1
|
Tadesse K, Ayalew G, Million Y, Gelaw A. Hepatitis B and hepatitis C virus infections and associated factors among prisoners in Gondar City, Northwest Ethiopia. PLoS One 2024; 19:e0301973. [PMID: 38626232 PMCID: PMC11020974 DOI: 10.1371/journal.pone.0301973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/26/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Globally, hepatitis B virus (HBV) and hepatitis C virus (HCV) cause considerable morbidity and mortality from their acute and chronic infections. The transmission of the viruses within the prisons is high due to overcrowding, and other risk behaviors such as drug use, and unsafe sexual practices. This study aimed at determining the prevalence and associated factors of HBV and HCV infections among prisoners in Gondar city, Northwest Ethiopia. METHODS A cross-sectional study was conducted in the Gondar City Prison Center from May 1, 2022, to July 30, 2022. A total of 299 prison inmates were selected by using a systematic random sampling technique. A semi-structured questionnaire was used to collect data on sociodemographic, clinical, behavioral and prison related factors. Five milliliters of blood sample were collected, and the serum was separated from the whole blood. The serum was tested for HBV surface antigen (HBsAg) and anti-HCV antibody by using an Enzyme-Linked Immunosorbent Assay (ELISA). Data was entered using EpiData version 4.6.0 and exported to SPSS version 20 for analysis. Logistic regression analysis was done to assess the association between the independent variables and HBV and HCV infections. P-values < 0.05 were considered statistically significant. RESULTS The overall seroprevalence of HBV or HCV infections was 10.4%. The seroprevalence of HBV and HCV infections was 7.0% and 4.0%, respectively. It has been demonstrated that having several heterosexual partners, sharing sharp materials in prison, having longer imprisonment, and having a body tattoo are significantly associated with HBV infection. The presence of a body tattoo, a history of surgical procedures, and previous imprisonment are associated risk factors for HCV infection. CONCLUSION The prevalence of HBV and HCV were high-intermediate and high, respectively. Therefore, preventative and control initiatives are needed in prisons to decrease the rate of infection and transmission.
Collapse
Affiliation(s)
- Kebebe Tadesse
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Department of Medical Laboratory Sciences, Pawe Health Science College, Pawe, Ethiopia
| | - Getnet Ayalew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yihenew Million
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aschalew Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Tadewos D, Tadesse S, Ejajo T, Tadesse T. Prevalence of Hepatitis B Virus Infection and Associated Factors Among High School Students in Shinshicho Town, Southern Ethiopia. Health Serv Insights 2024; 17:11786329241245232. [PMID: 38596812 PMCID: PMC11003333 DOI: 10.1177/11786329241245232] [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: 07/14/2023] [Accepted: 02/22/2024] [Indexed: 04/11/2024] Open
Abstract
Background Early identification of people living with hepatitis B virus infection is required to initiate treatment and care, prevent community transmission, and expand vaccination. However, only an estimated 10% of people living with chronic hepatitis B infection are diagnosed, and only 2% are on treatment globally. This study aimed to assess the prevalence of hepatitis B virus infection and its associated factors among high school students in Shinshicho Town, southern Ethiopia. Methods An institutional-based cross-sectional study was conducted among 380 high school students in Shinshicho Town, southern Ethiopia, from September to October 2022. A laboratory investigation of hepatitis B surface antigen was done to determine infection status. An odds ratio with a 95% confidence interval was used to declare statistical significance. Results The prevalence of hepatitis B virus infection among high school students in Shinshicho town was observed to be 7.6% (95% CI: 5.5, 10.5%). Age 20 to 24 years [AOR: 2.7; 95% CI: (1.0-7.0)], rural residence [AOR: 3.4; 95% CI: (1.3-8.9)], and history of unprotected drug injection [AOR: 11.3; 95% CI: (3.7-34.8)] were independently associated with hepatitis B virus infection. Conclusion A high prevalence of hepatitis B virus infection was observed among high school students in this study. Therefore, strengthening the school-based screen-and-treat program, especially targeting students from rural areas and young adults, and conducting awareness campaigns about the importance of practicing safe behaviors, such as avoiding unprotected drug injections, could contribute to the prevention and control of hepatitis B virus infection among high school students.
Collapse
Affiliation(s)
- Desta Tadewos
- School of Public Health, Wachemo University, Hossana, Ethiopia
| | - Sebsibe Tadesse
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tekle Ejajo
- School of Public Health, Wachemo University, Hossana, Ethiopia
| | - Tegegn Tadesse
- School of Public Health, Wachemo University, Hossana, Ethiopia
| |
Collapse
|
3
|
Beykaso G, Teklehaymanot T, Mulu A, Berhe N, Alemayehu DH, Giday M. Medicinal Plants in Treating Hepatitis B Among Communities of Central Region of Ethiopia. Hepat Med 2023; 15:265-277. [PMID: 38170153 PMCID: PMC10759923 DOI: 10.2147/hmer.s440351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose In Ethiopia, most people rely heavily on traditional therapeutic plants that have been used for years. The practice of traditional medicines use to treat hepatitis is currently gaining popularity due to the limited availability and affordability of modern drugs. The aim of this study was, therefore, to assess the traditional medicinal plants use to treat viral hepatitis among communities of Central region of Ethiopia. Methods Data was collected from November 2018 to December 2021 in Central Ethiopia. An open-ended semi-structured interview was used among purposively selected herbalists, traditional medicine entrepreneurs, village heads, and patients visiting traditional healers for hepatitis treatments. A 5 mL blood sample was collected from patients who visited a traditional healers' clinic for hepatitis treatment and tested for HBsAg and HCV-antibody by using ELISA. Among HBsAg-positives, further nucleic acid test for HBV-DNA load was assessed to measure the effects of prescribed medicinal plants. Results Herbalists cited 24 plants that were used for hepatitis treatment; of which Rumex nepalensis, Vangueria apiculata, and Solanum incanum were the most frequently cited plants. Remedies were commonly prepared by crushing or powdering, mixing them with water, and taken orally. Forty-two individuals were diagnosed and treated as hepatitis patients by herbalists, of which eight of them were HBsAg-positive but no positives for anti-HCV ELISA. At the third and sixth months of viral load assessment among HBsAg-positive, serum HBV-DNA suppression was observed in three individuals treated with different combinations of frequently cited plants. Conclusion In this study, traditional healers used various plants to treat hepatitis. HBV-DNA suppressive activity was detected in three NAT-positive individuals who were treated by using a mixture of these frequently cited and highest preference-ranked plants. This suggests that these plants have antiviral properties and serve as a basis for more pharmacological research in the quest for new antiviral agents.
Collapse
Affiliation(s)
- Gizachew Beykaso
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Tilahun Teklehaymanot
- Department of Immunology and Molecular Biology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andargachew Mulu
- Department of Virology, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Nega Berhe
- Department of Immunology and Molecular Biology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Mirutse Giday
- Department of Immunology and Molecular Biology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
4
|
Nikolopoulou GB, Tzoutzas I, Tsakris A, Maltezou HC. Hepatitis B in Healthcare Personnel: An Update on the Global Landscape. Viruses 2023; 15:2454. [PMID: 38140695 PMCID: PMC10748141 DOI: 10.3390/v15122454] [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: 11/25/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023] Open
Abstract
Despite the outstanding progress that has been made in the prevention, detection, and management of hepatitis B during the past decades, hepatitis B remains a problem among healthcare personnel (HCP) in many countries. We reviewed studies on all aspects of hepatitis B in HCP published from 2017 through April 2023. They revealed wide variations on the prevalence of infection among HCP, ranging from 0.6% in Europe to >8.7% in Africa, almost always in association with very low vaccination rates. Many studies found a significant association between HCP's knowledge about hepatitis B and hepatitis B vaccines, their vaccination status, and practices. This research also discloses global inequities regarding vaccination policies against hepatitis B, free-of-charge vaccinations, and access to post-exposure prophylaxis (PEP). Strategies to prevent and manage accidental exposures are needed in order to reduce the burden of hepatitis B on HCP, while written policies for all aspects of infection prevention, protective equipment, and PEP should be available. Lastly, HCP should be accordingly educated. These are all imperative given the decline of routine vaccinations in the COVID-19 era, particularly in countries with fragile vaccination programs, and the disruptions of interventions for hepatitis B that are expected to provide a pool of virus transmission to future generations.
