肯尼亚乙型肝炎病毒感染负担：系统评价和荟萃分析。
The burden of Hepatitis B virus infection in Kenya: A systematic review and meta-analysis.
机构信息
Laboratory of Medical Innovation, Department of Collaborative Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
出版信息
Front Public Health. 2023 Jan 26;11:986020. doi: 10.3389/fpubh.2023.986020. eCollection 2023.
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 (I = 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.
背景
慢性乙型肝炎病毒（HBV）感染可导致肝硬化和肝癌，是肯尼亚的一个主要公共卫生问题。然而，迄今为止，尚无系统评价和荟萃分析来估计该国的疾病负担。更好地了解 HBV 感染的流行率将有助于政府实施有效的消除疾病的策略。因此，进行了这项系统评价和荟萃分析，以总结和更新肯尼亚 HBV 负担的现有信息。
方法
我们系统地检索了 PubMed、Science Direct、Web of Science、Scopus、African Journals OnLine 和 Google Scholar 数据库，以检索 1990 年 1 月至 2021 年 6 月期间发表的基于乙型肝炎表面抗原（HBsAg）测量评估肯尼亚 HBV 感染流行率的原始研究。使用随机效应模型进行荟萃分析，在简单汇总分析后，以 95%置信区间（CI）估计 HBsAg 流行率。还调查了潜在的异质性来源。
结果
共纳入 50 项荟萃分析研究，样本量为 108448 人。肯尼亚 HBV 的总体汇总流行率估计为 7.8%（95%CI：5.8-10.1）。亚组分析显示，黄疸患者的流行率最高，为 41.7%（95%CI：13.5-73.3），而献血者的流行率最低，为 4.1%（95%CI：2.4-6.3）。HIV 感染者的流行率为 8.2%（95%CI：5.8-11.0）。研究间总变异的估计值显示存在高度异质性（I = 99%），这可以通过研究类型、个体的风险状况和研究区域来解释。
结论
我们提出了肯尼亚 HBV 流行率的首次系统评价和荟萃分析。我们的研究结果表明，肯尼亚的 HBV 负担仍然很大。这迫切需要实施公共卫生干预措施和战略政策，以控制该疾病并最终消除该疾病。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=264859，标识符：CRD42021264859。
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