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非洲医护人员中乙肝病毒感染的血清流行率及危险因素:一项系统评价与荟萃分析

Seroprevalence and risk factors of hepatitis B virus infection among healthcare workers in Africa: A systematic review and meta-analysis.

作者信息

Berhanu Leykun, Desye Belay, Daba Chala, Berihun Gete, Geto Abebe Kassa

机构信息

Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.

出版信息

PLoS One. 2025 Mar 25;20(3):e0319986. doi: 10.1371/journal.pone.0319986. eCollection 2025.

Abstract

BACKGROUND

Healthcare workers are at an increased risk of hepatitis B virus infection due to potential exposure to blood and other infectious materials. The infection can lead to acute liver disease and chronic liver complications such as cirrhosis and liver cancer. It can impact workforce health, leading to absenteeism, and increased healthcare costs. Hence, this study aimed to determine the seroprevalence and risk factors of the hepatitis B virus among healthcare workers in Africa.

MATERIALS AND METHODS

The protocol for this systematic review and meta-analysis was registered on PROSPERO with the registration number CRD42024556654. Literatures were searched from PubMed, Science Direct, HINARI, African Online Journal, Google Scholar, Google, Semantic Scholar, and Directory of Open Access Journals using relevant search terms. The process of searching relevant articles was completed on 1 August 2024. Studies with a quality evaluation indicator score of 50% or above were included in this study. The random effect model was used to measure the pooled seroprevalence and associated factors of hepatitis B virus infection among healthcare workers in Africa. The finding of the meta-analysis was presented using forest plots with a 95% confidence interval.

RESULT

Among 26 studies selected for meta-analysis, 6983 participants were included. The inclusion of 26 studies showed that the pooled prevalence of hepatitis B virus infection among healthcare workers was 17.2% (95% CI: 8.36, 26.04). Healthcare workers diagnosed with liver disease were 5.01 times more likely to having hepatitis B virus infection compared to those who were not diagnosed (POR = 5.01: 95% CI; 2.25,7.77). In addition, healthcare workers who did not receive technical training were 2.70 times more likely to having HBV infection than those who received training (POR = 2.70:95% CI; 1.10, 4.30). Furthermore, healthcare workers aged 40 years and above were 2.53 times more likely to having hepatitis B virus infection than young healthcare workers (POR = 2.53: 95% CI; 1.29,3.77).

CONCLUSION

The pooled prevalence of hepatitis B virus infection was high. Previously diagnosed liver diseases, the absence of technical training, and the age of healthcare workers were the factors influencing the pooled prevalence of HBV infection among healthcare workers. Hence, providing appropriate medical follow-up for healthcare workers diagnosed with liver disease, comprehensive training and education, and early detection and diagnosis of healthcare workers aged 40 years and above are the most important interventions to prevent the risk of hepatitis B virus infection.

摘要

背景

医护人员由于可能接触血液和其他传染性物质,感染乙型肝炎病毒的风险增加。这种感染可导致急性肝病以及肝硬化和肝癌等慢性肝脏并发症。它会影响劳动力健康,导致旷工,并增加医疗成本。因此,本研究旨在确定非洲医护人员中乙型肝炎病毒的血清流行率及危险因素。

材料与方法

本系统评价和荟萃分析的方案已在国际前瞻性系统评价注册库(PROSPERO)上注册,注册号为CRD42024556654。使用相关检索词从PubMed、科学Direct、HINARI、非洲在线期刊、谷歌学术、谷歌、语义学者和开放获取期刊目录中检索文献。检索相关文章的过程于2024年8月1日完成。质量评估指标得分在50%及以上的研究纳入本研究。采用随机效应模型来衡量非洲医护人员中乙型肝炎病毒感染的合并血清流行率及相关因素。荟萃分析的结果用95%置信区间的森林图表示。

结果

在纳入荟萃分析的26项研究中,共纳入6983名参与者。这26项研究的纳入结果显示,医护人员中乙型肝炎病毒感染的合并患病率为17.2%(95%置信区间:8.36,26.04)。被诊断患有肝病的医护人员感染乙型肝炎病毒的可能性是未被诊断者的5.01倍(比值比=5.01:95%置信区间;2.25,7.77)。此外,未接受技术培训的医护人员感染乙肝病毒的可能性是接受培训者的2.70倍(比值比=2.70:95%置信区间;1.10,4.30)。此外,40岁及以上的医护人员感染乙型肝炎病毒的可能性是年轻医护人员的2.53倍(比值比=2.53:95%置信区间;1.29,3.77)。

结论

乙型肝炎病毒感染的合并患病率较高。既往诊断的肝病、缺乏技术培训以及医护人员的年龄是影响医护人员中乙肝病毒感染合并患病率的因素。因此,为被诊断患有肝病的医护人员提供适当的医学随访、全面的培训和教育,以及对40岁及以上的医护人员进行早期检测和诊断是预防乙型肝炎病毒感染风险的最重要干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c06/11936272/31c0c8e1bba0/pone.0319986.g001.jpg

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