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BMC Infectious Diseases Jun 2023Sanitation or sanitary workers are exposed to hepatitis virus infections because of filthy and dangerous working conditions. The current global systematic review and... (Meta-Analysis)
Meta-Analysis
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.
Topics: Humans; Prevalence; Sewage; Hepatitis Viruses; Hepatitis A; Hepacivirus
PubMed: 37312028
DOI: 10.1186/s12879-023-08354-1 -
BMC Infectious Diseases Oct 2018Viral hepatitis is an important public health issue in sub-Saharan Africa. Due to rising mortality from cirrhosis and hepatocellular carcinoma and limited implementation... (Review)
Review
BACKGROUND
Viral hepatitis is an important public health issue in sub-Saharan Africa. Due to rising mortality from cirrhosis and hepatocellular carcinoma and limited implementation of screening and treatment programmes, it has been characterised as a neglected tropical disease. Synthesis of the existing evidence on the epidemiology of viral hepatitis B, C and D in Malawi is required to inform policy and identify research gaps.
METHODS
We searched Pubmed, EMBASE and Scopus for studies reporting the epidemiology of viral hepatitis B, C and D in Malawi from 1990 to 2018. Articles reporting prevalence estimates were included provided they described details of participant selection, inclusion criteria and laboratory methods (detection of HBsAg, anti-HCV or anti-HDV antibody, HCV antigen or HCV RNA or HDV RNA). We assessed study quality using a prevalence assessment tool. Where appropriate, a pooled prevalence was calculated using a DerSimonian Laird random effects model.
RESULTS
Searches identified 199 studies, 95 full text articles were reviewed and 19 articles were included. Hepatitis B surface antigen (HBsAg) seroprevalence was assessed in 14 general population cohorts. The pooled prevalence among adults was 8.1% (95% CI 6.1, 10.3). In 3 studies where HBsAg was stratified by HIV status, no effect of HIV on HBsAg prevalence was observed (OR 1.2 (95% CI: 0.8, 1.6, p = 0.80)). In a single study of HIV/HBV infected individuals, anti-hepatitis D antibody (anti-HDV) prevalence was low (1.5%). HCV antibody prevalence (anti-HCV) ranged from 0.7 to 18.0% among 12 cohorts in general populations. Among three studies which used PCR to confirm current infection, the pooled rate of HCV RNA confirmation among anti-HCV positive individuals was only 7.3% (95% CI: 0.0, 24.3).
CONCLUSIONS
Hepatitis B is highly prevalent in Malawi. There is a paucity of epidemiological data from rural areas where 85% of the population reside, and the Northern region. Priority research needs include large-scale representative community studies of HBV, HDV and HCV seroprevalence, assessment of children following introduction of the HBV vaccine in 2002, prevalence estimates of viral hepatitis among individuals with cirrhosis and HCC and data on HCV prevalence using PCR confirmation, to support a viral hepatitis strategy for Malawi.
Topics: HIV Infections; Hepatitis Antibodies; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis C; Hepatitis D; Humans; Malawi; Prevalence; RNA, Viral
PubMed: 30314448
DOI: 10.1186/s12879-018-3428-7 -
World Journal of Surgical Oncology Sep 2013To evaluate the efficacy and safety of adjuvant IFN therapy for viral hepatitis-related hepatocellular carcinoma (HCC) after treatment with surgical resection or... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the efficacy and safety of adjuvant IFN therapy for viral hepatitis-related hepatocellular carcinoma (HCC) after treatment with surgical resection or transarterial chemoembolization (TACE).
METHODS
Controlled trials of adjuvant treatment with IFN for patients with HCC published between 2000 and 2012 were searched electronically in MEDLINE, PubMed, Cochrane Library, and EMBASE databases. According to the heterogeneity of the studies, two different models - the fixed-effect model and the random-effect model - were applied to analyze the results.
RESULTS
Ten trials were screened according to inclusion and exclusion standards. Eight randomized, controlled trials and two non-randomized, controlled trials were included. These ten trials with a total of 1,029 subjects were eventually involved in the meta-analysis; 528 HCC patients were treated with adjuvant treatment with IFN and 501 patients with placebo. Compared to the control group, the recurrence rates of HCC in IFN group were significantly lower (odds ratio (OR) = 0.66; 95% confidence interval (CI) = 0.50 to 0.86; P = 0.02), especially after TACE treatment according to subgroup analysis (OR = 0.73; 95% CI = 0.52 to 1.01; P = 0.06 for surgical resection; and OR = 0.54; 95% CI = 0.33 to 0.86, P = 0.01 for TACE). The death rates in the IFN group also significantly decreased according to not only total events analysis (OR = 0.42; 95% CI = 0.32 to 0.56; P < 0.00001) but also subgroup analysis (OR = 0.51; 95% CI = 0.36 to 0.72; P = 0.0002 for surgical resection; and OR = 0.33; 95% CI = 0.21 to 0.50; P < 0.00001 for TACE).
