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Musafiri T, Kamali I, Kayihura C, de la Paix Gakuru J, Nyirahabihirwe F, Nizeyimana E, Kandamage P, Habinshuti P, Sekagarura R, Makuza JD, Karema N, Serumondo J, Ntakirutimana T, Ndahimana JD, Barnhart DA. Prevalence of hepatitis B and C infection and linkage to care among patients with Non-Communicable Diseases in three rural Rwandan districts: a retrospective cross-sectional study. BMC Infect Dis 2024; 24:247. [PMID: 38388353 PMCID: PMC10885378 DOI: 10.1186/s12879-023-08678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 10/06/2023] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Rwanda's Hepatitis C elimination campaign has relied on mass screening campaigns. An alternative "micro-elimination" strategy focused on specific populations, such as non-communicable disease (NCD) patients, could be a more efficient approach to identifying patients and linking them to care. METHODS This retrospective cross-sectional study used routine data collected during a targeted screening campaign among NCD patients in Kirehe, Kayonza, and Burera districts of Rwanda and patients receiving oncology services from the Butaro District Hospital. The campaign used rapid diagnostic tests to screen for Hepatitis B surface antigen (HBsAg) and Hepatitis C antibody (anti-HCV). We reported prevalences and 95% confidence intervals for HBsAg and anti-HCV, assessed for associations between patients' clinical programs and hepatitis B and C, and reported cascade of care for the two diseases. RESULTS Out of 7,603 NCD patients, 3398 (45.9%) self-reported a prior hepatitis screening. Prevalence of HBsAg was 2.0% (95% CI: 1.7%-2.3%) and anti-HCV was 6.7% (95% CI: 6.2%-7.3%). The prevalence of HBsAg was significantly higher among patients < 40 years (2.4%). Increased age was significantly associated with anti-HCV (12.0% among patients ≥ 70 years). Of the 148 individuals who screened positive for HbsAg, 123 had viral load results returned, 101 had detectable viral loads (median viral load: 451 UI/mL), and 12 were linked to care. Of the 507 individuals who screened positive for anti-HCV, 468 had their viral load results returned (median viral load: 1,130,000 UI/mL), 304 had detectable viral loads, and 230 were linked to care. CONCLUSION Anti-HCV prevalence among Rwandan patients with NCD was high, likely due to their older age. NCD-HCV co-infected patients had high HCV viral loads and may be at risk of poor outcomes from hepatitis C. Hepatitis C micro-elimination campaigns among NCD patients are a feasible and acceptable strategy to enhance case detection in this high-prevalence population with elevated viral loads and may support linkage to care for hepatitis C among elderly populations.
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Affiliation(s)
- Tumusime Musafiri
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
- Department of Public Health, Mount Kenya University, Kigali, Rwanda.
| | | | | | | | | | | | | | | | - Raymond Sekagarura
- Ministry of Health, Butaro District Hospital Cancer Center of Excellence, Burera, Rwanda
| | - Jean Damascene Makuza
- Rwanda Biomedical Centre, HIV, STIs, Viral Hepatitis and OVDC Division, Kigali, Rwanda
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Nadine Karema
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda
| | - Janvier Serumondo
- Rwanda Biomedical Centre, HIV, STIs, Viral Hepatitis and OVDC Division, Kigali, Rwanda
| | - Theoneste Ntakirutimana
- Department of Public Health, Mount Kenya University, Kigali, Rwanda
- School of Public Health, College of Medecine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Dale A Barnhart
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Laterite Data, Research, and Analytics, Nairobi, Kenya
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Faghihi SH, Azarbakhsh H, Piraee E. Epidemiological study of hepatitis B and hepatitis C infection in Kohgiluyeh and Boyer-Ahmad province (Iran) from 2008 to 2021: A cross-sectional study. Health Sci Rep 2024; 7:e1812. [PMID: 38328787 PMCID: PMC10848580 DOI: 10.1002/hsr2.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 02/09/2024] Open
Abstract
Background and Aims Viral hepatitis is one of the top five reasons people die from infections all around the world. The present study aimed to assess the epidemiological features of hepatitis B and hepatitis C infections in Kohgiluyeh and Boyer-Ahmad province. Methods The data were obtained via the census method from the registered hepatitis B and hepatitis C data in the reportable disease care system of Yasuj University of Medical Sciences. The collected data are the result of serological tests. The χ 2 test was used to evaluate the important risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. The joinpoint regression was performed to investigate the trend of HBV and HCV in recent years. Results Here, 1270 cases of hepatitis B and C were identified and reported in Kohgiluyeh and Boyer-Ahmad province from 2008 to 2021. The median age of patients was 38 (interquartile range: 31-51), varying significantly according to the type of hepatitis. The most common hepatitis in males was hepatitis C and in females, hepatitis B. Regarding the place of residence, HBV and HCV were both more prevalent in urban areas. The age group of 25-34 years has the highest prevalence of HBV and HCV. According to the joinpoint regression analysis, there is a decrease in the 14-year trend of incidence rate due to total hepatitis B and C: the annual percent change was -5.2% (95% confidence interval [CI]: -8.4 to -1.9, p = 0.005) for hepatitis B and -0.2% (95% CI: -10.7 to 11.6, p = 0.976) for hepatitis C. Conclusion This study shows the incidence rate of hepatitis B has been decreasing during the years of study but this trend has been stable for hepatitis C. Also, the highest number of cases of hepatitis B and C were reported in the age groups of 25-34 years. Hence, preventive interventions are vital in reducing the burden of these diseases.
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Affiliation(s)
- Sayed H. Faghihi
- Department of Epidemiology, Faculty of Health, Social Determinants of Health Research CenterYasuj University of Medical SciencesYasujIran
| | - Habibollah Azarbakhsh
- Department of Epidemiology, Faculty of HealthAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Elahe Piraee
- Department of Epidemiology, Faculty of Health, Social Determinants of Health Research CenterYasuj University of Medical SciencesYasujIran
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Lebbie W, Allan-Blitz LT, Nyama ET, Swaray M, Lavalie D, Mhango M, Patiño Rodriguez M, Gupta N, Bitwayiki R. Barriers to longitudinal follow-up for hepatitis B treatment in rural Sierra Leone: A mixed methods study of retention in care. Clin Liver Dis (Hoboken) 2024; 23:e0225. [PMID: 38831767 PMCID: PMC11146505 DOI: 10.1097/cld.0000000000000225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/03/2024] [Indexed: 06/05/2024] Open
Abstract
HBV disproportionately affects resource-limited settings, and retaining patients in longitudinal care remains challenging. We conducted a mixed methods investigation to understand the causes of losses to follow-up within an HBV clinic in rural Sierra Leone. We developed a multivariable logistic regression model of baseline clinical and sociodemographic factors predicting losses to follow-up, defined as failing to present for a follow-up visit within 14 months of enrollment. We included patients enrolled between April 30, 2019 and March 1, 2020, permitting 14 months of follow-up by April 30, 2021. We then developed a survey to solicit patient perspectives on the challenges surrounding retention. We interviewed randomly selected patients absent from HBV care for at least 6 months. Among 271 patients enrolled in the Kono HBV clinic, 176 (64.9%) did not have a follow-up visit within 14 months of the study end point. Incomplete baseline workup (aOR 2.9; 95% CI: 1.6-4.8), lack of treatment at baseline (aOR 5.0; 95% CI: 1.7-14.4), and having cirrhosis at baseline (aOR 3.3; 95% CI: 0.99-10.8) were independently associated with being lost to follow-up. For the patient survey, 21 patients completed the interview (median age 34 years [IQR: 25-38]). Travel-related factors were the most frequently reported barrier to retention (57%). Almost 30% suggested improved customer care might support retention in care; 24% requested to be given medication. In our setting, factors that might reduce losses to follow-up included expanded criteria for treatment initiation, overcoming transportation barriers, reducing wait times, ensuring against stockouts, and scaling up point-of-care testing services.
