喀麦隆丙型肝炎病毒感染的血清流行率：系统评价与荟萃分析。
Seroprevalence of hepatitis C virus infection in Cameroon: a systematic review and meta-analysis.
作者信息
Bigna Jean Joel, Amougou Marie A, Asangbeh Serra Lem, Kenne Angeladine Malaha, Nansseu Jobert Richie
机构信息
Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
Faculty of Medicine, University of Paris Sud XI, Le Kremlin Bicêtre, France.
出版信息
BMJ Open. 2017 Aug 28;7(8):e015748. doi: 10.1136/bmjopen-2016-015748.
OBJECTIVE
Better knowledge of hepatitis C virus (HCV) seroprevalence at the national level can help to implement pertinent strategies to address the HCV-related burden. The aim of this paper was to estimate the seroprevalence of HCV infection in Cameroon.
DESIGN
Systematic review and meta-analysis.
PARTICIPANTS
People residing in Cameroon.
DATA SOURCES
Electronic databases including PubMed/MEDLINE, AJOL, WHO-Afro Library, Africa Index Medicus, National Institute of Statistics and National AIDS Control Committee, Cameroon from 1 January 2000 to 15 December 2016 were searched. English and French languages papers were considered. Two independent investigators selected studies. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale.
RESULTS
31 studies including 36 407 individuals were finally considered. There was no national representative study. The overall pooled prevalence was 6.5% (95% CI 4.5% to 8.8%; I²=98.3%). A sensitivity analysis of individuals at low risk of HCV infection showed a pooled prevalence of 3.6% (95% CI 2.3% to 5.2%, I²=97.7%, 18 studies) among 22 860 individuals (general population, blood donors and pregnant women), which was higher than for a high-risk population (healthcare workers and people with other identified comorbidities), 12.2% (95% CI 4.9% to 22.2%; I²=98.3%, 13 studies); p=0.018. The prevalence was higher in the East region, in rural settings, and when using an enzyme immunoassay technique for detecting HCV antibodies. Sex, sites, study period, sample size, timing of data collection and methodological quality of studies were not sources of heterogeneity.
LIMITATION
One-third of studies (29.0%) had a low risk bias in their methodology and most were facility-based (87.1%).
CONCLUSION
The seroprevalence of HCV infection in Cameroon indicates the need for comprehensive and effective strategies to interrupt HCV transmission in the Cameroonian population. Specific attention is needed for the East region of the country, rural settings and high-risk populations. A national representative study is needed to provide better estimates.
目的
更好地了解全国范围内丙型肝炎病毒（HCV）的血清流行率有助于实施相关策略，以应对与HCV相关的负担。本文旨在估计喀麦隆HCV感染的血清流行率。
设计
系统评价和荟萃分析。
研究对象
居住在喀麦隆的人群。
数据来源
检索了电子数据库，包括PubMed/MEDLINE、AJOL、世界卫生组织非洲区域图书馆、非洲医学索引、喀麦隆国家统计局和国家艾滋病控制委员会，检索时间为2000年1月1日至2016年12月15日。纳入英文和法文论文。两名独立研究人员筛选研究。采用纽卡斯尔-渥太华量表评估研究的方法学质量。
结果
最终纳入31项研究，共36407人。没有全国代表性研究。总体合并患病率为6.5%（95%CI 4.5%至8.8%；I²=98.3%）。对HCV感染低风险个体的敏感性分析显示，在22860名个体（普通人群、献血者和孕妇）中，合并患病率为3.6%（95%CI 2.3%至5.2%，I²=97.7%，18项研究），高于高风险人群（医护人员和其他已确诊合并症患者），为12.2%（95%CI 4.9%至22.2%；I²=98.3%，13项研究）；p=0.018。东部地区、农村地区以及采用酶免疫测定技术检测HCV抗体时患病率较高。性别、研究地点、研究时间段、样本量、数据收集时间以及研究的方法学质量均不是异质性来源。
局限性
三分之一的研究（29.0%）在方法学上存在低风险偏倚，且大多数研究基于医疗机构（87.1%）。
结论
喀麦隆HCV感染的血清流行率表明需要采取全面有效的策略来阻断喀麦隆人群中的HCV传播。该国东部地区、农村地区和高风险人群需要特别关注。需要开展全国代表性研究以提供更准确的估计。
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