Collapse
Affiliation(s)
- Georgia B. Nikolopoulou
- Department of Hepatitis, National Public Health Organization, 3-5 Agrafon Street, 15123 Athens, Greece;
| | - Ioannis Tzoutzas
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, 11527 Athens, Greece;
| | - Athanasios Tsakris
- Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece;
| | - Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, 3-5 Agrafon Street, 15123 Athens, Greece
| |
Collapse
|
5
|
Ayele B, Weldehanna D, Demsiss W. Serological Evidence and Associated Factors of Hepatitis B Virus and Hepatitis C Virus Among Waste Handlers: A Cross-Sectional Study from Northeastern Ethiopia. Infect Drug Resist 2023; 16:4881-4890. [PMID: 37525632 PMCID: PMC10387244 DOI: 10.2147/idr.s416409] [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: 04/09/2023] [Accepted: 07/15/2023] [Indexed: 08/02/2023] Open
Abstract
Background The World Health Organization (WHO) has identified viral hepatitis, caused by hepatitis B virus (HBV) and hepatitis C virus (HCV), as one of the main global public health issues. People who work in the collection of waste materials, from either household or medical environments, are at greatest risk. Objective To determine the prevalence of and factors associated with HBV and HCV among medical and domestic waste handlers in Northeast Ethiopia. Methods A comparative cross-sectional study was conducted from January to April 2021 at selected healthcare facilities and municipal settings in Dessie town, Northeast Ethiopia. The sample size was determined using a double population proportion formula, and a simple random sampling technique was employed to select 70 individuals in the medical waste handlers (MWHs) group and 206 in the domestic waste handlers (DWHs) group. Five milliliters of venous blood was collected from each participant and tested for HBV and HCV using an enzyme-linked immunosorbent assay. Data were analyzed using SPSS version 23; the prevalence was computed, Fisher's exact test was used, and logistic regression was applied. Results A total of 276 study participants were enrolled and the overall seroprevalence of hepatitis virus was 5.1%. The seroprevalence of HBV infection among MWHs and DWHs was 8.6% and 1.9%, respectively. The overall seroprevalence of HCV infections among MWHs and DWHs was 4.3% and 0.5%, respectively. Medical waste handling, having a history of needle stick injury, and not using personal protective equipment were factors significantly associated with HBV infection. Conclusion The overall seroprevalence of viral hepatitis was high. The prevalence of HBV infection among MWHs was in line with the high endemicity classification of the WHO, and there was a significant difference in prevalence between DWHs and MWHs. Both groups of waste handlers should receive proper attention to protect them from HBV and HCV infection.
Collapse
Affiliation(s)
- Beju Ayele
- Amhara Public Health Institute, Dessie Branch, Dessie, Ethiopia
| | - Daniel Weldehanna
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara Region, 1145, Ethiopia
| | - Wondmagegn Demsiss
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara Region, 1145, Ethiopia
| |
Collapse
|
6
|
Israel E, Hizkel I, Geta T, Feleke T, Samuel B, Markos D. Triple sexually transmitted infections among pregnant woman in the context of Elimination of mother to child transmission in Southern Ethiopia: Reports from a survey of questionnaires and laboratory studies. Front Glob Womens Health 2023; 4:1190170. [PMID: 37404231 PMCID: PMC10316963 DOI: 10.3389/fgwh.2023.1190170] [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: 03/20/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction Sexually transmitted infections (STIs) cause a wide range of public health problems if left untreated. They can lead to adverse birth outcomes, including stillbirth, fetal loss, neonatal death, preterm birth, and low birth weight. Although great efforts have been made to reduce STIs nationally, their incidence remains high in Ethiopia, and their co-infection calls for urgent action. Therefore, this study aimed to identify the determinants of three STIs among pregnant women attending antenatal care (ANC) in the context of the elimination of mother-to-child transmission in public health facilities in Sawla Town, Gofa zone, Southern Ethiopia. Methods A cross-sectional study design was conducted among pregnant women attending antenatal care in public health facilities in Sawla Town, Southern Ethiopia, from May to July 2022. Data were collected from pregnant women's serum using an HIV rapid test, an HBsAg rapid test device, and a VDRL for HIV, HBV, and syphilis, respectively. Descriptive statistics, such as frequencies and percentages, were used to describe each relevant variable. Logistic regression analyses were used to identify the determinants of STIs. Results A total of 484 pregnant women attending antenatal care were screened. The mean age of the women was 24.0 ± 4.6 years, and nearly half of the participants had completed secondary school or higher. The overall seroprevalence of three STIs (HIV, HBV, and syphilis) among pregnant women was 6.8%. These three sexually transmitted infections were shown to be more common among pregnant women who were not able to read and write, had tattoos, had previously had an abortion, and had a history of multiple sexual partners. Conclusions The seroprevalence found in this study was intermediate in comparison with the WHO standard. Efforts should be made to strengthen the existing health education and RH service integration on STI screening, and treatment that further eliminates vertical infection.
Collapse
Affiliation(s)
- Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Iskindir Hizkel
- Department of Maternal and Child Health, Sawla Town Health Office, Gofa Zone, Sawla, Ethiopia
| | - Temesgen Geta
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tihun Feleke
- Department of Nursing, Hawassa College of Health Sciences, Hawassa, Ethiopia
| | - Beniyam Samuel
- Department of Midwifery, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Desta Markos
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| |
Collapse
|
7
|
Fofana DB, Somboro AM, Maiga M, Kampo MI, Diakité B, Cissoko Y, McFall SM, Hawkins CA, Maiga AI, Sylla M, Gozlan J, El-Sayed MH, Morand-Joubert L, Murphy RL, Diakité M, Holl JL. Hepatitis B Virus in West African Children: Systematic Review and Meta-Analysis of HIV and Other Factors Associated with Hepatitis B Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4142. [PMID: 36901164 PMCID: PMC10002029 DOI: 10.3390/ijerph20054142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
While Hepatitis B virus (HBV) and the human immunodeficiency virus (HIV) are endemic in West Africa, the prevalence of HBV/HIV coinfection and their associated risk factors in children remains unclear. In this review, we sought to assess HBsAg seroprevalence among 0- to 16-year-olds with and without HIV in West African countries and the risk factors associated with HBV infection in this population. Research articles between 2000 and 2021 that reported the prevalence of HBV and associated risk factors in children in West Africa were retrieved from the literature using the Africa Journals Online (AJOL), PubMed, Google Scholar, and Web of Science databases as search tools. StatsDirect, a statistical software, was used to perform a meta-analysis of the retained studies. HBV prevalence and heterogeneity were then assessed with a 95% confidence interval (CI). Publication bias was evaluated using funnel plot asymmetry and Egger's test. Twenty-seven articles conducted across seven West African countries were included in this review. HBV prevalence among persons aged 0 to 16 years was 5%, based on the random analysis, given the great heterogeneity of the studies. By country, the highest prevalence was observed in Benin (10%), followed by Nigeria (7%), and Ivory Coast (5%), with Togo (1%) having the lowest. HBV prevalence in an HIV-infected population of children was (9%). Vaccinated children had lower HBV prevalence (2%) than unvaccinated children (6%). HBV prevalence with a defined risk factor such as HIV co-infection, maternal HBsAg positivity, undergoing surgery, scarification, or being unvaccinated ranged from 3-9%. The study highlights the need to reinforce vaccination of newborns, screening for HBV, and HBV prophylaxis among pregnant women in Africa, particularly in West Africa, to achieve the WHO goal of HBV elimination, particularly in children.