CONCLUSIONS
Adjuvant IFN therapy may significantly reduce the recurrence rates of patients with viral hepatitis-related HCC and improve the survival of patients after surgical resection or TACE. The ideal dose mostly selected is 3 MIU/ml, three times per week, which can make patients tolerate the adverse reactions of IFN better and maintain effective concentrations for a long time.
Topics: Antiviral Agents; Carcinoma, Hepatocellular; Chemotherapy, Adjuvant; Hepatitis, Viral, Human; Humans; Interferon-alpha; Liver Neoplasms; Prognosis
PubMed: 24060218
DOI: 10.1186/1477-7819-11-240 -
BMC Cancer Jun 2021Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in Africa. In Africa, the major causes of HCC include chronic infection with...
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in Africa. In Africa, the major causes of HCC include chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV). Knowledge of the changes in the incidence of viral hepatitis-associated HCC over time and the factors responsible for such changes is key in informing policies for the prevention of viral hepatitis-associated HCC in Africa.
AIM
The study aimed to systematically summarize the changes in the prevalence of viral hepatitis among HCC patients and the overall effect of the prevalence of viral hepatitis on the incidence of HCC over the past four decades in Africa (1980-2019).
METHODS
A literature search was conducted in MEDLINE (PubMed), Google Scholar, Science Direct, Scopus, Web of Science, and African wide web for articles published on viral hepatitis-associated HCC in Africa from 1980 to 2019. The abstracts of the articles were screened for eligibility and those meeting the inclusion criteria were retrieved and reviewed.
RESULTS
A total of 272 studies were included in the analysis. Viral hepatitis-related HCC incidence changed by 1.17% (95% confidence interval (CI): 0.63-1.71, p < 0.001), 0.82% (95% CI: 0.45-1.18, p < 0.001), and 3.34% (95% CI: 2.44-4.25, p < 0.001) for every 1% change in the prevalence of HBV, HCV, and hepatitis D virus (HDV) respectively, per decade. The incidence of HBV-related HCC decreased by - 0.50% (95% CI: - 0.74 - - 0.25, p < 0.001) over the last 40 years, while HCV-related HCC increased.
CONCLUSION
Overall, the incidence of viral hepatitis-associated HCC has not declined, mainly due to no decline in the prevalence of HCV, HDV, and the high number of chronic hepatitis B carriers on the African continent. There is an urgent need for the allocation of resources for the implementation of treatment and preventive programs for HBV, HCV, HDV, and HCC in Africa. This systematic review is registered with PROSPERO®, number CRD42020169723.
Topics: Africa; Carcinoma, Hepatocellular; Hepatitis B; Hepatitis C; Hepatitis D; Hepatitis, Viral, Human; Humans; Liver Neoplasms
PubMed: 34144696
DOI: 10.1186/s12885-021-08426-y -
World Journal of Orthopedics Nov 2022Although the impact of microbial infections on orthopedic clinical outcomes is well recognized, the influence of viral infections on the musculoskeletal system might...
BACKGROUND
Although the impact of microbial infections on orthopedic clinical outcomes is well recognized, the influence of viral infections on the musculoskeletal system might have been underestimated.
AIM
To systematically review the available evidence on risk factors and musculoskeletal manifestations following viral infections and to propose a pertinent classification scheme.
METHODS
We searched MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), the Reference Citation Analysis (RCA), and Scopus for completed studies published before January 30, 2021, to evaluate risk factors and bone and joint manifestations of viral infection in animal models and patient registries. Quality assessment was performed using SYRCLE's risk of bias tool for animal studies, Moga score for case series, Wylde score for registry studies, and Newcastle-Ottawa Scale for case-control studies.
RESULTS
Six human and four animal studies were eligible for inclusion in the qualitative synthesis. Hepatitis C virus was implicated in several peri- and post-operative complications in patients without cirrhosis after major orthopedic surgery. Herpes virus may affect the integrity of lumbar discs, whereas Ross River and Chikungunya viruses provoke viral arthritis and bone loss.
CONCLUSION
Evidence of moderate strength suggested that viruses can cause moderate to severe arthritis and osteitis. Risk factors such as pre-existing rheumatologic disease contributed to higher disease severity and duration of symptoms. Therefore, based on our literature search, the proposed clinical and pathogenetic classification scheme is as follows: (1) Viral infections of bone or joint; (2) Active bone and joint inflammatory diseases secondary to viral infections in other organs or tissues; and (3) Viral infection as a risk factor for post-surgical bacterial infection.