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Affiliation(s)
| | - Lao-Tzu Allan-Blitz
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Mohamed Swaray
- Partners In Health, Freetown, Sierra Leone, Britannica, WA
| | - Daniel Lavalie
- Ministry of Health and Sanitation, Freetown, Sierra Leone, Britannica, WA
| | - Michael Mhango
- Partners In Health, Freetown, Sierra Leone, Britannica, WA
| | | | - Neil Gupta
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Remy Bitwayiki
- Partners In Health, Freetown, Sierra Leone, Britannica, WA
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Asgedom YS, Kassie GA, Woldegeorgis BZ, Meskele Koyira M, Kebede TM. Seroprevalence of hepatitis B virus infection and factors associated among pregnant women in Ethiopia: A systematic review and meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241235881. [PMID: 38444072 PMCID: PMC10916469 DOI: 10.1177/17455057241235881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/24/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hepatitis B virus infection is a major public health problem among pregnant women worldwide. Hepatitis B virus is highly infectious and is the most common cause of morbidity and mortality among pregnant women, and evidence is scarce on the pooled seroprevalence of hepatitis B virus in Ethiopia. OBJECTIVES This study aimed to investigate the pooled seroprevalence of hepatitis B virus infection and factors associated with pregnant women in Ethiopia. DESIGN A systematic review and meta-analysis was employed in accordance with the Preferred Reporting Items for Systematic Reviews. DATA SOURCES Searches were carried out in biomedical databases such as PubMed/Medline, Science Direct, Web of Science, Google Scholar, Hinari, and the Cochrane Library published in English until June 2023. METHODS Observational study designs were selected. Endnote citation manager was used to collect and organize the search outcomes and remove duplicate articles. The data were extracted using a Microsoft Excel spreadsheet and exported to STATA 16.0 software for the analysis. RESULTS A total of 48 research articles were included in the final analysis. The pooled estimated sero prevalence of hepatitis B virus infection among pregnant women in Ethiopia was 5.78% (95% confidence interval = 5.14, 6.43). History of abortion (odds ratio = 6.56, 95% confidence interval = 4.88, 8.90), history of blood transfusion (odds ratio = 5.74, 95% confidence interval = 4.04, 8.16), history of hospitalization (odds ratio = 5.40, 95% confidence interval = 3.68, 7.94), history of multiple sexual partner (odds ratio = 5.80, 95% confidence interval = 3.71, 9.05), history of surgical procedure (odds ratio = 7.39, 95% confidence interval = 4.16, 13.14), history of tattooing (odds ratio = 4.59, 95% confidence interval = 2.83, 7.43), and history of tooth extraction (odds ratio = 4.46, 95% confidence interval = 2.42, 8.22) were significantly associated with hepatitis B virus infection among pregnant women in Ethiopia. CONCLUSION The overall pooled prevalence of hepatitis B virus infection among pregnant women in Ethiopia is relatively high. Having a history of abortion, blood transfusion, hospitalization, multiple sexual partners, surgical procedures, tattooing, and tooth extraction were found to be risk factors for hepatitis B virus. Therefore, extensive screening programs for hepatitis B virus in all pregnant women in Ethiopia are needed to prevent further infection and decrease the vertical transmission caused by the disease. REGISTRATION NUMBER PROSPERO CRD: 42023438522.
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Cam Huong NT, Van Luu N, Nam NH, Ghula S, Atieh Qarawi AT, Mai Truc PT, Trung An DN, Huy NT, Le Hoa PT. Prevalence of hepatitis B virus infection in health check-up participants: a cross-sectional study at University Medical Center, Ho Chi Minh City, Vietnam. Hosp Pract (1995) 2023. [PMID: 37262352 DOI: 10.1080/21548331.2023.2221132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/31/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Vietnam is one of the countries in highly endemic areas of hepatitis B virus (HBV) infection in the world. Our study aims to determine the prevalence of HBV infection among different age groups of workers who had been included for annual general health checkups. METHODS This cross-sectional study was conducted at the Health Screening Department, University Medical Center at Ho Chi Minh City, Vietnam, using anonymous data from employees who had health checkups from June 2017 to June 2018. RESULTS A total of 5727 subjects were included, with an overall HBV prevalence of 9.0%. The prevalence of HBV infection was significantly higher in men and lowest in the age groups of 18-30. In multivariable analysis, the variables that were independently associated with HBV infection were male gender (Odd ratio (OR), 2.03; 95% confidence interval (CI), 1.58-2.60; p < 0.001), older than 30 years old (age group of 31-40: OR 1.7; 95% CI, 1.33-2.18; p < 0.001; of 41-50, OR 1.82; 95% CI, 1.37-2.43; p < 0.001); high total cholesterol (OR, 0.77; 95% CI, 0.64-0.94; p = 0.011), high triglyceride (OR, 0.53; 95% CI, 0.42-0.65; p < 0.001), and having significant fibrosis (OR, 2.7; 95% CI 1.85-3,95; p < 0.001). CONCLUSIONS The prevalence of HBV infection among employees on health assessments is still high (9%), even in the age group under 30 (7%). Male, age group older than 30, and significant liver fibrosis were the factors related to HBV infection. High cholesterol and level triglyceride were protective factors against HBV infection.
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Affiliation(s)
- Nguyen Thi Cam Huong
- Infectious Diseases Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City, Vietnam
| | - Nguyen Van Luu
- Infectious Diseases Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Hai Nam
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
| | - Suhaib Ghula
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- Medical School, University of Buckingham, Buckingham, UK
| | - Ahmad Taysir Atieh Qarawi
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- Lower Westchester Medical Associate, New York, P.C. Mount Vernon, USA
| | - Pham Thi Mai Truc
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- Imaging Diagnostic Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dang Nguyen Trung An
- Imaging Diagnostic Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Health Screening Department, University Medical Center, Ho Chi Minh City, Vietnam
| | - Nguyen Tien Huy
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Pham Thi Le Hoa
- Infectious Diseases Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City, Vietnam
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Şahin M, Yazla M. Change in Rates of HBsAg and Anti-HBs in Şırnak 20 Years After Introduction of Hepatitis B Vaccine into Routine Infant Immunization Program. INFECTIOUS DISEASES & CLINICAL MICROBIOLOGY 2023; 5:153-157. [PMID: 38633007 PMCID: PMC10986700 DOI: 10.36519/idcm.2023.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/23/2023] [Indexed: 04/19/2024]
Abstract
Objectives This study aimed to monitor the change in the rate of hepatitis B infections in Şırnak, a province in south-eastern Turkey, and to determine the rate of immunization for hepatitis B in this region after the national immunization program covered hepatitis B. Materials and Methods This retrospective study included patients born in 1998 or after and applied to different outpatient clinics in the province between April 2017 and June 2018. Patients in this study were screened for HBsAg and anti-HBs for various reasons. We analyzed confirmed HBsAg and anti-HBs positive results according to gender, age, and vertical transmission. Anti-HBs-positive patients were divided into four groups according to their ages, and the groups were compared. Results Out of 2713 patients, 1530 (56.4%) were male, and the mean age was 12.77 (0-20). Four patients (0.14%) were HBsAg positive, and the anti-HBs positivity rate was 61.22%. The difference was statistically significant when the anti-HBs positivity rate was compared between the age groups (p<0.001). The highest anti-HBs positivity rate was found in the 0 to 5 age group. Conclusion There has been a significant decrease in hepatitis B virus infection rates after introducing the hepatitis B vaccine into routine infant immunization programs. The widespread introduction of hepatitis B vaccination should be targeted in Turkey, considering its geographical and sociocultural diversity.
