Seroprevalence of transfusion transmissible viral infections (HIV, HBV and HCV) among voluntary blood donors at University of Gondar Comprehensive Specialized Hospital, Gondar; Northwest Ethiopia

Seroprevalence of Hepatitis B and C Viruses and Their Associated Factors Among Military Personnel at Military Camps in Central Gondar, Ethiopia: A Cross-Sectional Study

Background

Globally, viral hepatitis is a leading cause of death and is highly prevalent in Ethiopia. Military personnel are more vulnerable to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and there are no data on such populations in the study area. Therefore, this study aimed to determine the seroprevalence of HBV and HCV infections and their associated factors among military personnel in military camps in Central Gondar, Ethiopia.

Materials and Methods

This institutional-based cross-sectional study was conducted with 277 military personnel from April to August 2022 at military camps in Central Gondar, Ethiopia. A systematic random sampling technique was used to select the study participants. Sociodemographic and other relevant data were collected using a structured questionnaire. Five milliliters of venous blood were collected using a vacutainer tube and tested for hepatitis B surface antigens and anti-hepatitis C virus antibodies using an enzyme-linked immunosorbent assay. Data were analyzed using STATA version 14 software and logistic regression models were used to determine the association between HBV/HCV infection and risk factors.

Results

Out of 277 participants, the overall seroprevalence of HBV and HCV infections was 19 (6.9%) and 9 (3.3%), respectively. The rate of HBV and HCV co-infection was 2 (0.7%). Having multiple sexual partners (p = 0.048), frequent alcohol use (p = 0.034), hospitalization (p = 0.014), and history of receiving injections from traditional practitioners (p = 0.040) were significant predictors of HBV infection. In contrast, a history of blood transfusion (p = 0.048) and sexually transmitted infections (p = 0.039) were significant risk factors for HCV infection.

Conclusion and Recommendations

An intermediate prevalence of HBV and HCV infections was observed among the military personnel. Continuous screening, adherence to healthcare service guidelines, and strengthening of vaccination are crucial for preventing HBV and HCV infections.

Seroprevalence of viral transfusion transmissible infections (HBsAg, anti-HCV, anti-HIV, Syphilis) and coinfection among healthy volunteer blood donors during 5-years in Luanda, Angola

BACKGROUND

The transmission of diseases by blood products continues to be a worldwide health problem, especially in Africa. Seroprevalence rates of the Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human Immunodeficiency Virus (HIV), Syphilis, and Coinfection in Angola are poorly documented. This study aims to identify the seroprevalence of markers with positive results for Hepatitis B, C, HIV, Syphilis, and Coinfection in blood donors.

MATERIAL AND METHODS

A retrospective study was conducted using a database of positive serological markers for these infections and coinfection in 2734 blood donors traced from 2011 to 2016 in Luanda, Angola. The Chi-Square test (χ2) or Fisher's exact test was used to evaluate serological positivity and donors' characteristics. A p-value < 0.05 was considered statistically significant.

RESULTS

2734 blood donors aged 18 to 64 (median age 32 ± 9) were screened from 2011 to 2016. 73.9 % of the donors were positive for one Transfusion-Transmitted Infection (TTI), and 5.9 % showed evidence of multiple infections. The overall seroprevalence rate was 50.2 % (1373) for HBV, 20 % (436) for Syphilis, 7 % (191) for HIV, 5.1 % (140) for HCV, and 5.8 % for coinfected donors. 2467 (90 %) were men, and 267 (10 %) were women. We identified 118 (5.8 %) coinfected donors. Of those, 40 (33.9 %) simultaneously presented Hepatitis B virus surface antigen (HBsAg)/Syphilis, 24 (20.3 %) HBsAg/HIV, 22 (18.6 %) HBsAg/HCV, 20 (16.9 %) HIV/Syphilis, 8 (6.8 %) HCV/Syphilis, and 4 (3.4 %) HIV/HCV.