Collapse
Affiliation(s)
- Djeneba B. Fofana
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), for Department of Virology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, F-75012 Paris, France
| | - Anou M. Somboro
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Mamoudou Maiga
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
- Institute for Global Health, Northwestern University, Chicago, IL 60208, USA
| | | | - Brehima Diakité
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
| | - Yacouba Cissoko
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
| | - Sally M. McFall
- Institute for Global Health, Northwestern University, Chicago, IL 60208, USA
| | - Claudia A. Hawkins
- Institute for Global Health, Northwestern University, Chicago, IL 60208, USA
| | - Almoustapha I. Maiga
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
| | - Mariam Sylla
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
| | - Joël Gozlan
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), for Department of Virology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, F-75012 Paris, France
| | - Manal H. El-Sayed
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Laurence Morand-Joubert
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), for Department of Virology, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, F-75012 Paris, France
| | - Robert L. Murphy
- Institute for Global Health, Northwestern University, Chicago, IL 60208, USA
| | - Mahamadou Diakité
- Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako BP 1805, Mali
| | - Jane L. Holl
- Department of Neurology, University of Chicago, Chicago, IL 60637, USA
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Umer A, Teklemariam Z, Ayele F, Mengesha MM. Prevalence of hepatitis B infection and its associated factors among pregnant mothers attending antenatal care at public hospitals at Hararghe, Eastern Ethiopia. Front Glob Womens Health 2023; 4:1056488. [PMID: 37181544 PMCID: PMC10174709 DOI: 10.3389/fgwh.2023.1056488] [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: 09/28/2022] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Background Hepatitis B infection is one of the world's most serious public health problems, causing significant morbidity and mortality. More than 2 billion individuals around the world have been infected with the hepatitis B virus (HBV), and approximately 400 million people are chronically infected with the virus, with more than a million dying each year from hepatitis B virus-related liver disease. A newborn infant whose mother is positive for both HBsAg and HBeAg has a 90% chance of developing chronic infection by the age of 6. Its infectivity is a 100 times that of the human immunodeficiency virus, but it receives little attention in public health. Therefore, this study was conducted to assess the prevalence of hepatitis B infection and its associated factors among pregnant mothers attending antenatal care at public hospitals in west Hararghe, eastern Ethiopia 2020. Method This institution-based cross-sectional study was conducted on 300 pregnant mothers selected by systematic random sampling from September to December 2020. Data were collected by face-to-face interview using a pretested structured questionnaire. A blood sample was collected and tested for hepatitis B surface antigen using the enzyme-linked immunosorbent assay test method. Data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Science version 22 for analysis. Bivariate and multivariable logistic regressions were used to assess the association between outcome and predictor variables. P-value <0.05 was considered to be statistically significant. Results The overall seroprevalence of hepatitis B virus infection was 8% [95% confidence interval (CI): 5.3-11.0] among pregnant mothers. History of tonsillectomy [adjusted odd ratio (AOR) = 5.7; 95% CI: 1.3-23.9], tattoo (AOR = 4.3; 95% CI: 1.1, 17.0), having multiple sexual partners (AOR = 10.8; 95% CI: 2.5, 45.9), and history of contact with jaundiced patients (AOR = 5.6; 95% CI: 1.2, 25.7) were factors associated with the seroprevalence of hepatitis B virus infection among pregnant mothers. Conclusion The hepatitis B virus was highly prevalent. A history of tonsillectomy, tattooing, having multiple partners, and contact with jaundiced patients were factors associated with hepatitis B virus infection. To reduce HBV transmissions, the government should increase HBV vaccination coverage. All newborns should receive the hepatitis B vaccine as soon as possible after birth. It is also recommended that all pregnant women have HBsAg testing and antiviral prophylaxis to reduce the risk of transmission from mother to child. Hospitals, districts, regional health bureaus, and medical professionals should also educate pregnant women about hepatitis B virus transmission and prevention, both in the hospital and in the community, with a focus on modifiable risk factors.
Collapse
Affiliation(s)
- Abbas Umer
- West Hararghe Zone Health Office, Chiro, Ethiopia
| | - Zelalem Teklemariam
- School of Medical Laboratory Sciences, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Firayad Ayele
- School of Medical Laboratory Sciences, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
- Correspondence: Firayad Ayele
| | - Melkamu Merid Mengesha
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
10
|
Llop MJ, Gómez A, Llop P, López MS, Müller GV. Prediction of leptospirosis outbreaks by hydroclimatic covariates: a comparative study of statistical models. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:2529-2540. [PMID: 36306013 PMCID: PMC9614762 DOI: 10.1007/s00484-022-02378-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/25/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Leptospirosis, the infectious disease caused by a spirochete bacteria, is a major public health problem worldwide. In Argentina, some regions have climatic and geographical characteristics that favor the habitat of bacteria of the Leptospira genus, whose survival strongly depends on climatic factors, enhanced by climate change, which increase the problems associated with people's health. In order to have a method to predict leptospirosis cases, in this paper, five time series forecasting methods are compared: two parametric (autoregressive integrated moving average and an alternative one that allows covariates, ARIMA and ARIMAX, respectively), two nonparametric (Nadaraya-Watson Kernel estimator, one and two kernels versions, NW-1 K and NW-2 K), and one semiparametric (semi-functional partial linear regression, SFPLR) method. For this, the number of cases of leptospirosis registered from 2009 to 2020 in three important cities of northeastern Argentina is used, as well as hydroclimatic covariates related to the presence of cases. According to the obtained results, there is no method that improves considerably the rest and can be recommended as a unique tool for leptospirosis prediction. However, in general, the NW-2 K method gets a better performance. This work, in addition to using a long-term high-quality time series, enriches the area of applications of statistical models to epidemiological leptospirosis data by the incorporation of hydroclimatic variables, and it is recommended directing further efforts in this line of research, under the context of current climate change.
Collapse
Affiliation(s)
- María José Llop
- Facultad de Ingeniería Química, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina.
