Strasse 7, 97078, Wuerzburg, Germany.
| | - C Kasang
- Medical Mission Institute, Salvatorstrasse 7, 97067, Wuerzburg, Germany.
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Fox JM, Newton R, Bedaj M, Keding A, Molyneux E, Carpenter LM, Martin F, Mutalima N. Prevalence of hepatitis C virus in mothers and their children in Malawi. Trop Med Int Health 2015; 20:638-642. [PMID: 25611121 PMCID: PMC4418396 DOI: 10.1111/tmi.12465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objectives Hepatitis C virus (HCV) prevalence is poorly mapped in the East African region; with the advent of novel HCV therapies, better epidemiological data are required to target the infection. We sought to estimate HCV prevalence in healthy Malawian mothers and assess mother-to-child transmission (MTCT); context is provided by reviewing previously published HCV prevalence data from the region. Methods Using ELISA screening and confirmatory blot, serological testing of 418 healthy Malawian mothers for HCV was performed. To examine MTCT, the children of any positive women were also tested for HCV; all children had malignant disease unrelated to hepatocellular carcinoma. We compared our results to published literature on HCV prevalence in Malawi and its neighbouring countries. Results Three of 418 women were HCV reactive by ELISA; two were confirmed positive by immunoblot (0.5%). One child of an HCV-infected mother was HCV seropositive. The literature review revealed HCV prevalence ranging from 0 to 7.2% in the region, being highest in Tanzania and specifically for cohorts of inpatients and HIV-co-infected people. The overall estimated prevalence of HCV in Malawi was 1.0% (95%CI 0.7–1.4) when all studies were included (including this one), but lower in healthy cohorts alone at 0.3% (95%CI 0.1–1.2). Conclusions This is the first study using confirmatory tests to examine HCV prevalence in healthy Malawian mothers; the prevalence was low. Future studies need to address the source of infection in healthy women.
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Affiliation(s)
- James M Fox
- Centre for Immunology and Infection, University of York, York, UK
| | - Robert Newton
- Epidemiology and Cancer Statistics Group, University of York, York, UK.,MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Marija Bedaj
- Centre for Immunology and Infection, University of York, York, UK
| | - Ada Keding
- York Trials Unit, University of York, York, UK
| | | | | | - Fabiola Martin
- Centre for Immunology and Infection, University of York, York, UK
| | - Nora Mutalima
- Epidemiology and Cancer Statistics Group, University of York, York, UK
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11
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Kim JH, Nelson KE, Panzner U, Kasture Y, Labrique AB, Wierzba TF. A systematic review of the epidemiology of hepatitis E virus in Africa. BMC Infect Dis 2014; 14:308. [PMID: 24902967 PMCID: PMC4055251 DOI: 10.1186/1471-2334-14-308] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 05/28/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Hepatitis E Virus (HEV) infection is a newly recognized serious threat to global public health and Africa is suspected to be among the most severely affected regions in the world. Understanding HEV epidemiology in Africa will expedite the implementation of evidence-based control policies aimed at preventing the spread of HEV including policies for the use of available resources such as HEV vaccines. METHODS Here we present a comprehensive review of HEV epidemiology in Africa based on published data. We searched for articles on HEV epidemiology in Africa from online databases such as PubMed, Scopus, and ISI Web of Science and critically reviewed appropriate publications to extract consistent findings, identify knowledge gaps, and suggest future studies. RESULTS Taking a particularly high toll in pregnant women and their fetuses, HEV has infected human populations in 28 of 56 African countries. Since 1979, 17 HEV outbreaks have been reported about once every other year from Africa causing a reported 35,300 cases with 650 deaths. CONCLUSIONS In Africa, HEV infection is not new, is widespread, and the number of reported outbreaks are likely a significant underestimate. The authors suggest that this is a continent-wide public health problem that deserves the attention of local, regional and international agencies to implement control policies that can save numerous lives, especially those of pregnant women and their fetuses.