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Affiliation(s)
- Meyha Şahin
- Clinic of Infectious Diseases and Clinical Microbiology, İstanbul Medipol University Medipol Mega Hospital, İstanbul, Turkey
| | - Meltem Yazla
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
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The Cascade of Care for Hepatitis C Treatment in Rwanda: A Retrospective Cohort Study of the 2017–2019 Mass Screening and Treatment Campaign. Viruses 2023; 15:v15030661. [PMID: 36992370 PMCID: PMC10056983 DOI: 10.3390/v15030661] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
Access to hepatitis C (HCV) testing and treatment is still limited globally. To address this, the Government of Rwanda launched a voluntary mass screening and treatment campaign in 2017. We studied the progression of patients through the cascade of HCV care during this campaign. We conducted a retrospective cohort study and included all patients screened at 46 hospitals between April 2017 and October 2019. We used hierarchical logistic regression to assess factors associated with HCV positivity, gaps in care, and treatment failure. A total of 860,801 people attended the mass screening during the study period. Some 5.7% tested positive for anti-HCV, and 2.9% were confirmed positive. Of those who were confirmed positive, 52% initiated treatment, and 72% of those initiated treatment, completed treatment and returned for assessment 12 weeks afterward. The cure rate was 88%. HCV positivity was associated with age, socio-economic status, sex, marital status, and HIV coinfection. Treatment failure was associated with cirrhosis, baseline viral load, and a family history of HCV. Our results suggest that future HCV screening and testing interventions in Rwanda and other similar settings should target high-risk groups. High dropout rates suggest that more effort should be put into patient follow-up to increase adherence to care.
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Makokha GN, Zhang P, Hayes CN, Songok E, Chayama K. The burden of Hepatitis B virus infection in Kenya: A systematic review and meta-analysis. Front Public Health 2023; 11:986020. [PMID: 36778557 PMCID: PMC9909240 DOI: 10.3389/fpubh.2023.986020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Background Chronic Hepatitis B virus (HBV) infection causes liver cirrhosis and cancer and is a major public health concern in Kenya. However, so far no systematic review and meta-analysis has been conducted to estimate the burden of disease in the country. A better understanding of HBV infection prevalence will help the government implement efficient strategies at eliminating the disease. This systematic review and meta-analysis was therefore conducted to summarize and update the available information on the burden of HBV in Kenya. Method We systematically searched PubMed, Science Direct, Web of Science, Scopus, African Journals OnLine, and Google Scholar databases to retrieve primary studies conducted between January 1990 and June 2021 that assessed the prevalence of HBV infection in Kenya based on measurement of the Hepatitis B Surface Antigen (HBsAg). Meta-analysis was performed using the random effects model where HBsAg prevalence was estimated at a 95% confidence interval (CI) after simple pooling analysis. Potential sources of heterogeneity were also investigated. Results Fifty studies were included in the meta-analysis with a sample size of 108448. The overall pooled prevalence estimate of HBV in Kenya was 7.8% (95% CI: 5.8-10.1). Subgroup analysis revealed the highest prevalence among patients presenting with jaundice at 41.7% (95% CI: 13.5-73.3) whereas blood donors had the lowest prevalence at 4.1% (95% CI: 2.4-6.3). Prevalence in Human Immunodeficiency Virus (HIV)-infected individuals was 8.2% (95% CI: 5.8-11.0). An estimate of the total variation between studies revealed substantial heterogeneity (I2 = 99%) which could be explained by the study type, the risk status of individuals, and the region of study. Conclusion We present the first systematic review and meta-analysis of the prevalence of HBV in Kenya. Our results show that the burden of HBV in Kenya is still enormous. This calls for an urgent need to implement public health intervention measures and strategic policies that will bring the disease under control and lead to final elimination. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=264859, identifier: CRD42021264859.
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Affiliation(s)
- Grace Naswa Makokha
- Laboratory of Medical Innovation, Department of Collaborative Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan,*Correspondence: Grace Naswa Makokha ✉
| | - Peiyi Zhang
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - C. Nelson Hayes
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Elijah Songok
- Graduate School of Health Sciences, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Kazuaki Chayama
- Laboratory of Medical Innovation, Department of Collaborative Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Tazinkeng NN, Teuwafeu DG, Asombang AW, Agbor VN, Bloom SM, Nkhoma AN, Mohareb AM, Luma HN. Factors associated with hepatitis B and C among adults in Buea, Cameroon: A community-based cross-sectional study. Liver Int 2022; 42:2396-2402. [PMID: 35946051 DOI: 10.1111/liv.15390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/23/2022] [Accepted: 08/08/2022] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Viral hepatitis is a major cause of death in Africa. A paucity of community-based studies on the determinants of viral hepatitis in Africa impedes efforts to appropriately target prevention, screening, and treatment interventions. We assessed factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) in a semi-urban health district in Cameroon. METHODS We conducted a community-based, cross-sectional study from 28 February to 15 May 2021 in the Buea Health District in Buea, Cameroon. We recruited a sample of consenting individuals aged over 15 years old. Participants were surveyed for factors associated with HBV/HCV and were screened for HBV surface antigen (HBsAg) and HCV antibody using rapid point-of-care tests. We performed univariable and multivariable logistic regression analyses to identify factors associated with HBsAg and HCV seropositivity. RESULTS We screened 1144 participants (66% female) with a median age of 30 years (IQR: 23-44). HBsAg prevalence was 5.7% (95%CI: 4.5-7.2%) and HCV seropositivity was 1.9% (95%CI: 1.3-2.9%). Three people (0.3%) were seropositive for both HBsAg and HCV antibody. Male sex (adjusted OR [aOR] = 2.31; 95%CI: 1.28-4.18) and a history of traditional operation or scarification (aOR = 2.87; 95%CI: 1.67-4.92) were associated with HBsAg. None of the assessed factors was significantly associated with HCV antibody. CONCLUSION Men and participants with a history of traditional operation and scarification had higher odds of HBsAg. We did not observe any associations with HCV seropositivity. Prevention and screening efforts among adults in this setting should prioritize men and those with a history of traditional operation and scarification.