CONCLUSION

A high transfusion-transmissible infection prevalence was found compared to some countries in Sub-Saharan Africa. Therefore, intensifying the screening for these transfusion-transmitted infections in blood donors is critical to ensure blood safety.

Seroprevalence of Transfusion Transmissible Infections and Associated Risk Factors in Hospitalized Patients before Transfusion in Jinling Hospital Nanjing University: A Three-Year Retrospective Study

Transfusion-transmitted infections (TTIs), such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and treponema pallidum (TP), must be detected before blood transfusion. However, few studies have been conducted on the prevalence and accuracy of positive results in hospitalized patients. The purpose of this study was to investigate the real seroprevalence of TTIs among patients before blood transfusion and analyze the characteristics of false-positive results in Jinling Hospital, Nanjing University, China. TTI results were collected from medical records and analyzed retrospectively. Additionally, we also used confirmatory assays to verify the accuracy of positive results. The overall prevalence of TTI was 8.96%, which was related to gender and age. The real positive rates were 86.67% (HBV), 35.09% (HCV), 20.75% (HIV), and 100% (TP). Our results also showed that high-speed centrifugation can reduce the false-positive rate of HBsAg. In summary, the results demonstrated that the positive rates of TTIs in hospitalized patients are higher than those in the general population. We also confirmed the existence of false-positive results in serological screening for TTIs. The method of processing specimens through high-speed centrifugation could reduce the false-positive results of detecting antigens effectively.

Frequency of Hepatitis B, C, and Human Immunodeficiency Virus in Blood Donors

Introduction: Blood donation is considered an important source of infection transmitted through transfusion, especially in developing countries like Pakistan.

Objective: To find out the frequency of seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in the blood bank.

Methods: A prospective cohort study was carried out on blood donors at the National Institute of Blood Disease and Bone Marrow Transplant, Karachi, during the period of January 1, 2019 to December 31, 2020. The descriptive statistical analysis to find out the percentages and frequencies was implemented using SPSS version 23 (IBM Corp., Armonk, NY).

Results: During the study duration, a total of 23,656 blood donors visited and donated blood, including 12,234 blood donors in the year 2019 and 11,422 blood donors in the year 2020. According to the analysis, only 1.4% of patients with HBV, 1.5% with HCV, and 0.03% were seropositive in the year 2020. In 2019, 1.6% HBV, 2.07% HCV, and 0.09% HIV blood donors were seropositive with a significant 0.00 p-value.

Conclusion: It is concluded that hepatitis C is the most commonly occurring in donors compared to HBV and HIV. HBV vaccines are available in Pakistan, which is why cases are fewer than HCV.

Hepatitis and HIV Co-infection at University of Gondar Specialized Referral Hospital: Northwest Ethiopia

BACKGROUND

Viral infections are the most common diseases. Of them, human immunodeficiency virus (HIV), hepatitis B viruses (HBV), and hepatitis C viruses (HCV) are common. When HBV or HCV becomes co-morbid with HIV, they lead to severe forms of a disease and rapid death.

OBJECTIVE

This study aimed to determine the seroprevalence and associated factors of HBV and HCV among HIV-positive study participants.

METHODS

A cross-sectional study was conducted among 81 individuals, and a non-randomized purposive sampling technique was used. From each study participant, sociodemographic and clinical data were gathered by using a pretested questionnaire and data collection sheet, respectively. Further, a venous blood sample was collected for viral load count, and HBV and HCV determination. To keep the quality of test results, commercially prepared quality control samples were used. The data were entered to EPI-Info version 7 and analyzed by using SPSS version 20. The descriptive data were summarized in percentages, median, and IQR. Logistic regression was analyzed to determine associated factors. To say the data were statistically significant, the p-values should be less than 0.05.

RESULTS

A total of 81 study participants were included. Of them, 56.8% (46/81) and 67.9% (55/81) were female and urban residents, respectively. The prevalence of hepatitis co-infection was 21% (95% CI: 17%, 23%). Further, the prevalence of HBV/HIV and HCV/HIV was 13.5% (95% CI: 10.5%, 16.5%) and 8.6% (95% CI: 5.6%, 11.6%), respectively. Wise use of highly active antiretroviral therapy (HAART) 0.01 (0.00, 0.213) was a preventive factor to hepatitis infection.

