HBV prevalence in Sub-continental countries: a systematic review and meta-analysis

Abstract

Background: Hepatitis B virus (HBV) is a major source of disease burden worldwide, especially in developing nations. Although vaccine programs exist to control infections, certain sub-populations around the world continue to have very high prevalence of HBV infection. Methods: A systematic search of studies of HBV published after 2010 was conducted for India, Pakistan, Bangladesh, Nepal, Sri Lanka and Bhutan. Each paper was independently screened for risk of bias and inclusion. Data were extracted from included studies before being analysed to estimate pooled prevalence, and to conduct sub-group analyses. Random-effects models were used for estimating summary prevalence due to a high level of heterogeneity between studies, and funnel plots were combined with Eggers test to assess publication bias. Meta-regression was conducted to investigate sources of between-study heterogeneity. Results: The pooled prevalence of HBV across all studies was 4% (95% CI 0.02, 0.06). For countries with multiple studies, the pooled prevalence of HBV was 3% (95% CI 0.02, 0.05) for India, 6% (95% CI 0.04, 0.10) for Pakistan, 5% (95% CI of 0.02, 0.12) for Bangladesh, and 1% (95% CI 0.00, 0.08) for Nepal. There was some evidence of publication bias, and a high level of heterogeneity across studies. Risk of bias analysis found most studies to be of fair or moderate quality. Conclusions: The prevalence of HBV among sub-continental countries was higher than the global average but was not as high as some other regions. Countries with greater numbers of displaced persons had higher prevalence of HBV, with a wide range of prevalence between subpopulations likely reflecting differential uptake, and implementation, of vaccination programs.

An agent-based model to simulate the transmission dynamics of bloodborne pathogens within hospitals

“…Nevertheless, some countries still report a high HCV or HBV prevalence. A recent meta-analysis focusing on HBV prevalence in sub-continental countries showed that Pakistan and India still have a national prevalence over 5% (19). In addition, nosocomial outbreaks of bloodborne infections still occur nowadays, even in developed countries.…”