| | - Andrea Gómez
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- CEVARCAM, Facultad de Ingeniería y Ciencias Hídricas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - Pamela Llop
- Facultad de Ingeniería Química, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
| | - María Soledad López
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- CEVARCAM, Facultad de Ingeniería y Ciencias Hídricas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| | - Gabriela V Müller
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Santa Fe, Argentina
- CEVARCAM, Facultad de Ingeniería y Ciencias Hídricas, Universidad Nacional del Litoral (UNL), Santa Fe, Argentina
| |
Collapse
|
11
|
Tewuhibo D, Asmamaw G, Ayenew W. Cost-effectiveness analysis of current non-mandatory hepatitis B vaccination coverage vs expanding coverage among healthcare workers in Ethiopia. J Pharm Policy Pract 2022; 15:65. [PMID: 36253827 PMCID: PMC9575251 DOI: 10.1186/s40545-022-00458-4] [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: 06/14/2022] [Accepted: 10/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethiopia is a country with high endemicity in Hepatitis B (HepB) virus infection. However, only 14% of healthcare workers (HCWs) are currently immunized via a non-mandatory strategy in the country. Hence, this study aimed to estimate the cost-effectiveness of the current vaccination coverage and increasing coverage among HCWs in Ethiopia. METHODS Based on current practice, the study considered a monovalent HepB vaccine, which has a 90% protection rate with a complete three-dose series for lifelong protection. Markov model for current coverage (14%) and expanding vaccination coverage to 80% (as per World Health Organization (WHO) recommendation) was simulated based on the data got from both primary and secondary data. Secondary data, particularly cost and effectiveness data, were gained from published articles, WHO guidelines, and Ethiopian Federal Ministry of Health documents. Cost-related data for vaccination and chronic HepB treatment were also gathered by interviewing expertise from Tikur Anbesa specialized hospital. We conducted the study from a healthcare payer perspective, with a 3% discount rate of cost and health outcome as recommended by the WHO. The primary health outcome was measured by the Incremental Cost-Effectiveness Ratio (ICER). We employed deterministic analysis and tornado diagrams to manage parameter uncertainty and show a plausible range of cost and effectiveness of variables. RESULTS Current vaccination program is more expensive (USD 29.99) with a more additional cost of USD 1.32 and with reduced effectiveness of 0.08 Life Years (LYs) compared to the expanded HepB vaccination strategy which costs USD 28.67 and gives a relatively high total LY gain of 28.62. The resulting ICER was USD-16.23 per LYs gained. The negative ICER shows that the expanded HepB vaccination strategy dominated the current vaccination strategy. A one-way sensitivity analysis also revealed that the current vaccine coverage was dominated by an increase in the risk of infection among unvaccinated individuals. CONCLUSIONS Expanded vaccination coverage (to 80%) was found the most cost-effective strategy in Ethiopian HCWs compared to the current non-mandatory vaccine coverage (14%). In addition, the results of one-way and two-way sensitivity analysis reveal the robustness of our model conclusion.
Collapse
Affiliation(s)
- Dinksew Tewuhibo
- Department of Pharmacy, Madda Walabu University, Bale Robe, Ethiopia
| | - Getahun Asmamaw
- Department of Pharmacy, Arba Minch University, Arba Minch, Ethiopia.
| | - Wondim Ayenew
- Department of Pharmaceutics, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
12
|
Wondmagegn M, Wondimeneh Y, Getaneh A, Ayalew G. Seroprevalence of Hepatitis B Virus, Hepatitis C Virus, Syphilis and Associated Factors Among Female Sex Workers in Gondar Town, Northwest Ethiopia. Infect Drug Resist 2022; 15:5915-5927. [PMID: 36254334 PMCID: PMC9569237 DOI: 10.2147/idr.s380952] [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: 07/02/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are a public health problem worldwide. Hepatitis B virus infection (HBV), hepatitis C virus infection (HCV), and syphilis are among the STIs. Female sex workers (FSWs) continue to be a high-risk group for STIs due to a variety of factors, including exposure to unsafe sexual practices. Therefore, this study determines the seroprevalence of HBV, HCV, Treponema palladium, and associated factors among FSWs in Gondar town, Northwest Ethiopia. Methods A cross-sectional study was conducted on 194 FSWs from March to June 2021 in Gondar town. Socio-demographic and behavioral data were collected using a questionnaire. Five milliliters (5mL) of venous blood was collected and tested for hepatitis B surface antigens, anti-hepatitis C antibodies, and anti-syphilis antibodies using an enzyme-linked immunosorbent assay. Logistic regression, univariate, and multivariate analyses were carried out. A p-value of < 0.05 at a 95% confidence interval was considered statistically significant. Results A total of 194 FSWs were included in the study. The seroprevalence rates of HBV infection, HCV infection, and syphilis were 23 (11.9%), 13 (6.7%), and 22 (11.3%), respectively. All three infections were statistically associated with inconsistent condom use (AOR = 1.72, 95% CI: 1.95-5.07, p = 0.03); (AOR = 10.51, 95% CI: 1.62-68.26, p = 0.014); and (AOR = 17.3, 95% CI: 4.55-65.6, p = 0.001). Whereas sex stimulant drug use (AOR = 9.4, 95% CI: 1.002-88.14), intravenous drug use (AOR = 15.53, 95% CI: 1.9-127.99, p=0.011), and sex while having a vaginal ulcer (AOR = 5.72, 95% CI: 1.13-28.9, p=0.035) were all statistically associated with HCV infection. Conclusion The prevalence of HBV infection, HCV infection, and syphilis was comparatively higher. Regular screening, health education, and other preventative strategies are advised to lower the STI burden among FSWs.
Collapse
Affiliation(s)
- Mitikie Wondmagegn
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yitayih Wondimeneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alem Getaneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getnet Ayalew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Getnet Ayalew, Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia, Tel +251-918-73-00-13, Email
| |
Collapse
|
13
|
Sabeena S, Ravishankar N. Horizontal Modes of Transmission of Hepatitis B Virus (HBV): A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2181-2193. [PMID: 36415805 PMCID: PMC9647610 DOI: 10.18502/ijph.v51i10.10977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/14/2021] [Indexed: 11/06/2022]
Abstract
Background Horizontal transmission of hepatitis B virus (HBV) is a significant transmission route in households, among contact sport athletes and institutionalized individuals. Children often are infected by non-sexual close contacts with an increased tendency to become chronic carriers. Hence, the awareness about various high-risk behaviours leading to horizontal transmission in the community is essential. A systematic review and meta-analysis was carried out to assess quantitatively the pooled prevalence of horizontally transmitted HBV infection globally. Methods The study was started after ruling out registered or ongoing systematic reviews related to this topic in the PROSPERO database. The study protocol was documented in PROSPERO with a registration number CRD42021235165. We searched electronic databases for published articles in English between 1981 and April 2021 reporting horizontal modes of hepatitis B transmission among unvaccinated contacts. Meta-analysis was carried out in STATA version 13.0 (College Station, Texas 77,845 USA). The forest plots were constructed using metaprop package in STATA. Results Forty-one studies were systematically reviewed and 15 studies were qualified for the meta-analysis, including 1619 hepatitis B cases and 4869 contacts. The overall pooled prevalence of horizontally transmitted HBV infection among the contacts was 38% (95% CI 30%-46%). The pooled prevalence among 3,912 household contacts from nine qualified studies was estimated as 44% (95% CI 35%-54%). The pooled prevalence rates among institutionalized individuals and contact sport athletes were 30% (95% CI 23%-37%) and 18% (95% CI 5%-32%), respectively. Conclusion The likelihood of horizontal transmission of HBV is greater among household contacts of chronic carriers of HBV and institutionalized individuals.
Collapse
Affiliation(s)
- Sasidharanpillai Sabeena
- Clinical Virology, Allure Residency, Near the British School, Kathmandu, Nepal,Corresponding Author:
| | - Nagaraja Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
| |
Collapse
|
14
|
Brown R, Goulder P, Matthews PC. Sexual Dimorphism in Chronic Hepatitis B Virus (HBV) Infection: Evidence to Inform Elimination Efforts. Wellcome Open Res 2022; 7:32. [PMID: 36212217 PMCID: PMC9520633 DOI: 10.12688/wellcomeopenres.17601.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/20/2022] Open
Abstract
Sexual dimorphism in infectious diseases refers to the different infection susceptibilities and outcomes between males and females, and has been described for many pathogens, including hepatitis B virus (HBV). HBV is a substantial global health problem, with close to 300 million people chronically infected, and accounting for a million deaths each year, with an urgent need for enhanced interventions to support progress towards elimination goals. Sexual dimorphism has a strong influence in HBV infection, with males more likely to be exposed, to develop chronic infection, and to suffer from complications including cirrhosis and hepatocellular carcinoma (HCC) compared to females. Different outcomes are driven by differential immune responses, sexual dimorphism of the liver, and androgen response elements in the HBV genome. The impact of sex may also vary with age, with changes at puberty and influences of menarche, pregnancy and menopause in females. In addition, gender has complex influences on education, beliefs, behaviour and access to / engagement with healthcare services, which may contribute to differences in diagnosis and treatment. Interplay between these complex factors, alongside other attributes of host, virus and the environment, accounts for different outcomes of infection. However, gaps remain in our understanding of sexual dimorphism in HBV, and little effort has previously been made to harness this knowledge for translational gains. In this review, we assimilate human and animal data to consider the mechanism, outcomes and impact of sexual dimorphism, and consider how these insights can be used to inform advances in surveillance, treatment and prevention for HBV infection.