CONCLUSION AND RECOMMENDATION

The HBV and HCV co-infection among HIV-positive patients was a significant public health concern. Also, having wise use of HAART can reduce exposure to hepatitis co-infection. Therefore, clear strategies on hepatitis screening and wise use of HAART to HIV would be critical.

Knowledge, attitude and seropositivity of hepatitis B virus among blood donors in the Bamenda Regional Hospital Blood Bank, Cameroon

Introduction

despite the existence of a preventive vaccine against hepatitis B viral (HBV) infection, approximately 250 million people are infected with the virus worldwide. This study aimed at evaluating the level of knowledge, attitude and seropositivity of the disease among apparently healthy, potential blood donors at the blood service of the Bamenda Regional Hospital Blood Bank.

Methods

a cross-sectional study was carried out from March to May 2019 among 250 blood donors. Following screening for hepatitis B surface antigen (HBsAg) using the one-step HBsAg test strip, information on the level of knowledge and attitude towards the infection was obtained using a self-administered questionnaire. The correlation analysis was done to assess relationships between selected factors and knowledge of hepatitis B, p-value of 0.05 was considered as statistical significance.

Results

the seropositivity of HBV was 6.4% (n = 16). Overall, 46.8% (n = 19) of the study participants had adequate knowledge while 76.3% (n = 31) had a positive attitude toward the disease. The highest seropositivity was observed in singles (7.1%; n = 13), primary school leavers (14.3%; n = 5), unskilled laborers (14.5%; n = 8) and replacement donors (9.33%; n = 7). The probability of being hepatitis B seropositive was higher in males, students (aOR: 8.8, 95% CI 0.7-96.1; p = 0.046) and those who had attained higher education (aOR: 3.2, 95% CI 0.8-12.7; p = 0.016). Independent factors responsible for higher odds of inadequate knowledge were being a male and attaining secondary education. On the contrary, students (aOR: 0.3, 95% CI 0.1-0.8; p = 0.012) and those with a history of blood donation (aOR: 0.5, 95% CI 0.2-0.9; p = 0.042) recorded lower odds of inadequate knowledge.

Conclusion

the prevalence of hepatitis B among blood donors in this blood service is in the high intermediate category. Overall, the level of knowledge on this infection among these blood donors is average. These findings suggest that health education on HBV infection should be provided to the public as a major strategy to curb the infection.

Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia.

METHODS

Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg's Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I² statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics.

RESULTS

A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections.

CONCLUSION

The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.

Human Immunodeficiency Virus and Syphilis Among Blood Donors at Western Oromia, Ethiopia

Background

Blood transfusion saves lives and improves health, but many patients requiring transfusion do not have timely access to safe blood. Human immunodeficiency virus and syphilis are the commonest transfused transmitted infections and threats to blood recipients. Proper donor selection and screening of the donated blood for major transfusion-transmitted infections evidently reduced challenge in blood safety. Therefore, the objective of this study was to determine the sero-prevalence HIV and syphilis infections among blood donors at East Wollega, West Ethiopia.

Patients and Methods

A five-year (from January 2015 to December 2019) retrospective study was conducted by reviewing blood donor laboratory test results from Nekemte blood bank which is serving hospitals in Western Oromia. Blood donor data were analyzed by Statistical Package for Social Sciences version 20 software.

Results

The total of 17,810 individual’s blood was screened during the study period. The overall prevalence of HIV, syphilis, and their co-infection was 222 (1.25%), 142 (0.80%), and 5 (0.03%), respectively. The prevalence of HIV was associated with unmarried (AOR: 2.4; 95% CI: 1.5, 5.2), male (AOR: 2.1; 95% CI: 1.5, 2.9), and blood donors resident in a rural area (AOR: 1.5; 95% CI: 1.5, 5.9). Besides, the prevalence of syphilis was associated with education, age, marital status and residence of study participant.

