Seroprevalence of hepatitis B virus surface antigen (HBsAg) in Egypt (2000-2022): a systematic review with meta-analysis

Ahmed Azzam, Heba Khaled, Ola A Elbohy, Shueb Abdirahman Mohamed, Sana Mostafa Hussein Mohamed, Ahmed H Abdelkader, Ahmad Ashraf Ezzat, Amora Omar Ibrahim Elmowafy, Ola Ali El-Emam, Mona Awadalla, Neveen Refaey, Shimaa Mohamed Abdou Rizk, Ahmed Azzam, Heba Khaled, Ola A Elbohy, Shueb Abdirahman Mohamed, Sana Mostafa Hussein Mohamed, Ahmed H Abdelkader, Ahmad Ashraf Ezzat, Amora Omar Ibrahim Elmowafy, Ola Ali El-Emam, Mona Awadalla, Neveen Refaey, Shimaa Mohamed Abdou Rizk

Abstract

Background: Hepatitis B infection seriously threatens global public health, especially in developing nations. Despite several investigations on HBV incidence, the national pooled prevalence remains unknown, particularly in populations at-risk at whom interventions should be primarily aimed.

Methods: A comprehensive literature search of the following databases: Medline [PubMed], Scopus, Google Scholar, and Web of Science was conducted following the PRISMA guidelines. I-squared and Cochran's Q were used to measure the heterogeneity between the studies. Publications that matched the following were included: Primary studies published in Egypt from 2000 to 2022 reported HBV prevalence based on HBsAg. We excluded any studies that were not performed on Egyptians or that were performed on patients suspected of acute viral hepatitis or studies focusing on occult hepatitis or vaccination evaluation studies, or national surveys.

Results: The systematic review included 68 eligible studies reporting a total of 82 incidences of HBV infection based on hepatitis B surface antigen with a total sample size of 862,037. The pooled national prevalence among studies was estimated to be 3.67% [95% CI; 3: 4.39]. Children under 20 with a history of HBV vaccination during infancy had the lowest prevalence of 0.69%. The pooled prevalence of HBV infection among pregnant women, blood donors, and healthcare workers was 2.95%, 1.8%, and 1.1%, respectively. While patients with hemolytic anemia and hemodialysis patients, patients with malignancies, HCC patients, and chronic liver disease patients had the highest prevalences at 6.34%, 25.5%, 18.6%, and 34%, respectively. Studies reporting HBV prevalence in urban settings compared to rural settings revealed a similar HBV prevalence of 2.43% and 2.15%, respectively. Studies comparing HBV prevalence in males and females revealed a higher prevalence among males (3.75%) than females (2.2%).

Conclusion: In Egypt, hepatitis B infection is a significant public health issue. The blocking of mother-to-infant hepatitis B transmission, the scaling up of the scope of the existing vaccination program, and implementing new strategies, including screen-and-treat, may reduce the prevalence of the disease.

Keywords: Egypt; Epidemiology; HBV; Hepatitis B; Hepatitis B surface antigen; Meta‑analysis; Seroprevalence.

Conflict of interest statement

The authors declare no competing interests.

© 2023. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart depicting the selection of publications
Fig. 2
Fig. 2
Forest plot of HBV seroprevalence among the low-risk population
Fig. 3
Fig. 3
Forest plot of Children below 20 years of age with a history of HBV vaccination during infancy
Fig. 4
Fig. 4
Forest plot of HBV among healthy adults
Fig. 5
Fig. 5
Forest plot of HBV among pregnant women
Fig. 6
Fig. 6
Forest plot of HBV among blood donors
Fig. 7
Fig. 7
Forest plot of HBV seroprevalence among Health care workers
Fig. 8
Fig. 8
Forest plot of HBV seroprevalence among barbers, waste, and sewage workers
Fig. 9
Fig. 9
Forest plot of HBV seroprevalence among high-risk population
Fig. 10
Fig. 10
Forest plot of HBV seroprevalence among Patients with hemolytic anemia requiring blood transfusion or with end-stage renal failure requiring hemodialysis
Fig. 11
Fig. 11
Forest plot of HBV prevalence among patients with chronic liver disease
Fig. 12
Fig. 12
Forest plot of HBV seroprevalence among Patients HCC
Fig. 13
Fig. 13
Forest plot of HBV seroprevalence among Patients with HCV
Fig. 14
Fig. 14
Forest plot of HBV seroprevalence among Patients With malignancies
Fig. 15
Fig. 15
Forest plot of HBV seroprevalence among patients with heterogeneous clinical cases

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Source: PubMed

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