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Affiliation(s)
- Jong-Hoon Kim
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| | - Kenrad E Nelson
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Ursula Panzner
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| | - Yogita Kasture
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| | - Alain B Labrique
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Thomas F Wierzba
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
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Liu Y, Wu F. Global burden of aflatoxin-induced hepatocellular carcinoma: a risk assessment. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:818-24. [PMID: 20172840 PMCID: PMC2898859 DOI: 10.1289/ehp.0901388] [Citation(s) in RCA: 648] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 02/19/2010] [Indexed: 05/02/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC), or liver cancer, is the third leading cause of cancer deaths worldwide, with prevalence 16-32 times higher in developing countries than in developed countries. Aflatoxin, a contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus in maize and nuts, is a known human liver carcinogen. OBJECTIVES We sought to determine the global burden of HCC attributable to aflatoxin exposure. METHODS We conducted a quantitative cancer risk assessment, for which we collected global data on food-borne aflatoxin levels, consumption of aflatoxin-contaminated foods, and hepatitis B virus (HBV) prevalence. We calculated the cancer potency of aflatoxin for HBV-postive and HBV-negative individuals, as well as the uncertainty in all variables, to estimate the global burden of aflatoxin-related HCC. RESULTS Of the 550,000-600,000 new HCC cases worldwide each year, about 25,200-155,000 may be attributable to aflatoxin exposure. Most cases occur in sub-Saharan Africa, Southeast Asia, and China where populations suffer from both high HBV prevalence and largely uncontrolled aflatoxin exposure in food. CONCLUSIONS Aflatoxin may play a causative role in 4.6-28.2% of all global HCC cases.
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Affiliation(s)
| | - Felicia Wu
- Address correspondence to F. Wu, Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, 100 Technology Dr., Rm 560, Pittsburgh, PA 15219 USA. Telephone: (412) 624-1306. Fax: (412) 624-3040. E-mail:
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13
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Motta-Castro ARC, Martins RMB, Yoshida CFT, Teles SA, Paniago AM, Lima KMB, Gomes SA. Hepatitis B virus infection in isolated Afro-Brazilian communities. J Med Virol 2005; 77:188-93. [PMID: 16121385 DOI: 10.1002/jmv.20435] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The prevalence and genotypes of hepatitis B virus (HBV) have distinct geographical distribution. In Brazil, some African-descendants have been maintained as small isolated communities since the slavery period. In this study, HBV infection among these communities of African origin was examined. Individuals (1,058) living in 12 communities were interviewed and serum samples screened for the presence of HBV markers. HBsAg-positive sera were tested for HBV DNA by PCR and positive samples were genotyped by restriction fragment length polymorphism (RFLP). The overall prevalence of HBV infection was 19.8% (95% CI: 17.5-22.3), ranging from 5.5% to 42.4%, depending on the communities studied. Multivariate analysis of risk factors showed that increasing age, family history of hepatitis, and sexual activity were associated significantly with this infection. HBsAg was detected in 23/1,058 (2.2%) individuals. HBV DNA was present in 2/2 of HBeAg-positive serum samples and in 18/21 (85.7%) anti-HBe-positive samples. All HBV isolates belonged to genotype A, subtype Aa. Three RFLP patterns were identified: AI (17 isolates), AIV (1 isolate), and AVI (2 isolates). These findings suggest a common introduction of HBV during the slave trade from Africa to Brazil.