Collapse
Affiliation(s)
- Robin Brown
- Harris Manchester College, University of Oxford, Oxford, Oxon, OX1 3TD, UK
| | - Philip Goulder
- Department of Paediatrics, University of Oxford, Oxford, Oxon, OX1 3SY, UK
| | - Philippa C. Matthews
- Harris Manchester College, University of Oxford, Oxford, Oxon, OX1 3TD, UK
- The Francis Crick Institute, London, London, NW1 1AT, UK
- Division of Infection and Immunity, University College London, London, WC1E 6BT, UK
- Department of Infectious Diseases, University College London Hospital, London, NW1 2BU, UK
| |
Collapse
|
15
|
Brown R, Goulder P, Matthews PC. Sexual Dimorphism in Chronic Hepatitis B Virus (HBV) Infection: Evidence to Inform Elimination Efforts. Wellcome Open Res 2022; 7:32. [DOI: 10.12688/wellcomeopenres.17601.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/20/2022] Open
Abstract
Sexual dimorphism in infectious diseases refers to the different infection susceptibilities and outcomes between males and females, and has been described for many pathogens, including hepatitis B virus (HBV). HBV is a substantial global health problem, with close to 300 million people chronically infected, and accounting for a million deaths each year, with an urgent need for enhanced interventions to support progress towards elimination goals. Sexual dimorphism has a strong influence in HBV infection, with males more likely to be exposed, to develop chronic infection, and to suffer from complications including cirrhosis and hepatocellular carcinoma (HCC) compared to females. Different outcomes are driven by differential immune responses, sexual dimorphism of the liver, and androgen response elements in the HBV genome. The impact of sex may also vary with age, with changes at puberty and influences of menarche, pregnancy and menopause in females. In addition, gender has complex influences on education, beliefs, behaviour and access to / engagement with healthcare services, which may contribute to differences in diagnosis and treatment. Interplay between these complex factors, alongside other attributes of host, virus and the environment, accounts for different outcomes of infection. However, gaps remain in our understanding of sexual dimorphism in HBV, and little effort has previously been made to harness this knowledge for translational gains. In this review, we assimilate human and animal data to consider the mechanism, outcomes and impact of sexual dimorphism, and consider how these insights can be used to inform advances in surveillance, treatment and prevention for HBV infection.
Collapse
|
16
|
HIV, hepatitis B virus, and hepatitis C virus co-infection among HIV positives in antiretroviral treatment program in selected hospitals in Addis Ababa: A retrospective cross-sectional study. PLoS One 2022; 17:e0267230. [PMID: 35452472 PMCID: PMC9032368 DOI: 10.1371/journal.pone.0267230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/05/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction HIV co-infection with hepatitis B (HIV-HBV) and hepatitis C (HIV-HCV) is known to affect treatment outcomes of antiretroviral therapy (ART); however, its magnitude is not well documented. We aimed to determine the magnitude of HIV-HBV and HIV-HCV co-infections simultaneously in people living with HIV (PLHIV) enrolled in ART care in Addis Ababa. Methods We reviewed the medical records of adults ≥15 years who were receiving ART care in three high burden hospitals in Addis Ababa. Baseline clinical and laboratory test results were extracted from medical records. Co-infection was determined based on hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) tests obtained from the medical records. A multivariable logistic regression model was used to identify the risk factors for hepatitis B and C co-infections. Results A total of 873 HIV-positive participants were included in this study. The median age of the participants was 37.5 years, and 55.7% were women. Overall, HIV-HBV co-infection was 5.96% (95% CI: 4.56–7.74), and HIV-HCV co-infection was 1.72% (95% CI: 1.03–2.83). The multivariable logistic regression showed that the male sex was the most independent predictor for viral hepatitis B co-infection with an odds ratio of 2.42(95% CI:1.27–4.63). However, HIV-HCV co-infection did not show a significant association in any of the sociodemographic data of the participants. Conclusion HIV co-infection with hepatitis B was moderately high in individuals enrolled in ART care in Addis Ababa. Men had significantly higher HIV-HBV co-infection. HIV co-infection with hepatitis C was relatively low. Strengthening integrated viral hepatitis services with HIV care and treatment services should be emphasized to improve patient care in health facilities.
Collapse
|
17
|
Seyoum E, Demissie M, Worku A, Mihret A, Abdissa A, Berhane Y. Retention on antiretroviral therapy in person with HIV and viral hepatitis coinfection in Ethiopia: a retrospective cohort study. BMC Public Health 2022; 22:644. [PMID: 35379215 PMCID: PMC8978407 DOI: 10.1186/s12889-022-13025-y] [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: 04/28/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background HIV coinfection with viral hepatitis B (HBV) or viral hepatitis C (HCV) is not uncommon in Ethiopia. Although the coinfections are presumed to interfere with antiretroviral treatment (ART), this is not widely studied in Sub-Saharan African settings. This study was conducted to determine ART retention in persons coinfected with HIV + HBV or HIV + HCV. Methods We reviewed the medical records of HIV-positive adults who initiated ART between 2011 to 2018 in four high-burden hospitals of Addis Ababa. Retention in care was the primary outcome of the study, which was compared between HIV and either HBV or HCV coinfected persons, and HIV-monoinfected persons. A parametric Gompertz regression model was used to compare retention between the coinfected and monoinfected groups. Results A total of 132 coinfected persons and 514 HIV-monoinfected individuals who initiated ART in 2011–2018 were compared. At 12-months of follow-up, 81.06% [95% CI: 73.3–86.9%] of the coinfected and 86.96% [95% CI: 83.7–89.6%] of the monoinfected were still on ART care. Cumulative retention in the coinfected group was 68.93% [60.4–76.3%] versus 80.35% [76.6–83.5%, p = 0.0048] in the monoinfected group. The cumulative retention was lower (61.25, 95% CI: 49.9–71.4%) in male coinfected patients than male monoinfected patients (77.77, 95% CI: 71.8–82.7%, p = 0.0041). In contrast, cumulative retention was similar in females in the coinfected group (80.76, 95% CI:67.3–89.5%) versus the monoinfected group (82.29, 95% CI:77.4–86.3%, p = 0.792). Overall, HIV-positive with viral hepatitis coinfection were 24 and 31% less likely to still be on ART care than the monoinfected group at 12 months and overall, with sub-distribution adjusted hazard ratio (AHR) of 0.76(95% CI:0.61–0.96, p = 0.021) and 0.69(95% CI:0.54–0.87, p = 0.002) respectively. Conclusions We observed that coinfected individuals are less likely to stay on ART than HIV monoinfected individuals. The low retention in the coinfected group from this study may affect the success of survival gained in people living with HIV (PLHIV) in the long term. More concerted efforts need to be made to retain coinfected individuals at least at the level of monoinfected persons on long-term ART care. Future studies are needed to better understand the difference in retention, preferable in a prospective manner. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13025-y.
