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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: 28] [Impact Index Per Article: 9.3] [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.
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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
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Joseph F, Rodrigue KW, Serges T, Salomon NP, Christian TN, Carlos TTM, Samuel F, Anne-Esther NN, Colizzi V, Celine NN. Hepatitis B infection and risk factors among children living with HIV in Yaounde, Cameroon: an integrated management. BMC Pediatr 2019; 19:366. [PMID: 31640616 PMCID: PMC6805430 DOI: 10.1186/s12887-019-1750-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022] Open
Abstract
Background The endemicity of hepatitis B virus (HBV) prompted the systematic immunization of newborns in Cameroon since 2005. In the frame of a considerable burden of HIV/HBV co-infection (17.5%), monitoring HBV among children living with HIV (CLHIV) would guide toward HIV/HBV integrated paediatric care. We sought to ascertain the prevalence and determinants of HBV infection in the population of CLHIV and performance of commonly used rapid diagnosis tests (RDTs). Methods Cross-sectional study conducted from February through June 2017 in a subset of CLHIV ≤15 years old at the Essos Hospital Centre, Yaounde, Cameroon. HBV was tested by HBsAg ELISA sandwich in duplicates for each sample, and the mean optical density was calculated. The Determinants of HBV-prevalencewere evaluated, and p < 0.05 was the significance threshold. The performance of two HBV RDTs (Diaspot vs. HBV-5) was evaluated in comparison to ELISA (used as gold standard). Results Of the 83 CLHIV enrolled (54.2% female, mean age 8.7 [±3.8] years, 60% vaccinated against HBV, all breastfed), HBV-prevalence was 2.41% (2/83). HBV-positivity was significantly associated with unknown maternal HBV status (2.9% [2/69] vs. 0.0% [0/14], p = 0.0097) and vaginal delivery (2.4% [2/82] vs. 0.0% [0/1], p = 0.0018). Moreover, the most likely to be positive were aged 11 and 15 years, and had experienced neither anti-HBV vaccination nor anti-HBV serum administration, and both had not been treated with any antiseptic solution at birth. Regarding the performance of Diaspot vs. HBV-5 respectively, sensitivity was 100% (2/2) vs. 50% (1/2), while specificity was 100% (45/45) vs. 97.8% (44/45); positive and negative predictive values of Diaspot versus HBV-5 were respectively 100% (2/2) and 100% (45/45) versus 50% (1/2) and 97.8% (44/45). Conclusion HBV-infection in the population of CLHIV appears at a moderate prevalence, suggesting a decreased burden likely due to preventive measures including the wide vaccine coverage. Focusing on mothers with unknown HBV status and promoting safer delivery mode (caesarean section) for HBV-positive motherswould contribute toward pediatric HBV elimination. In context of limited resources, Diaspot test appears more reliable to rollout HBV-infection in the population of CLHIV. As findings are limited to a small sample size, studies on a wider population would be relevant.
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Affiliation(s)
- Fokam Joseph
- Chantal BIYA International Reference Centre (CIRCB) for Research on HIV/AIDS prevention and management, Yaounde, Cameroon.,Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon.,National HIV Drug Resistance Working Group, Ministry of Public Health, Yaounde, Cameroon
| | - Kamga Wouambo Rodrigue
- Faculty of Science, Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. .,Department of Health Sciences, Estuary Academy and Strategic Institute (IUES/INSAM/ISSAS), Higher Institute of Health Applied Sciences, University of Buea, Buea, Cameroon.
| | - Tchatchouang Serges
- Faculty of Science, Department of Biochemistry, University of Yaounde 1, Yaounde, Cameroon
| | - Nguwoh Philippe Salomon
- Department of Health Sciences, Estuary Academy and Strategic Institute (IUES/INSAM/ISSAS), Higher Institute of Health Applied Sciences, University of Buea, Buea, Cameroon.,National Public Health Laboratory, Ministry of Public Health, Yaounde, Cameroon
| | | | - Tommo Tchouaket Michel Carlos
- Chantal BIYA International Reference Centre (CIRCB) for Research on HIV/AIDS prevention and management, Yaounde, Cameroon
| | - Fosso Samuel
- Laboratoire Biosanté International, Yaounde, Cameroon
| | | | - Vittorio Colizzi
- Cameroon Evangelic University, Bandjoun, Cameroon.,UNESCO Board of Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Nkenfou Nguefeu Celine
- Chantal BIYA International Reference Centre (CIRCB) for Research on HIV/AIDS prevention and management, Yaounde, Cameroon.,Higher Teacher Training College (ENS), University of Yaounde 1, Yaounde, Cameroon
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Adetokunboh OO, Awotiwon A, Ndwandwe D, Uthman OA, Wiysonge CS. The burden of vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa: a systematic review and meta-analysis. Hum Vaccin Immunother 2019; 15:2590-2605. [PMID: 30945963 PMCID: PMC6930054 DOI: 10.1080/21645515.2019.1599676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/05/2019] [Accepted: 03/18/2019] [Indexed: 12/27/2022] Open
Abstract
There are knowledge gaps regarding evidence-based research on the burden of vaccine-preventable diseases among human immunodeficiency virus (HIV)-infected and HIV-exposed children aged <18 years in sub-Saharan Africa. It is therefore essential to determine the trend and burden of vaccine-preventable diseases. We completed a systematic review and meta-analysis to identify the incidence, prevalence and case-fatality rates (CFR) attributed to various vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa. The trends in the prevalence of vaccine-preventable diseases among HIV-infected and HIV-exposed children were also determined. Nine studies on tuberculosis (TB) were pooled to give an overall incidence rate estimate of 60 (95% confidence interval [CI] 30-70) per 1,000 child-years. The incidence of pneumococcal infections varied between 109-1509 per 100,000 while pertussis was between 2.9 and 3.7 per 1000 child-year. Twenty-two TB prevalence studies reported an estimated prevalence of 16%. Fifteen prevalence studies on hepatitis B infection were pooled together with an estimated prevalence of 5%. The pooled prevalence for pneumococcal infections was 2% while rotavirus diarrhoea reported a prevalence of 13%. Twenty-nine studies on TB were pooled to give an overall CFR estimate of 17% while pneumococcal infections in HIV-infected and exposed children were pooled together with a resultant rate of 15%. Some of the vaccine-preventable diseases still have high incidences, prevalence and CFR among HIV-infected and HIV-exposed children. There is also a dearth of research data on the burden of several vaccine-preventable diseases among HIV-infected and exposed children and a need for more studies in this area.
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Affiliation(s)
- Olatunji O. Adetokunboh
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ajibola Awotiwon
- Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Olalekan A. Uthman
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Warwick Medical School - Population Evidence and Technologies, University of Warwick, Coventry, UK
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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