PubMed: 36439372
DOI: 10.5312/wjo.v13.i11.1015 -
EClinicalMedicine Mar 2024The World Health Organization seeks to eliminate viral hepatitis as a public health threat by 2030. This review and meta-analysis aims to evaluate the effectiveness of...
BACKGROUND
The World Health Organization seeks to eliminate viral hepatitis as a public health threat by 2030. This review and meta-analysis aims to evaluate the effectiveness of programs for hepatitis B and C testing and treatment in community pharmacies.
METHODS
Medline, Embase, Cochrane CENTRAL, and Global Health were searched from database inception until 12 November 2023. Comparative and single arm intervention studies were eligible for inclusion if they assessed delivery of any of the following interventions for hepatitis B or C in pharmacies: (1) pre-testing risk assessment, (2) testing, (3) pre-treatment assessment or (4) treatment. Primary outcomes were proportions testing positive and reaching each stage in the cascade. Random effects meta-analysis was used to estimate pooled proportions stratified by recruitment strategy and setting where possible; other results were synthesised narratively. This study was pre-registered (PROSPERO: CRD42022324218).
FINDINGS
Twenty-seven studies (4 comparative, 23 single arm) were included, of which 26 reported hepatitis C outcomes and four reported hepatitis B outcomes. History of injecting drug use was the most identified risk factor from pre-testing risk assessments. The pooled proportion hepatitis C antibody positive from of 19 studies testing 5096 participants was 16.6% (95% CI 11.0%-23.0%; heterogeneity = 96.6%). The pooled proportion antibody positive was significantly higher when testing targeted people with specified risk factors (32.5%, 95% CI 24.8%-40.6%; heterogeneity = 82.4%) compared with non-targeted or other recruitment methods 4.0% (95% CI 2.1%-6.5%; heterogeneity = 83.5%). Meta-analysis of 14 studies with 813 participants eligible for pre-treatment assessment showed pooled attendance rates were significantly higher in pharmacies (92.7%, 95% CI 79.1%-99.9%; heterogeneity = 72.4%) compared with referral to non-pharmacy settings (53.5%, 95% CI 36.5%-70.1%; heterogeneity = 92.3%). The pooled proportion initiating treatment was 85.6% (95% CI 74.8%-94.3%; heterogeneity = 75.1%). This did not differ significantly between pharmacy and non-pharmacy settings.
INTERPRETATION
These findings add pharmacies to the growing evidence supporting community-based testing and treatment for hepatitis C. Few comparative studies and high degrees of statistical heterogeneity were important limitations. Hepatitis B care in pharmacies presents an opportunity for future research.
FUNDING
None.
PubMed: 38440399
DOI: 10.1016/j.eclinm.2024.102489 -
Journal of the International AIDS... May 2023Key populations (sex workers, men who have sex with men, people who inject drugs, people in prisons and other closed settings, and trans and gender diverse individuals)... (Meta-Analysis)
Meta-Analysis Review
Counselling behavioural interventions for HIV, STI and viral hepatitis among key populations: a systematic review of effectiveness, values and preferences, and cost studies.
INTRODUCTION
Key populations (sex workers, men who have sex with men, people who inject drugs, people in prisons and other closed settings, and trans and gender diverse individuals) are disproportionately affected by HIV, sexually transmitted infections (STIs) and viral hepatitis (VH). Counselling behavioural interventions are widely used, but their impact on HIV/STI/VH acquisition is unclear.
METHODS
To inform World Health Organization guidelines, we conducted a systematic review and meta-analysis of effectiveness, values and preferences, and cost studies about counselling behavioural interventions with key populations. We searched CINAHL, PsycINFO, PubMed and EMBASE for studies published between January 2010 and December 2022; screened abstracts; and extracted data in duplicate. The effectiveness review included randomized controlled trials (RCTs) with HIV/STI/VH incidence outcomes; secondary review outcomes of unprotected sex, needle/syringe sharing and mortality were captured if studies also included primary review outcomes. We assessed the risk of bias using the Cochrane Collaboration tool, generated pooled risk ratios through random effects meta-analysis and summarized findings in GRADE evidence profiles. Values and preferences and cost data were summarized descriptively.
RESULTS
We identified nine effectiveness, two values and preferences, and two cost articles. Meta-analysis of six RCTs showed no statistically significant effect of counselling behavioural interventions on HIV incidence (1280 participants; combined risk ratio [RR]: 0.70, 95% confidence interval [CI]: 0.41-1.20) or STI incidence (3783 participants; RR: 0.99; 95% CI: 0.74-1.31). One RCT with 139 participants showed possible effects on hepatitis C virus incidence. There was no effect on secondary review outcomes of unprotected (condomless) sex (seven RCTs; 1811 participants; RR: 0.82, 95% CI: 0.66-1.02) and needle/syringe sharing (two RCTs; 564 participants; RR 0.72; 95% CI: 0.32-1.63). There was moderate certainty in the lack of effect across outcomes. Two values and preferences studies found that participants liked specific counselling behavioural interventions. Two cost studies found reasonable intervention costs.