Collapse
Affiliation(s)
- Eleni Seyoum
- Institute of Public Health, University of Gondar, Gondar, Ethiopia & Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, 10433, Addis Ababa, Ethiopia.
| | - Meaza Demissie
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| |
Collapse
|
18
|
Brown R, Goulder P, Matthews PC. Sexual Dimorphism in Chronic Hepatitis B Virus (HBV) Infection: Evidence to Inform Elimination Efforts. Wellcome Open Res 2022; 7:32. [DOI: 10.12688/wellcomeopenres.17601.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/20/2022] Open
Abstract
Sexual dimorphism in infectious diseases refers to the different infection susceptibilities and outcomes between males and females, and has been described for many pathogens, including hepatitis B virus (HBV) infection. HBV is a substantial global health problem, with close to 300 million people infected, and accounting for a million deaths each year, with an urgent need for enhanced interventions to support progress towards elimination goals. Sexual dimorphism has a strong influence in HBV infection, with males more likely to be exposed, to develop chronic infection, and to suffer from complications including cirrhosis and hepatocellular carcinoma (HCC) compared to females. Different outcomes are driven by differential immune responses, sexual dimorphism of the liver, and androgen response elements in the HBV genome. The impact of sex may also vary with age, with changes at puberty and influences of menarche, pregnancy and menopause in females. In addition, gender has complex influences on education, beliefs, behaviour and access to / engagement with healthcare services, which may contribute to differences in diagnosis and treatment. Interplay between these complex factors, alongside other attributes of host, virus and the environment, accounts for different outcomes of infection. However, gaps remain in our understanding of sexual dimorphism in HBV, and little effort has previously been made to harness this knowledge for translational gains. In this review, we assimilate human and animal data to consider the mechanism, outcomes and impact of sexual dimorphism, considering how these insights can be used to inform advances in surveillance, treatment and prevention for HBV infection.
Collapse
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Beykaso G, Mulu A, Giday M, Berhe N, Selamu M, Mihret A, Teklehaymanot T. Burden and Transmission Risks of Viral Hepatitis in Southern Ethiopia: Evidence Needed for Prevention and Control Measures. Risk Manag Healthc Policy 2021; 14:4843-4852. [PMID: 34880693 PMCID: PMC8646867 DOI: 10.2147/rmhp.s336776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver-associated morbidity and mortality for millions of people globally. Ethiopia is one of the viral hepatitis-endemic countries with no national strategy for surveillance and limited data. As such, this study aimed to investigated the extent and associated risk factors of HBV and HCV among community members in southern Ethiopia. METHODS A community-based cross-sectional study was conducted from January 2020 to August 2020. A structured questionnaire was used to collect behavioral and sociodemographic data. Serum samples were collected and assayed for seromarkers of HBV (HBsAg, anti-HBc, and anti-HBs) and HCV (anti-HCV) using ELISAs. In HBsAg-positive samples, HBV DNA was further quantified using RT-PCR. Data were entered into EpiData 3.1 and analyzed using SPSS 21.0. Descriptive statistics and logistic regression analysis were employed. RESULTS The study included 693 participants. Seromarkers for HBsAg, anti-HCV, anti-HBc, and anti-HBs were found to be 9.5%, 1.4%, 31.1%, and 14.3%, respectively. In 66 HBsAg positives, 57 (86.4%) had quantifiable HBV DNA. Prevalence of current HBV infection (HBsAg+, anti-HBc+, anti-HBs-) and lifetime exposure (positive for either HBsAg or anti-HBc) to HBV were 8.7% and 31.9%, respectively, and 63.1% of participants were vulnerable or had no evidence of prior HBV infection (HBsAg-, anti-HBc-, anti-HBs-). On multivariate logistic regression analysis, multiple sexual contacts, family history of hepatitis infection, alcohol consumption, and khat chewing were significantly associated with HBV. The seroprevalence of HBV was relatively high in this study area. CONCLUSION This study showed high prevalence of HBV infection, but low prevalence of HCV. This indicates that HBV is a major health problem in this community. Population-based surveillance, care, and treatment, as well as behavioral change and education programs, should be enhanced to minimize risk exposure.
Collapse
Affiliation(s)
- Gizachew Beykaso
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Andargachew Mulu
- Department of Virology, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mirutse Giday
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nega Berhe
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Markos Selamu
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Adane Mihret
- Department of Virology, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tilahun Teklehaymanot
- Department of Molecular Biology and Immunology, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
21
|
Tesfaye BT, Feyissa TM, Workneh AB, Gudina EK, Yizengaw MA. Chronic Liver Disease in Ethiopia with a Particular Focus on the Etiological Spectrums: A Systematic Review and Meta-Analysis of Observational Studies. Can J Gastroenterol Hepatol 2021; 2021:8740157. [PMID: 34858892 PMCID: PMC8632430 DOI: 10.1155/2021/8740157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background In Ethiopia, chronic liver disease (CLD) is the 7th leading cause of death, accounting for about 24 deaths per 100000 populations in 2019. Despite its burden, there is a lack of compiled pieces of evidence on CLD in the country. Thus, this systematic review and meta-analysis is intended to provide the pooled estimates of CLD etiologies and mortality rate in CLD patients in Ethiopia. Method PubMed, Google Scholar, ScienceDirect, institutional repositories, national digital library, and the bibliography of the eligible articles information were the source of data for the present review. The keywords "hepatitis, chronic" [Mesh], "end-Stage Liver Disease" [Mesh], "chronic liver disease", "liver cirrhosis" [Mesh], and "Ethiopia" were used for the searches. Overall, we retrieved 199 records and 12 were included in this review. We used the DerSimonian-Laird random-effects models to perform the meta-analysis. We conducted subgroup and meta-regression analyses to account for the heterogeneity of the estimates. Result Hepatitis B virus, alcohol, and hepatitis C virus are the three most common etiologies of CLD in Ethiopia accounting for a pooled estimate of 40.0% [95% CI: 29.0, 51.0, I 2 = 96.3, p < 0.001], 17.0% [95% CI: 9.0, 25.0, I 2 = 96.7, p < 0.001], and 15.0% [95% CI: 9.0, 21.0, I 2 = 95.8, p < 0.001], respectively. Unidentified etiology report has a substantial contribution accounting for an estimated pooled proportion of 45% [95% CI: 34.0, 56.0%, Q = 32.08, p < 0.001, I 2 = 87.53] of the CLD cases in the country. On the other hand, the overall hospital mortality rate in CLD patients is 25.0% [95% CI: 2.0, 47.0, I2 = 94.6, p < 0.001] in Ethiopia. Conclusion Hepatitis B virus, hepatitis C virus, and alcohol are the three most common contributors to CLD cases in Ethiopia. The authors warrant routine screening and strengthening of preventive and treatment programs for viral hepatitis B and C, further enhancing the alcohol policy of the country.
