A systematic review of the epidemiology of hepatitis E virus in Africa

Abstract

BackgroundHepatitis E Virus (HEV) infection is a newly recognized serious threat to global public health and Africa is suspected to be among the most severely affected regions in the world. Understanding HEV epidemiology in Africa will expedite the implementation of evidence-based control policies aimed at preventing the spread of HEV including policies for the use of available resources such as HEV vaccines.MethodsHere we present a comprehensive review of HEV epidemiology in Africa based on published data. We searched for articles on HEV epidemiology in Africa from online databases such as PubMed, Scopus, and ISI Web of Science and critically reviewed appropriate publications to extract consistent findings, identify knowledge gaps, and suggest future studies.ResultsTaking a particularly high toll in pregnant women and their fetuses, HEV has infected human populations in 28 of 56 African countries. Since 1979, 17 HEV outbreaks have been reported about once every other year from Africa causing a reported 35,300 cases with 650 deaths.ConclusionsIn Africa, HEV infection is not new, is widespread, and the number of reported outbreaks are likely a significant underestimate. The authors suggest that this is a continent-wide public health problem that deserves the attention of local, regional and international agencies to implement control policies that can save numerous lives, especially those of pregnant women and their fetuses.

High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo

“…HAV and HEV are waterborne viruses that usually cause acute hepatitis without progressing to chronic liver diseases (5, 6). According to the Global Burden of Disease study, 101.7 million cases of HAV and 28.4 million cases of HEV infection occurred worldwide in 2013 (7).…”

Seroprevalence for Hepatitis E and Other Viral Hepatitides among Diverse Populations, Malawi

“…Data from earlier studies in Tanzania suggested either lack of exposure or low levels of HEV among women ( 7 , 8 ). A review of the epidemiology of HEV in Africa by Kim et al ( 9 ) provides a listing of seroprevalence of HEV antibodies in various African countries.…”

High Hepatitis E Seroprevalence Among Displaced Persons in South Sudan

“…HEV seroprevalence estimates from Africa vary widely though seroprevalence estimates of over 60% within the general population have not been found frequently, even during or after large outbreaks 5,23. Even in “hyperendemic” areas, including Nepal and Bangladesh, documented seroprevalence has typically been estimated at levels well below those in this study 24.…”