Conclusion

In the current study, the sero-prevalence of HIV and syphilis among blood donors was low, when it was compared to other sub-Saharan Africa country. However, to ensure the health of all recipients screening blood using standard methods is highly recommended.

Seroprevalence of Hepatitis C Viral Infection in Ethiopia: A Systematic Review and Meta-Analysis

Background

Hepatitis C virus is a highly genetically heterogenous bloodborne pathogen that is responsible for acute and chronic hepatitis. Globally, an estimated 71 million population is chronically infected with this virus from which 399,000 people die every year. Its prevalence is high in Ethiopia and varies from region to region, even among different studies within a region.

Methods

Electronic databases, including Science Direct, Medline, HINARI, African Journals Online, TRIP database, African Index Medicus, and Directory of Open Access Journals, searched from 2010 to 2020 and published articles were included. Due to evidence of considerable heterogeneity, the pooled prevalence of anti-HCV was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, sensitivity analysis, and meta-regression. Funnel plots and Egger's test statistics were used to determine the presence of publication bias.

Results

The analysis of 56 articles showed that the prevalence of anti-HCV in Ethiopia ranged from 0% to 22%. The pooled prevalence estimated was 2% (95% CI 2.0–3.0), and the meta-regression statistics indicated that the diagnostic method (p=0.037), study group (p=0.005), and level of bias (p=0.035) showed statistically significant association with the outcome variable. The sensitivity analysis claims no influence on the overall effect estimate while removing a single study from the analysis at a time. Egger's test statistics (p ≤ 0.001) declare the presence of publication bias that is handled using time and fill analysis.

Conclusions

The pooled prevalence of anti-HCV in Ethiopia was high. Predictor variables, including the diagnostic method, study group, and level of bias, showed a statistically significant relationship with the outcome variable. Strengthening the scope of existing prevention and control programs and implementing novel approaches, including screen-and-treat, could significantly help to tackle this critical public health issue. The study provides a current estimate which is valuable for policymakers and other responsible bodies.

Seroprevalence of hepatitis c virus infection among blood donors in Ethiopia: a systematic review and meta-analysis

Background

Blood transfusion is one of the routine therapeutic interventions in hospitals that can be lifesaving. However, this intervention is related to several transfusion-related infections. Hepatitis C viral infection is one of the most common causes of transfusion-related hepatitis. Subsequently, this systematic review and meta-analysis was aimed to estimate the seroprevalence of hepatitis C virus infection among blood donors in Ethiopia.

Methods

PubMed, Google Scholar, Health InterNetwork Access to Research Initiative (HINARI), Excerpta Medica database (EMBASE), and Cochrane library, the web of science, African journal of online (AJOL), and Google Scholar was searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 14. Publication bias was checked by funnel plot, contour-enhanced funnel plots, trim and fill analysis and more objectively through Egger’s regression test, with P <  0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done by region and study period. A sensitivity analysis was employed.

Result

A total of 25 studies with 197,172 study participants were used to estimate the seroprevalence of hepatitis c virus among blood donors. The overall seroprevalence of hepatitis C virus was 0.819% (95% CI: 0.67–0.969; I2 = 92.3%). Regional sub-group analysis showed that the pooled prevalence of hepatitis c virus infection among blood donors found to be 0.563% in Somali, 1.08% in Oromia, 0.847% in Amhara, and 0.908% in south nations nationalities and peoples region.

Conclusion

The pooled seroprevalence of hepatitis C virus infection among blood donors in Ethiopia found to be low. Moreover, there should be systematic strategies that enhance donor screening and retention of safe regular donors.

Prevalence of Hepatitis B Virus and Hepatitis C Virus Among Blood Donors in Nekemte Blood Bank, Western Oromia, Ethiopia: Retrospective 5 Years Study

Background

Hepatitis B virus and hepatitis C virus are the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and trends of HBV and HCV infections among blood donors over a period of 5 years at Nekemte blood bank, Ethiopia.