Collapse
Affiliation(s)
- Behailu Terefe Tesfaye
- Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Ethiopia
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
| | - Temesgen Mulugeta Feyissa
- Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Ethiopia
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
| | - Azmeraw Bekele Workneh
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
- Jimma University, Institute of Health, School of Pharmacy, Social Pharmacy Unit, Jimma, Ethiopia
| | - Esayas Kebede Gudina
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
- Jimma University, Institute of Health, Department of Internal Medicine, Jimma, Ethiopia
| | - Mengist Awoke Yizengaw
- Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Ethiopia
- Jimma University Medical Center, Institute of Health, Jimma, Ethiopia
| |
Collapse
|
22
|
Ajuwon BI, Yujuico I, Roper K, Richardson A, Sheel M, Lidbury BA. Hepatitis B virus infection in Nigeria: a systematic review and meta-analysis of data published between 2010 and 2019. BMC Infect Dis 2021; 21:1120. [PMID: 34717586 PMCID: PMC8556927 DOI: 10.1186/s12879-021-06800-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023] Open
Abstract
Background Hepatitis B virus (HBV) is an infectious disease of global significance, causing a significant health burden in Africa due to complications associated with infection, such as cirrhosis and liver cancer. In Nigeria, which is considered a high prevalence country, estimates of HBV cases are inconsistent, and therefore additional clarity is required to manage HBV-associated public health challenges. Methods A systematic review of the literature (via PubMed, Advanced Google Scholar, African Index Medicus) was conducted to retrieve primary studies published between 1 January 2010 and 31 December 2019, with a random-effects model based on proportions used to estimate the population-based prevalence of HBV in the Nigerian population. Results The final analyses included 47 studies with 21,702 participants that revealed a pooled prevalence of 9.5%. A prevalence estimate above 8% in a population is classified as high. Sub-group analyses revealed the highest HBV prevalence in rural settings (10.7%). The North West region had the highest prevalence (12.1%) among Nigeria’s six geopolitical zones/regions. The estimate of total variation between studies indicated substantial heterogeneity. These variations could be explained by setting and geographical region. The statistical test for Egger’s regression showed no evidence of publication bias (p = 0.879). Conclusions We present an up-to-date review on the prevalence of HBV in Nigeria, which will provide critical data to optimise and assess the impact of current prevention and control strategies, including disease surveillance and diagnoses, vaccination policies and management for those infected. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06800-6.
Collapse
Affiliation(s)
- Busayo I Ajuwon
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia. .,Department of Biosciences and Biotechnology, Faculty of Pure and Applied Sciences, Kwara State University, Malete, Nigeria.
| | - Isabelle Yujuico
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Katrina Roper
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Alice Richardson
- Statistical Consulting Unit, The Australian National University, Acton, ACT, Australia
| | - Meru Sheel
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Brett A Lidbury
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia.,Department of Health Evidence, Radboud UMC, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
23
|
Hepatitis B vaccination status and associated factors among students of medicine and health sciences in Wolkite University, Southwest Ethiopia: A cross-sectional study. PLoS One 2021; 16:e0257621. [PMID: 34547021 PMCID: PMC8454964 DOI: 10.1371/journal.pone.0257621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/05/2021] [Indexed: 01/21/2023] Open
Abstract
Background Hepatitis B virus (HBV) infection is a significant global public health problem. Health care providers and medical students in developing countries including Ethiopia are at an increased risk of contracting HBV due to the high burden of this infection. The most effective way of prevention against HBV infection is vaccination of health care providers. However, there is a paucity of data on the HBV vaccination coverage among students of health science in Ethiopia. Therefore, this study aimed to determine HBV vaccination coverage and associated factors, level of knowledge, attitudes, and practices (KAP) towards HBV among students of medicine and health science at Wolkite University. Materials and methods A cross-sectional study was conducted at Wolkite University among 417 study participants from November to December 2020. The study participants were recruited by using a simple random sampling technique. Data were collected using a self-administered structured questionnaire and analyzed using SPSS version 21. A binary logistic regression model was used to determine the factors associated with full-dose vaccination status. Statistical significance was set at P-value <0.05. Results Out of the 417 study participants, 5.8% (95%CI: 3.8–7.9) received a full-dose of the HBV vaccine in this study. Unavailability and high cost of the vaccine were frequently mentioned reasons for not being vaccinated against HBV. About 73.6%, 36.2%, and 47% of participants had good knowledge, positive attitudes, and good practices towards HBV, respectively. Being male gender (AOR: 8.8; 95%CI: 2.9–27), rural residence (AOR: 3.6; 95%CI:1.2–10.6), positive attitude (AOR: 0.44; 95%CI: 0.1–1.1), good practice (AOR: 0.17; 95%CI: 0.05–0.5), medicine department (AOR: 5.9; 95%CI: 1.2–29), being second-year student (AOR: 11.7; 95%CI: 2.7–50.9), third-year student (AOR: 19; 95%CI: 4.25–45), and fourth-year student (AOR: 27; 95%CI: 5.8–56) were significantly associated factors with full-dose vaccination status. Conclusion Our study revealed that only small proportions (5.8%) of study participants received full-dose HBV vaccination. Vaccinations of students before starting clinical attachments, provisions of training for students on infection prevention mechanism and universal precautions particularly on HBV, increasing the uptake of the HBV vaccine, creating awareness on attitude and practice of students towards HBV to enhance uptake of the vaccine are recommended.
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Kinfe H, Sendo EG, Gebremedhin KB. Prevalence of Hepatitis B Virus Infection and Factors Associated with Hepatitis B Virus Infection Among Pregnant Women Presented to Antenatal Care Clinics at Adigrat General Hospital in Northern Ethiopia. Int J Womens Health 2021; 13:119-127. [PMID: 33519245 PMCID: PMC7837579 DOI: 10.2147/ijwh.s280806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/28/2020] [Indexed: 12/25/2022] Open
Abstract
Background Hepatitis B infection is among the most common public health concerns globally, particularly in low- and middle-income countries. The prevalence of hepatitis B infection is more common among most vulnerable populations, including pregnant women. However, there are limited studies on hepatitis B virus infection among pregnant women in low-income countries, including Ethiopia, and the previous studies focused on the general population rather than the pregnant women. The purpose of this study was to estimate the prevalence and examine factors associated with hepatitis B virus infection among pregnant women in the Northern Ethiopia. Methods nstitution-based cross-sectional study design and a structured face-to-face interview were used to collect data from the study participants. Simple random sampling method was used to select eligible study participants. Data were entered using EpiData version 3.1, and SPSS version 20 was used for the data analysis. We analyzed the data to examine factors associated with hepatitis B virus infection using binary and multivariable logistic regression models. Results The overall prevalence of hepatitis B virus infection among the study participants was 9.2%. The majority (46.7%) of the study participants infected by hepatitis B were in the age group 25-34 years. The study found that married study participants were more likely to be infected by hepatitis B when compared to the unmarried study participants. Having history of abortion [OR = 0.12 (95% CI: 0.03, 0.47), P < 0.01] and having history of tattooing [OR = 0.21 (95% CI: 0.07, 0.62), P < 0.01] were found to be statistically significantly associated with the prevalence of hepatitis B virus infection among pregnant women. Conclusion A significant number of pregnant women participating in the study were infected by the hepatitis B virus which needs efficient intervention to reduce the infection rate. Further, educational status, having history of surgery, dental procedure, ear piercing, abortion and tattooing were found statistically to be significant before controlling for confounders. But, after controlling for confounders, only having history of tattooing and having history of abortion were found to be independent factors affecting the prevalence of the infection.