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Affiliation(s)
- Nkengeh N Tazinkeng
- Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Pan-African Organization for Health, Education and Research, Manchester, Missouri, USA.,Department of Population Health Research, Health Education and Research Organization (HERO), Buea, Cameroon.,Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Denis G Teuwafeu
- Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Department of Internal Medicine, Buea Regional Hospital, Buea, Cameroon
| | - Akwi W Asombang
- Pan-African Organization for Health, Education and Research, Manchester, Missouri, USA.,Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Valirie N Agbor
- Department of Population Health Research, Health Education and Research Organization (HERO), Buea, Cameroon.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Seth M Bloom
- Pan-African Organization for Health, Education and Research, Manchester, Missouri, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA.,Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
| | - Alick N Nkhoma
- Pan-African Organization for Health, Education and Research, Manchester, Missouri, USA.,University Hospital of the North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Amir M Mohareb
- Harvard Medical School, Boston, Massachusetts, USA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
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Al-Matary AM, Al Gashaa FAS. Comparison of different rapid screening tests and ELISA for HBV, HCV, and HIV among healthy blood donors and recipients at Jibla University Hospital Yemen. J Med Life 2022; 15:1403-1408. [PMID: 36567845 PMCID: PMC9762378 DOI: 10.25122/jml-2022-0051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/21/2022] [Indexed: 12/27/2022] Open
Abstract
Blood transfusion is associated with many risks, especially exposure to blood transfusion-transmitted infections considered one of the main causes of death worldwide, including hepatitis B (HBV) and C virus (HCV) and human immunodeficiency virus (HIV). The threat posed by blood-borne pathogens is disproportionately high, especially in developing countries, so there is a need for continuous monitoring of blood transfusions to prevent transmitting diseases. Rapid diagnostic immunochromatographic technique (ICT) methods are the most widely used methods in developing countries, although ELISA and molecular testing are considered more accurate worldwide. Therefore, the study aimed to compare the analytical sensitivity between rapid tests and the ELISA method for detecting HBV, HCV, and HIV infection among blood donors. Four hundred (400) blood donor samples were tested using the Rapid Test Kits (INTEC, SD, ABON, and CLUN), and the ELISA method was used as a confirmatory test. Out of 400 blood samples tested for viral infection, HBV, HCV, and HIV were detected in 8, 10, and 2 samples, respectively, using the ELISA technique. This study observed that the rate of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in addition to determining the diagnostic accuracy rate and error rate for all rapid diagnostic kits in detecting HBV, HCV and HIV are less accurate and associated with more false negatives compared to the ELISA technique. This study showed a significant difference in sensitivity between ELISA and rapid diagnostic immunochromatographic technique (ICT) groups; therefore, rapid diagnosis is not suitable for testing the quality of infectious markers for blood donors.
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Affiliation(s)
| | - Fadhl Ahmed Saed Al Gashaa
- Department of Biology, Al Farabi University College, Baghdad, Iraq,Department of Medical Microbiology, College of Science, Ibb University, Ibb, Yemen,Corresponding Author: Fadhl Ahmed Saed Al Gashaa, Department of Biology, Al Farabi University College, Baghdad, Iraq. Department of Medical Microbiology, College of Science, Ibb University, Ibb, Yemen. E-mail:
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11
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Estimating Prevalence of Hepatitis B Virus Coinfection Among Adults With Tuberculosis: A Systematic Review With Meta-analysis. J Clin Gastroenterol 2022; 56:601-617. [PMID: 34009841 DOI: 10.1097/mcg.0000000000001533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/15/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND While patients with hepatitis B virus (HBV) infection and tuberculosis (TB) have similar risk factors, little is known regarding the prevalence of HBV and TB coinfection. We aim to evaluate the prevalence of HBV among patients with TB across world regions. METHODS We systematically reviewed the literature using PubMed from inception through September 1, 2019, to identify studies that provided data to calculate HBV coinfection prevalence among adults with TB infection. Prevalence estimates of HBV coinfection among TB patients were stratified by world regions and calculated using meta-analyses with random-effects models. RESULTS A total of 36 studies met inclusion criteria (4 from the Africa region, 6 from the Americas region, 5 from the Eastern Mediterranean region, 2 from European region, 6 from Southeast Asia region, and 13 from the Western Pacific region). On meta-analysis, overall pooled HBV coinfection prevalence among TB patients was 7.1%, but varied by world region. Region-specific pooled HBV prevalence among TB patients was highest in Africa region [11.4%, 95% confidence interval (CI): 3.45-19.31] and Western Pacific region (10.8%, 95% CI: 8.68-12.84), and was lowest in the Americas (2.2%, 95% CI: 0.78-3.53). Sensitivity analyses yielded similar HBV prevalence estimates across world regions. CONCLUSIONS In this meta-analysis, we observed HBV coinfection prevalence among TB patients to be 38% to 450% higher than published estimates from the Polaris group of region-specific overall HBV prevalence. Timely identification of HBV infection among TB patients will improve patient outcomes by allowing for closer clinical monitoring and management, which may reduce the risk of liver dysfunction and liver failure related to TB treatment.
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12
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Skrlec I, Talapko J. Hepatitis B and circadian rhythm of the liver. World J Gastroenterol 2022; 28:3282-3296. [PMID: 36158265 PMCID: PMC9346465 DOI: 10.3748/wjg.v28.i27.3282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/15/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
The circadian rhythm in humans is determined by the central clock located in the hypothalamus’s suprachiasmatic nucleus, and it synchronizes the peripheral clocks in other tissues. Circadian clock genes and clock-controlled genes exist in almost all cell types. They have an essential role in many physiological processes, including lipid metabolism in the liver, regulation of the immune system, and the severity of infections. In addition, circadian rhythm genes can stimulate the immune response of host cells to virus infection. Hepatitis B virus (HBV) infection is the leading cause of liver disease and liver cancer globally. HBV infection depends on the host cell, and hepatocyte circadian rhythm genes are associated with HBV replication, survival, and spread. The core circadian rhythm proteins, REV-ERB and brain and muscle ARNTL-like protein 1, have a crucial role in HBV replication in hepatocytes. In addition to influencing the virus’s life cycle, the circadian rhythm also affects the pharmacokinetics and efficacy of antiviral vaccines. Therefore, it is vital to apply antiviral therapy at the appropriate time of day to reduce toxicity and improve the effectiveness of antiviral treatment. For these reasons, understanding the role of the circadian rhythm in the regulation of HBV infection and host responses to the virus provides us with a new perspective of the interplay of the circadian rhythm and anti-HBV therapy. Therefore, this review emphasizes the importance of the circadian rhythm in HBV infection and the optimization of antiviral treatment based on the circadian rhythm-dependent immune response.
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Affiliation(s)
- Ivana Skrlec
- Department of Biophysics, Biology, and Chemistry, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Jasminka Talapko
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, Osijek 31000, Croatia
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13
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Saha Turna N, Havelaar A, Adesogan A, Wu F. Aflatoxin M1 in milk does not contribute substantially to global liver cancer incidence. Am J Clin Nutr 2022; 115:1473-1480. [PMID: 35470382 DOI: 10.1093/ajcn/nqac033] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 02/02/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND For 60 y, it has been known that aflatoxin B1 (AFB1), a mycotoxin produced by Aspergillus fungi in certain food and feed crops, causes hepatocellular carcinoma (liver cancer; HCC) in humans. The annual global burden of AFB1-related HCC has been estimated. However, much less is known about the potential carcinogenic impact of a metabolite of AFB1 called aflatoxin M1 (AFM1), which is secreted in milk when dairy animals consume AFB1-contaminated feed. The cancer risk of AFM1 to humans from milk consumption has not yet been evaluated. OBJECTIVES We sought to estimate the global risk of AFM1-related liver cancer through liquid milk consumption, accounting for possible synergies between AFM1 and chronic infection with hepatitis B virus (HBV) in increasing cancer risk. METHODS We conducted a quantitative cancer risk assessment by analyzing extensive datasets of national population sizes, dairy consumption patterns, AFM1 concentrations in milk in 40 nations, and chronic HBV prevalence. Two separate cancer risk assessments were conducted: assuming a possible synergy between AFM1 and HBV in increasing cancer risk in a manner similar to that of AFB1 and HBV, and assuming no such synergy. RESULTS If there is no synergy between AFM1 and HBV, AFM1 may contribute ∼0.001% of total annual HCC cases globally. If there is synergy between AFM1 and HBV infection, AFM1 may contribute ∼0.003% of all HCC cases worldwide. In each case, the total expected AFM1-attributable cancer cases are ∼13-32 worldwide. CONCLUSION AFM1 exposure through liquid milk consumption does not substantially increase liver cancer risk in humans. Policymakers should consider this low risk against the nutritional benefits of milk consumption, particularly to children, in a current global situation of milk being discarded because of AFM1 concentrations exceeding regulatory standards.
