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Meta-Analysis
. 2024 Dec;44(12):3238-3249.
doi: 10.1111/liv.16102. Epub 2024 Sep 13.

Prevalence, trends, and distribution of hepatitis C virus among the general population in sub-Saharan Africa: A systematic review and meta-analysis

Getahun Molla Kassa  1   2 , Josephine G Walker  1 , Tesfa Sewunet Alamneh  1   2 , Melaku Tileku Tamiru  3   4 , Sandra Bivegete  1 , Aynishet Adane  5 , Wondwossen Amogne  6 , John F Dillon  3 , Peter Vickerman  1 , Emebet Dagne  7 , Elias Ali Yesuf  8 , Matthew Hickman  1 , Clare E French  1   9 , Aaron G Lim  1 ; DESTINE NIHR Global Health Research Group
Collaborators, Affiliations
Meta-Analysis

Prevalence, trends, and distribution of hepatitis C virus among the general population in sub-Saharan Africa: A systematic review and meta-analysis

Getahun Molla Kassa et al. Liver Int. 2024 Dec.

Abstract

Background and aims: Although the evidence is uncertain, existing estimates for hepatitis C virus (HCV) in sub-Saharan Africa (SSA) indicate a high burden. We estimated HCV seroprevalence and viraemic prevalence among the general population in SSA.

Methods: We searched Medline, Embase, Web of Science, APA PsycINFO, and World Health Organization Africa Index Medicus for community-based studies. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool, and heterogeneity using the index of heterogeneity (I2). Two approaches were deployed. First, we used random-effects meta-analysis to pool prevalence. Second, to derive representative estimates, we weighted each country's HCV seroprevalence using 2021 United Nations country population sizes.

Results: We synthesized 130 studies. Overall, SSA HCV seroprevalence from the random-effects model was 4.17% (95% confidence interval [CI]: 3.71-4.66, I2 = 99.30%). There were no differences between males (4.31%) and females (4.03%). Seroprevalence was 2.25%, 3.31%, and 16.23% for ages ≤20, 21-64, and ≥65 years, respectively, and was higher in rural (6.63%) versus urban (2.93%). There was indication of decrement overtime from 5.74% to 4.35% to 3.03% in the years 1984-2000, 2001-2014, and 2015-2023, respectively. The weighted overall SSA HCV seroprevalence was estimated to be 2.30% (95% CI: 1.59-3.00) with regional variation: Africa-Southern (.79%), Africa-Central (1.47%), Africa-Eastern (2.71%), and Africa-Western (2.88%). HCV viremia among HCV seropositives was 54.77% (95% CI: 47.80-61.66).

Conclusions: HCV seroprevalence in SSA remains high. Populations aged ≥65 years, rural communities, Africa-Western, and some countries in Africa-Central and Africa-Eastern appear disproportionately affected. These results underline the need for governmental commitment to achieve the 2030 global HCV elimination targets.

Keywords: HCV; SSA; general population; seroprevalence; viraemic prevalence.

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Conflict of interest statement

The authors do not have any disclosures to report.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta Analysis 2020 flow diagram which included databases searches and other sources.
FIGURE 2
FIGURE 2
Forest plot for HCV seroprevalence using all included studies stratified by subregions of sub‐Saharan Africa.
FIGURE 3
FIGURE 3
Country‐level geographical distribution of HCV seroprevalence (A) and viraemic prevalence among HCV seropositive (B) among the general population in sub‐Saharan Africa (grey areas are countries without data and dark areas are Africa‐Northern region).
FIGURE 4
FIGURE 4
Seroprevalence of hepatitis C virus over‐time among the general population in sub‐Saharan Africa and its subregions.
See this image and copyright information in PMC

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