Collapse
Affiliation(s)
| | - Endalew Gemechu Sendo
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | |
Collapse
|
26
|
Orlien SMS, Ahmed TA, Ismael NY, Berhe Belay N, Kran AMB, Gundersen SG, Johannessen A. Field performance of HBsAg rapid diagnostic tests in rural Ethiopia. J Virol Methods 2020; 289:114061. [PMID: 33388369 DOI: 10.1016/j.jviromet.2020.114061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/12/2020] [Accepted: 12/22/2020] [Indexed: 12/27/2022]
Abstract
Point-of-care rapid diagnostic tests (POC-RDTs) are widely used to screen and diagnose hepatitis B virus (HBV) infection and are often the only available diagnostic tools in resource-limited settings. The aim of this study was to evaluate the validity of three hepatitis B surface antigen (HBsAg) POC-RDTs (Healgen®, Advanced Quality™ and Determine™) in an area with high prevalence of HBV in eastern Ethiopia. Results were compared with a commercial enzyme linked immunosorbent assay (ELISA) as gold standard. Quantification of HBsAg was performed in false negative samples. A total of 511 subjects were screened, of whom 81 (15.9 %) were HBsAg-positive with the gold standard. All three POC-RDTs were positive in 65 of the 81 positive samples, yielding a sensitivity (95 % confidence interval) of 80.2 % (70.3-87.5) and a specificity of 99.8 % (98.7-100 for Healgen® and Determine™; 98.6-100 for Advanced Quality™). False negatives were observed in 16 patients associated with low levels of HBsAg (median 1.5 IU/mL). All three POC-RDTs had reasonably high sensitivity and excellent specificity, but false negative results were observed in patients with low titres of HBsAg. Thus, these POC-RDTs might be useful to identify patients in need of HBV treatment, but cannot be recommended as blood donor screening tests.
Collapse
Affiliation(s)
- Stian Magnus Staurung Orlien
- Department of Paediatrics, Vestfold Hospital Trust, Tønsberg, Norway; The Morbid Obesity Center, Children and Adolescents, Vestfold Hospital Trust, Tønsberg, Norway; Regional Centre for Imported and Tropical Diseases, Oslo University Hospital Ullevål, Oslo, Norway.
| | - Tekabe Abdosh Ahmed
- Department of Internal Medicine, Jugal Hospital, Harar, Ethiopia; Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Nejib Yusuf Ismael
- Haramaya University College of Health and Medical Sciences, Harar, Ethiopia; Department of Internal Medicine, Hiwot Fana Specialized University Hospital, Harar, Ethiopia
| | - Nega Berhe Belay
- Regional Centre for Imported and Tropical Diseases, Oslo University Hospital Ullevål, Oslo, Norway; Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anne-Marte Bakken Kran
- Department of Microbiology, Oslo University Hospital, Oslo, Norway; Department of Infectious Disease Registries, Norwegian Institute of Public Health, Oslo, Norway
| | - Svein Gunnar Gundersen
- Department of Global Development and Planning, University of Agder, Kristiansand, Norway
| | - Asgeir Johannessen
- Regional Centre for Imported and Tropical Diseases, Oslo University Hospital Ullevål, Oslo, Norway; Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway
| |
Collapse
|
27
|
Awoke N, Mulgeta H, Lolaso T, Tekalign T, Samuel S, Obsa MS, Olana R. Full-dose hepatitis B virus vaccination coverage and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis. PLoS One 2020; 15:e0241226. [PMID: 33108365 PMCID: PMC7591041 DOI: 10.1371/journal.pone.0241226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The hepatitis B vaccine is the backbone of hepatitis B prevention. All health care workers must receive a full-dose (3-dose vaccine series) to achieve >90% protection against hepatitis B virus. There is limited evidence available on vaccination coverage of HBV among health care workers in Ethiopia. Therefore, the objective of this study was to estimate the national full-dose hepatitis B vaccination coverage and the associated factors among health care workers in Ethiopia. METHODS Studies were retrieved from PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and Google Scholar by using a combination of search terms with Boolean operators. The quality of each study was evaluated independently by three authors using the modified Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Statistical analyses were performed using STATA™ Version 14 software. Meta-analysis was carried out using a random-effects (DerSimonian and Laird) method. The heterogeneity test was conducted by using I-squared (I2) statistics. Leave-one-out sensitivity analysis was performed. RESULTS A total of 15 articles with 5734 participants were included in this systematic review and meta-analysis. The pooled prevalence of full-dose hepatitis B virus vaccination coverage among health care workers in Ethiopia was 20.04% (95% CI: 13.83, 26.26); I2 = 98.9%). Being male sex (p = 0.002), having work experience of less than 5 years (p < 0.001), educational level of diploma and below (p = 0.003), health care providers who received training on infection prevention (p < 0.001), and those who had a history of exposure to blood and body fluids (p = 0.001), were factors significantly associated with full-dose hepatitis B virus vaccination. CONCLUSION The national full-dose hepatitis B vaccination coverage among health care workers was low. Training of health care workers in infection prevention, particularly in hepatitis B and testing and providing hepatitis B vaccination for newly recruited staff and every 5 years for those long-term workers were recommended to increase the uptake of the vaccine.
Collapse
Affiliation(s)
- Nefsu Awoke
- Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Henok Mulgeta
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tsegaye Lolaso
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tiwabwork Tekalign
- Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Serawit Samuel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Mohammed Suleiman Obsa
- Department of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Robera Olana
- Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| |
Collapse
|
28
|
Epidemiology of hepatitis B and C virus infections among patients who booked for surgical procedures at Felegehiwot referral hospital, Northwest Ethiopia. PLoS One 2020; 15:e0234822. [PMID: 32555634 PMCID: PMC7299365 DOI: 10.1371/journal.pone.0234822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/02/2020] [Indexed: 01/17/2023] Open
Abstract
Background Hepatitis B virus(HBV) and hepatitis C virus(HCV) are the main causes of cirrhosis, liver cancer, and death. This study aimed to determine the seroprevalence and associated factors of HBV surface antigen(HBsAg) and anti-HCV among patients screened for surgery at Felegehiwot referral hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted among 433 patients in 2018. Data on socio-demographic and risk factors were collected by an exit interview using a pretested structured questionnaire. A venous blood sample of 5ml was collected from each participant, and serum was tested for HBsAg and anti-HCV using one-step rapid test kits and enzyme-linked immunosorbent assay. Multivariable logistic regression analysis was computed to identify factors associated with HBV and HCV infections. The odds ratio with 95%CI was used to describe the strength of association and statistical significance. Results A total of 422 patients gave data and included in the analysis. The mean age of patients was 36±5 years. About two-thirds, 269(64%) and 274(65%) patients were males, and from rural areas, respectively. The seroprevalence of HBsAg was 34(8%) followed by 18(4.3%) anti-HCV and 4(0.9%) co-infections. Being single(AOR = 1.96, 95%CI = 1.12–3.10), rural residence (AOR = 2.68, 95%CI = 1.28–5.61), ever heard about HBV (AOR = 2.41, 95%CI = 1.18–5.20), having multiple sexual partners(AOR = 2.85, 95%CI = 1.30–5.58), HIV positive(AOR = 3.14, 95%CI = 1.31–7.61), history of tooth extraction(AOR = 3.0, 95%CI = 1.40–6.56), hospitalization history(AOR = 2.95, 95%CI = 1.26–5.81), sharing of sharp instruments (AOR = 3.86, 95%CI = 1.82–8.79), and had blood contact(AOR = 2.64, 95%CI = 1.14–5.42) were statistically significant factors to HBV infection. Similarly, sharing of sharp instruments(AOR = 4.65, 95%CI = 1.32–15.1), tooth extraction practice(AOR = 2.81, 95%CI = 1.12–6.56), surgical history (AOR = 3.68, 95%CI = 1.64–9.82), hospitalization history(AOR = 4.51, 95%CI = 1.62–8.35) and had blood contact(AOR = 3.2, 95%CI = 1.56–8.51) were significant factors to HCV infection. Conclusion The seroprevalence of HBsAg and ant-HCV was high compared to WHO and previous study findings. Giving special attention to awareness creation, rural settings, improving personal behaviors, infection prevention activities of health facilities, quality of healthcare procedures is crucial to prevent viral hepatitis infection.
Collapse
|