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Affiliation(s)
- Nikita Saha Turna
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI, USA.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Arie Havelaar
- Department of Animal Sciences, University of Florida, Gainesville, FL, USA.,Food Systems Institute, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Adegbola Adesogan
- Department of Animal Sciences, University of Florida, Gainesville, FL, USA.,Food Systems Institute, University of Florida, Gainesville, FL, USA
| | - Felicia Wu
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI, USA.,Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, USA
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14
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Nyirahabihirwe F, Kamali I, Barnhart DA, Gakuru JDLP, Musafiri T, Rwamuhinda DD, Mutabazi P, Mukayirabuka S, Makuza JD, Kassim N, Mubiligi JM, Ndahimana JD, Kateera F. Implementation of Refugees' Inclusion in National Viral Hepatitis B and Hepatitis C Screening Campaign in Mahama Refugee Camp, Rwanda. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00349. [PMID: 35487545 PMCID: PMC9053140 DOI: 10.9745/ghsp-d-21-00349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/15/2022] [Indexed: 12/22/2022]
Abstract
Conducting a high-quality mass screening campaign for Hepatitis B virus and Hepatitis C virus was a feasible, effective, and low-cost strategy to integrate refugees into Rwanda's national hepatitis prevention and management program. Introduction: The World Health Organization has called for the elimination of hepatitis B virus (HBV) and hepatitis C virus (HCV) as public health threats by 2030. In response to the United Nations High Commissioner for Refugees requests, Rwanda became the first country to include refugees in its national viral hepatitis prevention and management program in 2019. We used secondary data to describe the implementation of the first HBV and HCV screening program among refugees in Rwanda. Methods: Rapid diagnostic tests were used to screen for HBV surface antigen (HBsAg) and HCV antibody (anti-HCV). We used routine data collected during the HBV and HCV mass screening campaign among Burundian refugees living in Mahama camp and program records to estimate the screening coverage, the prevalence of HBV and HCV, and the cost of the campaign. Results: Over 28 days in February and March 2020, 26,498 unique individuals were screened for HBV and HCV, reflecting a screening coverage of 77.9% (95% confidence interval [CI]=76.5%, 78.4%). Coverage was greater than 90% among women aged 30–64 years, but younger age groups and men were less likely to be screened. On average, 946 clients were screened per day. The prevalence of anti-HCV was 1.1% (95% CI=1.0%, 1.3%), and the prevalence of HBsAg was 3.8% (95% CI=3.6%, 4.0%). We estimate that the total cost of the campaign was US$177,336.60, reflecting a per-person-screened cost of US$6.69. Conclusion: Conducting a mass screening was a feasible and effective strategy to achieve high screening coverage and identify refugees who were eligible for HBV and HCV treatment. This screening program in the Mahama refugee camp can serve as a reference for other refugee camps in Rwanda and elsewhere.
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Affiliation(s)
| | - Innocent Kamali
- Partners In Health- Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda
| | - Dale A Barnhart
- Partners In Health- Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | - Jean Damascene Makuza
- Rwanda Biomedical Centre, Kigali, Rwanda.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Noor Kassim
- United Nations High Commissioner for Refugees, Kigali Rwanda
| | - Joel M Mubiligi
- Partners In Health- Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda
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Abate D, Tolera A, Hawulte B, Tesfa T, Geleto A. Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia. INFECTIOUS DISEASES: RESEARCH AND TREATMENT 2022; 15:11786337211062622. [PMID: 35023926 PMCID: PMC8744165 DOI: 10.1177/11786337211062622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022]
Abstract
Background: Healthcare providers are in high occupational risk of Hepatitis B virus
infection than that of the general population because of the high risk of
occupational exposure to patients’ body fluids and accidental sharp
injuries. There are no large facility-based studies conducted on the
prevalence of HBV infection and its associated factors among health care
providers in eastern Ethiopia. Objective: This study aimed at investigating the seroprevalence of Hepatitis B Virus and
its associated factors among the healthcare providers in public health
facilities in eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 438 randomly
selected healthcare providers in eastern Ethiopia from March to June 2018.
Pretested structured questionnaire was used to collect data on
socio-demographic characteristics and other risk factors. In addition, a
2.5 ml blood was collected and the serum was analyzed for Hepatitis B
surface antigen using the Instant Hepatitis B surface antigen kit. Data were
entered using Epidata version 3.1 and analyzed using SPSS statistical
packages version 22. Descriptive summary measures were used. Bivariate and
multivariable logistic regression was conducted at 95% CI. An association at
P-value <.05 was considered statistically
significant. Results: A total of 438 (92.02% response rate) health care providers have participated
in this study. The prevalence of hepatitis B virus infection was 9.6%. There
were no significant differences in the HBV infection rates among healthcare
providers with respect to socio-demographic characteristics
(P-value >.05). After adjusting for some variables,
the following variables remained statistically significantly associated with
HBsAg positive result in the multivariable analysis: exposure to body fluids
(AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury
(AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery
(AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner
(AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95%
CI [2.75, 13.51]). Conclusion: This study showed a high prevalence of HBV infection among health care
providers in eastern Ethiopia. This is significant because health
professionals may be at increased risk of chronic complications and may also
be source of infection for their clients and general population during their
healthcare practice. Management commitment that should focus on occupational
safety and health promotions is necessary.
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Affiliation(s)
- Degu Abate
- Department of Medical Laboratory Sciences, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Abebe Tolera
- School of Public Health, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Behailu Hawulte
- School of Public Health, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Tewodros Tesfa
- Department of Medical Laboratory Sciences, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Ayele Geleto
- School of Public Health, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
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Prevalence and associated risk factors for hepatitis B and C viruses among refugee populations living in Mahama, Rwanda: A cross-sectional study. PLoS One 2021; 16:e0257917. [PMID: 34634039 PMCID: PMC8504757 DOI: 10.1371/journal.pone.0257917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/13/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION As part of the integration of refugees into Rwanda's national hepatitis C elimination agenda, a mass screening campaign for hepatitis B (HBV) and hepatitis C (HCV) was conducted among Burundian refugees living in Mahama Camp, Eastern Rwanda. This cross-sectional survey used data from the screening campaign to report on the epidemiology of viral hepatitis in this setting. METHODS Rapid diagnostic tests (RDTs) were used to screen for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) among people of ≥15years old. We calculated seroprevalence for HBsAg and anti-HCV by age and sex and also calculated age-and-sex adjusted risk ratios (ARR) for other possible risk factors. RESULTS Of the 26,498 screened refugees, 1,006 (3.8%) and 297 (1.1%) tested positive for HBsAg and Anti-HCV, respectively. HBsAg was more prevalent among men than women and most common among people 25-54 years old. Anti-HCV prevalence increased with age group with no difference between sexes. After adjusting for age and sex, having a household contact with HBsAg was associated with 1.59 times higher risk of having HBsAg (95% CI: 1.27, 1.99) and having a household contact with anti-HCV was associated with 3.66 times higher risk of Anti-HCV (95% CI: 2.26, 5.93). Self-reporting having HBV, HCV, liver disease, or previously screened for HBV and HCV were significantly associated with both HBsAg and anti-HCV, but RDT-confirmed HBsAg and anti-HCV statuses were not associated with each other. Other risk factors for HBsAg included diabetes (ARR = 1.97, 95% CI: 1.08, 3.59) and family history of hepatitis B (ARR = 1.32, 95% CI: 1.11, 1.56) and for anti-HCV included heart disease (ARR = 1.91, 95% CI: 1.30, 2.80) and history of surgery (ARR = 1.70, 95% CI: 1.24, 2.32). CONCLUSION Sero-prevalence and risks factors for hepatitis B and C among Burundian were comparable to that in the Rwandan general population. Contact tracing among household members of identified HBsAg and anti-HCV infected case may be an effective approach to targeted hepatitis screening given the high risk among self-reported cases. Expanded access to voluntary testing may be needed to improve access to hepatitis treatment and care in other refugee settings.
