非洲献血者中乙型肝炎病毒表面抗原的血清流行率：系统评价和荟萃分析。

Seroprevalence of Hepatitis B virus surface antigen among African blood donors: a systematic review and meta-analysis.

机构信息

Department of Community Medicine, Information, and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.

Health Research Network Associated Laboratory (RISE), CINTESIS - Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal.

出版信息

Front Public Health. 2024 Oct 21;12:1434816. doi: 10.3389/fpubh.2024.1434816. eCollection 2024.

DOI:10.3389/fpubh.2024.1434816

PMID:39498113

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11532187/

Abstract

BACKGROUND

Transfusion Transmitted Infections (TTIs) are still a growing public health problem in Africa. Studies that synthesize the available evidence on the seroprevalence of Hepatitis B Surface Antigen (HBsAg) among African blood donors are scarce. Therefore, this study aimed to synthesize qualitatively and quantitatively the seroprevalence of Hepatitis B Virus Surface Antigen (HBsAg) among blood donors in Africa.

METHODS

We conducted a systematic review and meta-analysis where we included all studies that reported the seroprevalence of HBsAg among blood donors in Africa. The references were searched from electronic databases: PubMed, Web of Science, Cochrane, Scopus, WHO research database-HINARI, Global Index Medicus and ClinicalTrials.gov. We further analyzed the full list of references of all included studies. The pooled seroprevalence was estimated through random effect model. The heterogeneity was assessed through Cochrane's test and , respectively. Meta-regression, subgroup and sensitivity analyses were conducted.

RESULTS

We obtained 124 studies that met our inclusion criteria, comprising 3,573,211 blood donors tested for HBsAg. The pooled seroprevalence of HBsAg among blood donors in Africa was 6.93% (95% CI: 5.95-7.97%; = 100%; < 0.001). We found that the heterogeneity was explained by the study performed country and, African region. The higher prevalence was observed in Western 10.09% (95% CI: 8.75-11.50%), Central 7.81% (95% CI: 5.34-10.71%), and Eastern African region 4.87% (95% CI: 3.77-6.11%) and lower prevalence were observed in Southern 2.47% (95% CI: 0.54-5.75%) followed by Northern Africa region with 1.73% (95% CI: 0.45-3.79%). Additionally, based on the date of publication, we found that the highest prevalence was observed in studies published between 2001 and 2010 (9.41, 95% CI: 7.19-11.90) and the lowest prevalence was observed in studies published between 2011 and 2024 (6.26%; 95% CI: 5.19-7.42).

CONCLUSION

The seroprevalence of HBsAg among blood donors in Africa is still very high and heterogeneous. Therefore, intensifying the screening and vaccination of the population for Hepatitis B is critical to ensure blood safety toward eliminating Hepatitis B in Africa.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395616, PROSPERO CRD42023395616.

摘要

背景

在非洲，经输血传播的感染（TTIs）仍然是一个日益严重的公共卫生问题。关于非洲献血者乙型肝炎表面抗原（HBsAg）血清流行率的研究很少。因此，本研究旨在定性和定量综合评估非洲献血者中乙型肝炎病毒表面抗原（HBsAg）的血清流行率。

方法

我们进行了系统评价和荟萃分析，纳入了所有报告非洲献血者 HBsAg 血清流行率的研究。参考文献从电子数据库中检索：PubMed、Web of Science、Cochrane、Scopus、世界卫生组织研究数据库-HINARI、全球索引医学和 ClinicalTrials.gov。我们进一步分析了所有纳入研究的完整参考文献列表。通过随机效应模型估计合并的血清流行率。通过 Cochrane's 检验和分别评估异质性。进行了荟萃回归、亚组和敏感性分析。

结果

我们获得了 124 项符合纳入标准的研究，共纳入了 3573211 名接受 HBsAg 检测的献血者。非洲献血者中 HBsAg 的合并血清流行率为 6.93%（95%CI：5.95-7.97%； = 100%； < 0.001）。我们发现，研究进行的国家和非洲地区解释了异质性。在西部（10.09%，95%CI：8.75-11.50%）、中部（7.81%，95%CI：5.34-10.71%）和东部非洲地区（4.87%，95%CI：3.77-6.11%）观察到较高的流行率，在南部（2.47%，95%CI：0.54-5.75%）和北部非洲地区（1.73%，95%CI：0.45-3.79%）观察到较低的流行率。此外，根据发表日期，我们发现 2001 年至 2010 年发表的研究中观察到的流行率最高（9.41，95%CI：7.19-11.90%），2011 年至 2024 年发表的研究中观察到的流行率最低（6.26%，95%CI：5.19-7.42%）。