Sero-prevalence of hepatitis viral infections among sanitary workers across worldwide: a systematic review and meta-analysis

Abstract

Background: Sanitation or sanitary workers are exposed to hepatitis virus infections because of filthy and dangerous working conditions. The current global systematic review and meta-analysis aimed to estimate the pooled sero-prevalence of occupationally associated hepatitis virus infection among them.

Methods: Preferred Reporting Items for Systematic Reviews (PRISMA), and Population, Intervention, Comparison, Outcome and study design (PICOS) were used for flow diagram, and review questions, respectively. Four databases other methods were used published articles from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords were used: (Occupation *OR Job *OR Work) AND (Hepatitis A *OR Hepatitis B virus *OR Hepatitis C virus *OR Hepatitis E virus) AND (Solid waste collectors [SWCs] *OR Street sweepers [SS] *OR Sewage workers [STWs] *OR health care facilities cleaners [HCFCs)) AND (Countries). Stata MP/17 software was used for pooled prevalence analysis, meta-regression analysis (Hedges) at a 95% confidence interval (CI:95%).

Results: A total of 182 studies were identified studies, a total of 28 studies were included from twelve countries. Of these, from developed (n = 7) and developing countries (n = 5). From total a of 9049 sanitary workers, 5951(66%), 2280 (25%) and 818 (9%) were STWs, SWCs and SS, respectively. Globally, the pooled sero-prevalence of occupational-related hepatitis viral infections among sanitary workers was 38.06% (95% CI: 30-0.46.12). Of this, it was 42.96% (95% CI: 32.63-53.29) and 29.81% (95% CI: 17.59-42.02) for high-income and low-income countries, respectively. Meanwhile, by sub-analysis, the highest pooled sero-prevalence of hepatitis viral infections by categories, type and year were 47.66% (95%CI: 37.42-57.90), 48.45% (95% CI: 37.95-58.96), and 48.30% (95% CI: 36.13-60.47) for SWTs, HAV, and 2000 to 2010 year, respectively.

Conclusion: The consistency of the evidence suggests that sanitation workers, particularly sewage workers, are susceptible to occupationally acquired hepatitis regardless of their working conditions, necessitating significant changes to occupational health and safety regulations from governmental policies and other initiatives to reduce risks among sanitary workers.

Keywords: Hepatitis Virus; Infections; Occupation; Sanitary workers; Worldwide.

Fig. 1

Screening Process. Flow diagram for systematic review and Meta-Analysis is adapted from PRISMA 2020 Protocol

Fig. 2

Analysis by Globe and Regions. Sero-prevalence of occupational-related hepatitis among sanitary workers by regions

Fig. 3

Analysis by Occupations (Categories). Sero-prevalence of hepatitis by occupations within subgroup of sanitary workers

Fig. 4

Analysis by Hepatitis viral Type. Sero-prevalence of hepatitis (HAV, HBV, HCV & HEV) among sanitary workers in worldwide

Fig. 5

Analysis Year-by-Year. Sero-prevalence of hepatitis by Years among sanitary workers across world

Fig. 6

Sensitivity Analysis. After removing three smallest outcomes (a). After removing three largest outcomes(b). Sensitivity analysis after removing two smallest outcomes(a) and three largest outcomes(b)

Fig. 7

Publication Bias for eligible found from high-income and low-income countries