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Kafeero HM, Ndagire D, Ocama P, Kudamba A, Walusansa A, Sendagire H. Prevalence and predictors of hepatitis B virus (HBV) infection in east Africa: evidence from a systematic review and meta-analysis of epidemiological studies published from 2005 to 2020. Arch Public Health 2021; 79:167. [PMID: 34537079 PMCID: PMC8449462 DOI: 10.1186/s13690-021-00686-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The epidemiology of hepatitis B virus (HBV) in the general population in east Africa is not well documented. In this meta-analysis, we examined 37 full published research articles to synthesise up-to-date data on the prevalence and predictors of the HBV burden for the effective prevention and management of the virus in our region. METHODS We examined 37 full published research articles found using PubMed, Scopus, African Journal Online (AJOL), and Google Scholar between May and October 2020. Dichotomous data on HBV prevalence and predictors of infection were extracted from the individual studies. The HBV prevalence, test of proportion, relative risk, and I2 statistics for heterogeneity were calculated using MedCalc software version 19.1.3. Begg's tests was used to test for publication bias. Sources of heterogeneity were analysed through sensitivity analysis, meta-regression, and sub-group analysis at 95% CI. P < 0.05 was considered significant for all analyses. RESULTS The prevalence of HBV was generally high (6.025%), with publications from Kenya (8.54%), Uganda (8.454%) and those from between 2011 and 2015 (8.759%) reporting the highest prevalence (P < 0.05). Blood transfusion, scarification, promiscuity, HIV seropositivity, and being male were independent predictors significantly associated with HBV infection (P < 0.05), with the male sex being the most strongly associated predictor of HBV infection. Meta-regressions for the pooled HBV prevalence and sample size, as well as the year of publication, lacked statistical significance (P > 0.05). Omitting the study with the largest sample size slightly increased pooled HBV prevalence to 6.149%, suggesting that the studies are robust. Begg's test showed no evidence of publication bias for overall meta-analysis (p > 0.05). CONCLUSION The burden of HBV is still high, with the male sex, blood transfusion, body scarification, and HIV seropositivity being potential predictors of infection. Thus, it is important to scale up control and prevention measures targeting persons at high risk.
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Affiliation(s)
- Hussein Mukasa Kafeero
- Department of Medical Microbiology, Faculty of Health Sciences, Habib Medical School, Islamic University in Uganda, P.O. Box 7689, Kampala, Uganda.
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O. Box 7062, 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
| | - Ali Kudamba
- Department of Human Physiology, Faculty of Health Sciences, Habib Medical School, Islamic University in Uganda, P.O. Box 7689, Kampala, Uganda
| | - Abdul Walusansa
- Department of Medical Microbiology, Faculty of Health Sciences, Habib Medical School, Islamic University in Uganda, P.O. Box 7689, Kampala, Uganda
| | - Hakim Sendagire
- Department of Medical Microbiology, Faculty of Health Sciences, Habib Medical School, Islamic University in Uganda, P.O. Box 7689, Kampala, Uganda
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
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Mengiste DA, Dirbsa AT, Ayele BH, Hailegiyorgis TT. Hepatitis B virus infection and its associated factors among medical waste collectors at public health facilities in eastern Ethiopia: a facility-based cross-sectional study. BMC Infect Dis 2021; 21:233. [PMID: 33639871 PMCID: PMC7912495 DOI: 10.1186/s12879-021-05918-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. RESULTS From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53-15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02-12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12-7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16-25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. CONCLUSION This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.
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Affiliation(s)
- Degu Abate Mengiste
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, P.O. Box, 235, Harar, Ethiopia
| | - Abebe Tolera Dirbsa
- Epidemiology and Biostatistics Unit, College of Health and Medical Sciences, School of Public Health, Haramaya University, P.O. Box, 235, Harar, Ethiopia
| | - Behailu Hawulte Ayele
- Public Health and Policy Unit, College of Health and Medical Sciences, School of Public Health, Haramaya University, P.O. Box, 235, Harar, Ethiopia
| | - Tewodros Tesfa Hailegiyorgis
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, P.O. Box, 235, Harar, Ethiopia
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19
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Tesfa T, Hawulte B, Tolera A, Abate D. Hepatitis B virus infection and associated risk factors among medical students in eastern Ethiopia. PLoS One 2021; 16:e0247267. [PMID: 33606777 PMCID: PMC7894878 DOI: 10.1371/journal.pone.0247267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/03/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) is a highly contagious pathogen that has become a severe public health problem and a major cause of morbidity and mortality, particularly in developing countries. Medical students are at high occupational risk during their training. However, no facility-based studies were found among medical students in eastern Ethiopia. Thus, this study aimed to investigate the seroprevalence of Hepatitis B Virus and associated factors among medical students in eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted among 407 randomly selected medical students from March to June 2018. A pretested and structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. A 5ml blood was collected, and the serum was analyzed for Hepatitis B surface antigen (HBsAg) using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Outcome and explanatory variables were described using descriptive summary measures. Binary and multivariable logistic regression was conducted at 95% CI and an association at P-value < 0.05 was declared statistically significant. RESULTS The seroprevalence of hepatitis B virus surface antigen was 11.5% (95%CI = 8.6, 14.7). Poor knowledge of universal precaution guideline (AOR = 2.58; 95% CI = [1.35-4.93]), history of needle stick injury (AOR = 2.11; 95% CI = [1.07-4.18]) and never been vaccinated for HBV (AOR = 2.34; 95% CI = [1.17-4.69]) were found statistically significantly associated with HBsAg positivity after multivariate analysis. CONCLUSION Hepatitis B virus infection rate is high among health care trainees in eastern Ethiopia. Improvement at health care practice centers safety through training on universal precaution guidelines, and scaling up HBV vaccination is mandatory.