DISCUSSION
Evidence was limited and mostly on HIV, but showed no effect of counselling behavioural interventions on HIV/VH/STI incidence among key populations.
CONCLUSIONS
While there may be other benefits, the choice to provide counselling behavioural interventions for key populations should be made with an understanding of the potential limitations on incidence outcomes.
Topics: Male; Humans; HIV Infections; Sexually Transmitted Diseases; Behavior Therapy; Hepatitis C; Counseling
PubMed: 37221978
DOI: 10.1002/jia2.26085 -
Epidemiology and Infection Jul 2016It is of great concern that pregnant women with acute viral hepatitis (AVH) type E have serious consequences. This study aimed to estimate the case-fatality risk (CFR)... (Meta-Analysis)
Meta-Analysis Review
It is of great concern that pregnant women with acute viral hepatitis (AVH) type E have serious consequences. This study aimed to estimate the case-fatality risk (CFR) and potential risk factors of pregnant women with AVH type E. We searched the PubMed, EMBASE, and Web of Science databases for studies containing data on CFR in pregnancy with AVH type E. A pooled estimate of CFR was calculated using a random-effects model. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. We identified 47 eligible studies with a total African and Asian population of 3968 individuals. The pooled CFRs of maternal and fetal outcomes were 20·8% [95% confidence interval (CI) 16·6-25·3] and 34·2% (95% CI 26·0-43·0), respectively. Compared with these, the pooled CFR was highest (61·2%) in women with fulminant hepatic failure (FHF). Community-based surveys had lower pooled CFR (12·2%, 95% CI 9·2-15·6) and heterogeneity (25·8%, 95% CI 20·1-32·0) than hospital-based surveys. Univariate analysis showed that hospital-based surveying (P = 0·007), and patients in the third trimester of pregnancy or with FHF (P < 0·05), were significantly associated with CFR. Intrauterine fetal mortality (27·0%) was statistically higher than neonatal mortality (3·9%). Control measures for HEV infection would reduce feto-maternal mortality in Asia and Africa.
Topics: Adolescent; Adult; Female; Hepatitis E; Hepatitis E virus; Humans; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Young Adult
PubMed: 26939626
DOI: 10.1017/S0950268816000418 -
BioMed Research International 2020Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern...
Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. . This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. . Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors.
Topics: Adult; Africa, Northern; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Europe; Female; Genotype; Hepatitis B; Hepatitis B Vaccines; Hepatitis B virus; Humans; Liver Neoplasms; Male; Mediterranean Region; Middle Aged; Middle East; Prevalence; Vaccination; Young Adult
PubMed: 32626758
DOI: 10.1155/2020/7027169 -
PloS One 2021A previous review on hepatitis A virus (HAV) seroprevalence in 2005 categorized Southeast Asia as a low HAV endemicity region. In 2010, the World Health Organization...
BACKGROUND
A previous review on hepatitis A virus (HAV) seroprevalence in 2005 categorized Southeast Asia as a low HAV endemicity region. In 2010, the World Health Organization modified this from low to low/medium endemicity, pointing out that these estimates were based on limited evidence. Since then, there has been no attempt to review HAV epidemiology from this region. We conducted a systematic review of literature to collect information on HAV incidence and seroprevalence in select countries in the Southeast Asian region, specifically, The Association of Southeast Asian Nations over the last 20 years.
METHODOLOGY
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. From the relevant articles, we extracted data and conducted a risk of bias assessment of individual studies.
RESULTS
The search yielded 22 and 13 publications on HAV seroprevalence and incidence, respectively. Overall, our findings point to a very low HAV endemicity profile in Thailand and Singapore and evidence of a shift towards low HAV endemicity in Indonesia, Lao People's Democratic Republic, Malaysia, the Philippines, and Vietnam. Only Singapore, Thailand, Malaysia, and the Philippines have existing HAV disease surveillance and reported incidence rates below 1 per 100,000. Several outbreaks with varying magnitude documented in the region provide insights into the evolving epidemiology of HAV in the region. Risk of bias assessment of studies revealed that the individual studies were of low to medium risk.
CONCLUSIONS/SIGNIFICANCE
The available HAV endemicity profiles in Southeast Asian countries, aside from Thailand, are limited and outdated, but suggest an endemicity shift in the region that is not fully documented yet. These findings highlight the need to update information on HAV epidemiology through strengthening of disease surveillance mechanisms to confirm the shift in HAV endemicity in the region.
Topics: Asia, Southeastern; Hepatitis A; Hepatitis A virus; Humans; Incidence; Seroepidemiologic Studies
PubMed: 34851983
DOI: 10.1371/journal.pone.0258659