Methods

A retrospective study was conducted from January 2015 to December 2019 at Nekemte blood bank. The recorded blood donors' history and laboratory tests were reviewed by data collectors analyzed with Statistical Package for the Social Sciences version 20 software. A p-value of less than 0.005 was considered statistically significant.

Results

A total of 17,810 consecutive blood donors were screened between January 2015 and December 2019. The seroprevalence of HBV and HCV was 3.06% and 0.64%, respectively. The prevalence of HBV was significantly associated with male (AOR: 2.51; 95% CI: 1.17, 2.91), unmarried (AOR: 2.81; 95% CI: 1.79, 2.51) and rural (AOR: 2.11; 95% CI: 1.17, 3.05) blood donors. The prevalence of HCV was significantly associated with blood donor those were male (AOR: 3.01; 95% CI: 1.17, 3.91), within 45-65 years of age (AOR: 3.56: 95% CI: 1.14, 3.99) and unmarried (AOR: 3.14; 95% CI: 1.65, 3.96).

Conclusion

The current study shows the prevalence of hepatitis B virus was higher among study participants. However, the prevalence of HCV was low compared to the study conducted in other countries in Africa, a substantial percentage of the blood donors harbor HCV infections. Therefore, it is recommended to increase awareness of people (particularly on unmarried, male and rural resident) on modes of transmission and prevention of infection could help in reducing the burden of both HBV and HCV.

Sero-prevalence of transfusion transmittable infections: HIV, Hepatitis B, C and Treponema pallidum and associated factors among blood donors in Ethiopia: A retrospective study

Background

Blood transfusion is a therapeutic procedure that has proven to be effective in saving millions of lives. However, its safety is still a crucial issue that needs due attention. Unsafe blood transfusion is one of the sources of transmission for infectious agents. Therefore, the objective of this study was to assess the sero-prevalence of Transfusion Transmittable Infections (TTIs) such as Human immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Treponema pallidum, and associated factors among blood donors in Ethiopia.

Methods

A retrospective cross-sectional study design was used to measure the prevalence of transfusion transmittable infections using data collected from 2014 to 2019 in fourteen blood bank facilities in Ethiopia. Screening of HIV, HBV and HCV was done by using the Enzyme-Linked Immunosorbent Assay (ELISA). Presence of Treponema pallidum infection was assessed using rapid plasma reagin (RPR). Records of blood donors were collected using a checklist from Central Blood Bank Laboratory (BBL) electronic database and reviewed. Data was entered, cleaned and analyzed using SPSS version 23. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity, and for each of the transfusion transmittable infection. P value < 0.05 was considered statistically significant.

Result

A total of 554,954 blood donors in the fourteen blood bank facilities from 2014–2019 was included in the study. The overall sero-prevalence of HBV, Treponema pallidum, HIV and HCV, was 2.4%, 0.9%, 0.4% and 0.4% respectively. The prevalence of TTIs was comparatively higher in 2014, 5.70% and lowest in 2019, 3.40%. The odds of screening HBV in blood donors in age group of 35–39 and 40–44 were 1.2 [1.1, 1.3] and 1.3 [1.1, 1.5] respectively. The odds of screening HCV in blood donors in the age group of 25–34, 35–44 and 45–54 were 1.3 [1.1, 1.5], 1.3 [1.1, 1.7] and 1.7 [1.2, 2.2] respectively. The likelihood of having at least one infection among blood donors was 1.2 [1.1, 1.3] times in male blood donors compared to female. The odds of getting at least one TTI and Treponema pallidum in unemployed blood donors were 2.4 [2.0, 2.8] and 8.1 [6.1, 10.7] respectively. The probability of getting those who have at least one TTIs, HBV and Treponema pallidum were higher in blood donors those who live in Semi Urban and Rural parts of the country than those who live in Urban areas. The odds of having at least one TTI, HBV and HCV in blood donors with mobile mode of blood donation were 1.4 [1.3, 1.6], 1.6 [1.4, 1.8], and 1.6 [1.1, 2.2].