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Affiliation(s)
- Tewodros Tesfa
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Behailu Hawulte
- Public Health and Policy Unit, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abebe Tolera
- Epidemiology and Biostatistics Unit, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Degu Abate
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Mansour-Ghanaei F, Joukar F, Naghipour M, Hassanipour S, Yeganeh S, Sepehrimanesh M, Fathalipour M. Epidemiologic profile of viral hepatitis B and C in North of Iran: results from PERSIAN Guilan Cohort Study (PGCS). BMC Res Notes 2021; 14:59. [PMID: 33568187 PMCID: PMC7877021 DOI: 10.1186/s13104-021-05474-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/02/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Hepatitis B (HB) and C (HC) are two severe viral infectious diseases with a deleterious impact on global health. This study aimed to evaluate the prevalence of HB and HC in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study using immunological and molecular methods. RESULTS The blood samples were obtained from 10,520 enrolled participants. Complete biochemical and hematological tests, as well as urine analysis, were assessed. The presence of HBsAg, anti-HBs, anti-HBc, and anti-HCV antibodies for all participant and HBeAg and anti-HBe antibodies for HB-positive patients were evaluated. Moreover, HB genomic DNA and HC genomic RNA were extracted from serum samples of HB-positive patients. The real-time PCR assay was employed to quantify the gene copies of hepatitis B and C viruses. HC genotyping was also performed. The prevalence of HB and HC was 0.24% (95% CI 0.16-0.35) and 0.11% (95% CI 0.06-0.19), respectively. Rural participants were significantly more HB-positive than the urban people (P = 0.045), while males were significantly more HC-positive than the females (P = 0.013). The prevalence of HB and HC in this area were lower than those of other geographical locations of Iran, which may be due to different lifestyles or other unknown reasons.
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Affiliation(s)
- Fariborz Mansour-Ghanaei
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheil Hassanipour
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Yeganeh
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Mohammad Fathalipour
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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21
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Talla C, Itanyi IU, Tsuyuki K, Stadnick N, Ogidi AG, Olakunde BO, Patel D, Oko JO, Aarons G, Onoka CA, Ezeanolue EE. Hepatitis B infection and risk factors among pregnant women and their male partners in the Baby Shower Programme in Nigeria: a cross-sectional study. Trop Med Int Health 2020; 26:316-326. [PMID: 33247862 DOI: 10.1111/tmi.13531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To determine the population prevalence and determinants of hepatitis B (Hep B) status, and status discordance, among pregnant women and their male partners in Nigeria. METHODS Cross-sectional study assessing the seroprevalence of Hep B virus in a cohort of 16 920 pregnant women and their male partners in northcentral Nigeria. Rapid HBsAg antibody test was used for Hep B diagnosis. Demographic, socio-economic and behavioural information was collected through interviewer-administered questionnaires and evaluated as determinants of Hep B status and couple status discordance using logistic regression. RESULTS Of 16 920 participants who had a Hep B test result, 6750 couples and 1316 discordant couples were identified. The prevalence of Hep B among all participants was 10.9%, with lower prevalence among pregnant women (10.2%) than their male partners (11.9%), P < 0.001. The prevalence of Hep B sero-discordance among couples was 19.5% (1316/6750). Younger age, prior Hep B testing and a prior positive Hep B test increased the odds of Hep B infection while being a woman decreased the odds of Hep B among all participants, and among couples. Furthermore, polygamy (adjusted odds ratio [AOR]: 1.49, 95% confidence interval [CI]: 1.19-1.87), prior Hep B testing (AOR: 2.38, 95% CI: 1.14-4.97) and a prior positive Hep B test result were significant determinants of status discordance among the participating couples. CONCLUSION The prevalence of Hep B among pregnant women and their male partners in northcentral Nigeria is high. A large-scale intervention is required to reduce Hep B prevalence in this setting.
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Affiliation(s)
- Carol Talla
- Caritas Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California, San Diego, CA, USA
| | - Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, CA, USA.,UC San Diego Dissemination and Implementation Science Center, San Diego, CA, USA
| | - Amaka Grace Ogidi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Babayemi Oluwaseun Olakunde
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,National Agency for the Control of AIDS, Abuja, Nigeria
| | - Dina Patel
- Healthy Sunrise Foundation, Las Vegas, NV, USA
| | | | - Gregory Aarons
- Department of Psychiatry, University of California, San Diego, CA, USA.,UC San Diego Dissemination and Implementation Science Center, San Diego, CA, USA
| | - Chima Ariel Onoka
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,Healthy Sunrise Foundation, Las Vegas, NV, USA
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22
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Kumar SS, Chinnakali P, Dhodapkar R, Mohan P, Olickal JJ, Hamide A. Willingness and yield of screening for hepatitis B among outpatients of a tertiary care centre, Puducherry, South India. Trop Doct 2020; 51:197-202. [PMID: 33270536 DOI: 10.1177/0049475520975940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
India's National Viral Hepatitis Control Programme recommends screening outpatients for hepatitis B at tertiary care centres. We aimed to assess the yield of screening and reasons for refusal for testing. We included adult outpatients at a tertiary care centre, South India during September and October 2019. Participants' willingness to be tested and the reasons for refusal were noted. Fingerstick blood sample was tested for HBsAg using rapid kit. Of a total of 700 participants, 157 (22%, 95% CI: 19.4-25.7%) were unwilling to be tested. Men were more unwilling (26%) compared to women (19%) (aPR 1.90 95% CI: 1.22-2.94; p = 0.004). 'Lack of time' was the most common reason reported for refusal (10%). Of 543 participants tested, 15 (2.8%, 95% CI: 1.6-4.5%) were positive for HBsAg. Similar studies from other regions in India are required for the estimation of yield of opportunistic approach.
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Affiliation(s)
- Swetha S Kumar
- MPH Scholar, JIPMER International School of Public Health (JISPH), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Palanivel Chinnakali
- Additional Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Rahul Dhodapkar
- Additional Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Pazhanivel Mohan
- Associate Professor, Department of Medical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jeby J Olickal
- PhD Scholar, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Abdoul Hamide
- Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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23
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Makuza JD, Nisingizwe MP, Rwema JOT, Dushimiyimana D, Habimana DS, Umuraza S, Serumondo J, Ngwije A, Semakula M, Gupta N, Nsanzimana S, Janjua NZ. Role of unsafe medical practices and sexual behaviours in the hepatitis B and C syndemic and HIV co-infection in Rwanda: a cross-sectional study. BMJ Open 2020; 10:e036711. [PMID: 32660951 PMCID: PMC7359181 DOI: 10.1136/bmjopen-2019-036711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study describes the burden of the hepatitis B, C and HIV co-infections and assesses associated risk factors. SETTING This analysis used data from a viral hepatitis screening campaign conducted in six districts in Rwanda from April to May 2019. Ten health centres per district were selected according to population size and distance. PARTICIPANTS The campaign collected information from 156 499 participants (51 496 males and 104 953 females) on sociodemographic, clinical and behavioural characteristics. People who were not Rwandan by nationality or under 15 years old were excluded. PRIMARY AND SECONDARY OUTCOMES The outcomes of interest included chronic hepatitis C virus (HCV) infection, chronic hepatitis B virus (HBV) infection, HIV infection, co-infection HIV/HBV, co-infection HIV/HCV, co-infection HBV/HCV and co-infection HCV/HBV/HIV. Multivariable logistic regressions were used to assess factors associated with HBV, HCV and HIV, mono and co-infections. RESULTS Of 156 499 individuals screened, 3465 (2.2%) were hepatitis B surface antigen positive and 83% (2872/3465) of them had detectable HBV desoxy-nucleic acid (HBV DNA). A total of 4382 (2.8%) individuals were positive for antibody-HCV (anti-HCV) and 3163 (72.2%) had detectable HCV ribo-nucleic acid (RNA). Overall, 36 (0.02%) had HBV/HCV co-infection, 153 (0.1%) HBV/HIV co-infection, 238 (0.15%) HCV/HIV co-infection and 3 (0.002%) had triple infection. Scarification or receiving an operation from traditional healer was associated with all infections. Healthcare risk factors-history of surgery or transfusion-were associated with higher likelihood of HIV infection with OR 1.42 (95% CI 1.21 to 1.66) and OR 1.48 (1.29 to 1.70), respectively, while history of physical traumatic assault was associated with a higher likelihood of HIV and HBV/HIV co-infections with OR 1.69 (95% CI 1.51 to 1.88) and OR 1.82 (1.08 to 3.05), respectively. CONCLUSIONS Overall, mono-infections were common and there were differences in significant risk factors associated with various infections. These findings highlight the magnitude of co-infections and differences in underlying risk factors that are important for designing prevention and care programmes.