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Affiliation(s)
- Ana R C Motta-Castro
- Departamento de Farmácia Bioquímica, Universidade Federal de Mato Grosso do Sul (UFMS), Mato Grosso do Sul, Brazil
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Kitundu J, Msengi A, Matee M, Fataki M, Kazimoto T, Mpembeni R, Mnubhi E, Kalokola F. Post-transfusion hepatitis C seroprevalence in Tanzanian children. ANNALS OF TROPICAL PAEDIATRICS 2001; 21:343-8. [PMID: 11732153 DOI: 10.1080/07430170120093535] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In Tanzania, children with malaria-associated anaemia are frequently given blood transfusions, and donor blood is not screened for hepatitis C virus (HCV) infection. To determine the seroprevalence of HCV infection in Tanzanian children previously transfused with blood, 184 children (92 transfused, 92 not transfused) aged between 15 and 59 months matched for age and sex were screened for HCV antibodies by the particle agglutination test using Serodia anti-HCV (Fujirebio Inc., Japan). The overall prevalence of HCV infection was 7.1% (13/184). HCV seropositivity was 5.4% (5/92) among children with a history of blood transfusion and 8.6% (8/92) among the non-transfused. There was no significant difference in the prevalence of HCV infection between transfused and non-transfused children. None of the factors investigated, such as gender, the nutrition and HIV serostatus of the children and the marital and education status of their mothers, was associated with HCV seropositivity. Further studies are recommended to identify the factors associated with HCV infection in Tanzanian children.
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Affiliation(s)
- J Kitundu
- Departments of Paediatrics and Child Health, Muhimbili University College of Health Sciences, PO Box 65001, Dar es Salaam, Tanzania.
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Combe P, La Ruche G, Bonard D, Ouassa T, Faye-Ketté H, Sylla-Koko F, Dabis F. Hepatitis B and C infections, human immunodeficiency virus and other sexually transmitted infections among women of childbearing age in Côte d'Ivoire, West Africa. Trans R Soc Trop Med Hyg 2001; 95:493-6. [PMID: 11706657 DOI: 10.1016/s0035-9203(01)90015-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Few studies have been conducted in developing countries to estimate the prevalence of hepatitis C virus (HCV) infection and its association with human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). We have screened for hepatitis B virus (HBV) and HCV markers 200 HIV-1-positive, 23 HIV-2-positive and 206 HIV-negative women attending gynaecology clinics in 1995/96 in Abidjan, Côte d'Ivoire, a sample selected among 2198 consecutive consultants. Taking into account the prevalence of 21.7% for HIV in this population, the overall prevalence of anti-HBV core antibody was 81.6%, that for hepatitis B surface antigen was 9.9% and for HCV antibody was 3.3%. HIV infection and other STDs were not associated with HBV or HCV markers. Moreover, HBV and HCV markers were not statistically associated. Our results confirm the high prevalence of HIV in Abidjan and the endemic situation of HBV infection. Furthermore, HCV infection is not infrequent in this developing country setting, not explained by sexual transmission.
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Affiliation(s)
- P Combe
- Centre de Diagnostic et de Recherche sur le SIDA, PACCI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
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Bartoloni A, Bartalesi F, Roselli M, Mantella A, Arce CC, Paradisi F, Hall AJ. Prevalence of antibodies against hepatitis A and E viruses among rural populations of the Chaco region, south-eastern Bolivia. Trop Med Int Health 1999; 4:596-601. [PMID: 10540299 DOI: 10.1046/j.1365-3156.1999.00457.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We conducted a cross-sectional study to determine the seroprevalence of antibodies against hepatitis A and hepatitis E viruses (HAV and HEV) in the population of two rural areas, Camiri and Villa Montes, of the Chaco region, south-eastern Bolivia. HAV antibodies were detected in 461 (94.1%) of 490 serum samples tested, not differing significantly between sexes and study areas. The HAV seropositivity rate (64.7%) was high even in the youngest age group (1-5 years). The prevalence of HEV was 7.3%, with no significant differences between sexes. The prevalence of HEV antibodies in the population of the Camiri area (10.4%) was significantly higher than in the Villa Montes area (4.4%), possibly due to the better quality of drinking water in the Villa Montes area. In the population </= 30 years of age, the HEV seropositivity rate (4.4%) was significantly lower than in the >/= 31 year-old group. This is consistent with findings in other countries. This is the first report of the prevalence of HEV infection in Bolivia.
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Affiliation(s)
- A Bartoloni
- Clinica di Malattie Infettive, Università di Firenze, Italia
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