Conclusion

The current magnitudes of TTIs are lower when compared to other previous studies conducted in Ethiopia. Older age, male, occupation, donations from mobile sites, residents of semi urban and rural settings were found to be strongly associated with sero-positivity of TTIs. Hence, strict donor screening and testing particularly taking the above factors into consideration is strongly recommended.

Barriers to Effective Transfusion Practices in Limited-Resource Settings: From Infrastructure to Cultural Beliefs

Background

Surgery and anesthesia are indivisible parts of health care, but safe and timely care requires more than operating rooms and skilled providers. One vital component of a functional surgical system is reliable blood transfusion. While almost half of all blood is donated in high-income countries (HICs), over eighty percent of the global population lives outside of these countries. High-income countries have on average 30 donations per 1000 people, and the average age of transfusion recipient is over 65. Most low-income countries (LICs) have fewer than five donations per 1000 people, where maternal hemorrhage and childhood anemia are the most common indications for transfusion. In LICs, greater than 50% of blood is administered to children under 5 years of age. This study aims to snapshot, by survey, available resources for transfusion and then discusses the infrastructure and cultural barriers to optimal transfusion practice.

Methods

In January 2019, a 10-question survey was sent electronically to physician anesthesiologists working in low- and middle-income countries to examine resources and practice patterns for blood transfusion. Subsequent discussions illustrate obstacles contributing to low availability of blood products and illuminate infrastructure and cultural barriers preventing optimal transfusion practices.

Survey Results

Acquiring whole blood takes hours. Clinicians wait days to receive packed red blood cells or platelets. Fresh frozen plasma is available but untimely. For many, protocols for massive transfusion are rare, and for transfusion, ratios are nonexistent. Complete blood counts take hours, and coagulation profiles are severely delayed.

Discussion of Infrastructure and Cultural Barriers

With few voluntary, unpaid, donors and inconsistent supply of testing kits, donated blood is unsafe. Donors are seasonal for farming communities, endemic malaria areas, and student donors recruited through schools. Cultural beliefs fuel distrust. Transfusion specialists, concentrated in urban areas, see rural patients presenting late. Inadequate triaging and supervision jeopardize patients to shock. Inadequate blood storage leads to waste. Modeling systems from HICs fail to overcome hurdles faced by clinicians working with distinctive belief systems and unique patient populations.

An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia

Background

Hepatitis B virus is one of the major public health concerns globally. It is highly infectious and can be transmitted from person to person through vertically or horizontally via contaminated body fluids. Despite the provision of an effective vaccine, it remains a major problem worldwide, particularly among the developing countries.

Methods

Online electronic databases including PubMed, Google Scholar, Science Direct, African Index Medicus, African Journals Online, and WHO Afro Library were searched and published articles from 2010 to June 8, 2019, were considered. Both authors independently screened articles and extracted the data. Funnel-Plots and Egger’s test statistics were used to determine the presence of small-study effects and publication bias. The pooled prevalence of HBV was analyzed using the random-effects model. The possible sources of heterogeneity was analyzed through subgroup analysis, sensitivity analysis, and meta-regression.

Results

The overall pooled prevalence of HBV was 6% and among subgroups, pregnant women, healthcare workers, and HIV positive patients accounted for 5% for each group. Relatively low prevalence (4%) was obtained among blood donors. The Egger’s test statistics (p = 0.747) indicated the absence of publication bias. In addition, from the sensitivity analysis, there was no influence on the overall effect estimate while removing a single study at a time. The level of heterogeneity was reduced among pregnant women, HIV positive and studies with unknown sampling techniques. After conducting meta-regression, province, study group, screening method, and quality of papers were identified as sources of heterogeneity.

Conclusions

The overall pooled prevalence of HBV in Ethiopia was high. Strengthening and scaling up of the scope of the existing vaccination program and implementing novel approaches including screen-and-treat could be implemented to reduce the burden of the disease. Generally, the study can provide current prevalence estimate of HBV that could vital for intervention to tackle the disease.