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Affiliation(s)
| | - Marie Paul Nisingizwe
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean Olivier Twahirwa Rwema
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Center for Teaching and Learning, Baltimore, Maryland, USA
| | | | | | - Sabine Umuraza
- Health Department, Clinton Health Access Initiative, Kigali, Rwanda
| | | | - Alida Ngwije
- Health Department, Clinton Health Access Initiative, Kigali, Rwanda
| | - Muhamed Semakula
- IHDPC, Rwanda Biomedical Center, Kigali, Kigali City, Rwanda
- I-Biostat Department of Sciences, Hasselt University, Hasselt, Limburg, Belgium
| | - Neil Gupta
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Naveed Zafar Janjua
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Clinical Prevention Services, British Columbia Center for Diseases Control, Vancouver, British Columbia, Canada
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24
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Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis. Infect Dis Obstet Gynecol 2020; 2020:9418475. [PMID: 32577077 PMCID: PMC7305536 DOI: 10.1155/2020/9418475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/23/2020] [Indexed: 12/20/2022] Open
Abstract
Background Hepatitis B virus (HBV) is an infectious and a global public health problem. The prevalence of HBV infection among pregnant women is between 2.3% and 7.9%. HBV infection during pregnancy is associated with prenatal transmission to the fetus. HBV has an effective vaccine which reduces up to 96% of the transmission. Although different studies were conducted in Ethiopia, none of them showed the national prevalence of HBV infection among pregnant women. Therefore, this study was conducted to determine the pooled prevalence of HBV and its associated factors in Ethiopia. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles. All observational published studies were retrieved using relevant search terms in Google Scholar, African Online Journal, CINAHL, and PubMed databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I 2 statistics were used to test heterogeneity whereas Begg's and Egger's tests were used to assess publication bias. Odds ratio (OR) with a 95% confidence interval (CI) was presented using the forest plot. Results A total of twenty-three studies were included in this systematic review and meta-analysis. The pooled prevalence of HBV in Ethiopia was 4.75% (95% CI: 4.06, 5.44). The subgroup analysis showed a higher prevalence of HBV infection among pregnant women in Gambella (7.9%) and the lowest in Southern Nations, Nationalities, and Peoples' Region (SNNPR) (2.3%). Associated factors with HBV infection include history of multiple sexual partner (OR = 6.02 (95%CI = 3.86, 9.36)), blood transfusion history (OR = 5.71 (95%CI = 3.25, 10.04)), abortion history (OR = 3.58 (95%CI = 2.10, 6.09)), and history of body tattoo (OR = 2.83 (95%CI = 1.55, 5.17)). Conclusions HBV infection among pregnant women is a common public health problem in Ethiopia. Multiple sexual partners, abortion history, blood transfusion history, and body tattoo were significantly associated with HBV infection. Policies and strategies should focus on factors identified in this study to improve the prevention of HBV among pregnant women.
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25
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Sonderup MW, Dusheiko G, Desalegn H, Lemoine M, Tzeuton C, Taylor-Robinson SD, Spearman CW. Hepatitis B in sub-Saharan Africa-How many patients need therapy? J Viral Hepat 2020; 27:560-567. [PMID: 31800145 DOI: 10.1111/jvh.13247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022]
Abstract
Hepatitis B is endemic in sub-Saharan Africa with ~60 million people chronically infected. While prevention, through vaccination, is central to elimination strategies, only 11 countries have birth dose vaccination and full vaccine coverage remains at suboptimal levels. Furthermore, to fully realize elimination, those chronically infected need to be identified, assessed for therapy and then linked to care. Given current treatment criteria, the precise quantum of people warranting therapy, according to criteria, is essentially unknown. The issue is further complicated by data to suggest differences in the numbers of people requiring treatment when applying WHO as compared to European Association for the Study of the Liver, EASL, criteria. Optimal determination of treatment eligibility is further hindered by the lack of available tools to adequately assess individual patients. It is conceivable that accurately determining the number of those requiring treatment, given the heterogeneity of hepatitis B in Africa, is difficult. Better studies and data are required. More signifcantly, improved access and availability to the diagnostic tools needed to assess patients in additon to access to drugs are as, if not more important, to achieve elimination.
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Affiliation(s)
- Mark W Sonderup
- Division of Hepatology, Department of Medicine, Faculty of health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Geoffrey Dusheiko
- Liver Unit, Kings College Hospital, London, UK
- Division of Medicine, University College London Medical School, London, UK
| | - Hailemichael Desalegn
- Medical Department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Maud Lemoine
- Department of Surgery and Cancer, Liver Unit, St Mary's Hospital NHS, Imperial College London, London, UK
| | - Christian Tzeuton
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Simon D Taylor-Robinson
- Department of Surgery and Cancer, Liver Unit, St Mary's Hospital NHS, Imperial College London, London, UK
| | - C Wendy Spearman
- Division of Hepatology, Department of Medicine, Faculty of health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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26
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Tan Z, Dong H, Liu Q, Liu H, Zhao P, Wang P, Li Y, Zhang D, Zhao Z, Dong Y. A label-free immunosensor based on PtPd NCs@MoS 2 nanoenzymes for hepatitis B surface antigen detection. Biosens Bioelectron 2019; 142:111556. [PMID: 31377574 DOI: 10.1016/j.bios.2019.111556] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 12/11/2022]
Abstract
Nowadays, nanomaterials with enzymatic properties have aroused wide interest because of their special advantages, such as catalytic activity, simple preparation method and high stability. We introduced new nanoenzymes to a label-free electrochemical immunosensor for Hepatitis B surface antigen (HBs Ag) detection. In this study, PtPd nanocubes@MoS2 nanoenzymes (PtPd NCs@MoS2) were prepared by loading PtPd nanocubes (PtPd NCs) on molybdenum disulfide nano-sheet (MoS2) through in situ redox polymerization. The prepared nanoenzymes exhibited enhanced peroxidase-like activity than separate MoS2 and PtPd NCs. The catalytic process of PtPd NCs@MoS2 is in agreement with the Michaelis-Menten kinetic equation. PtPd NCs@MoS2 were used for sensitive detection of HBs Ag, which is ascribed to their superior peroxidase activity, good conductivity and high specific surface area and synergistic amplification for current signals. Compared with the detection limit of colorimetric method (3.3 pg/mL), the electrochemical method (10.2 fg/mL) shows a lower detection limit and a wider linear range from 32 fg/mL to 100 ng/mL, so it is more suitable for quantitative analysis of Hepatitis B. In summary, the prepared immunosensor provides a better opportunity for early diagnosis of Hepatitis B and also has further applications in biosensing and medical diagnostics.
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Affiliation(s)
- Zhaoling Tan
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Hui Dong
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Qing Liu
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China.
| | - Hui Liu
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Pingping Zhao
- College of Chemical and Environmental Engineering, Shandong University of Science and Technology, PR China
| | - Ping Wang
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Yueyun Li
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Daopeng Zhang
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Zengdian Zhao
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
| | - Yunhui Dong
- School of Chemistry and Chemical Engineering, Shandong University of Technology, Zibo, 255049, PR China
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