Hepatitis E infection among Ghanaians: a systematic review

Ofori‐Asenso, Richard; Agyeman, Akosua Adom

doi:10.1186/s40249-017-0239-9

Cited by 6 publications

(8 citation statements)

References 38 publications

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“…The detection of acute cases of HEV (IgM positive) and a high prevalence of IgG together indicate the presence and possible circulation of the virus in the Ghanaian population. Our estimate falls within the prevalence range of 5.8%–71.5% previously reported by Ofori-Asenso et al [ 30 ]. Although most cases of HEV infections are thought to be self-limiting, severe cases could also occur [ 13 , 31 ].…”

Section: Discussionsupporting

confidence: 90%

Aetiology of viral hepatitis among jaundiced patients presenting to a tertiary hospital in Ghana

et al. 2018

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BackgroundViral hepatitis continues to play significant role in causing morbidity and mortality in sub-Saharan Africa. Apart from the few population based studies available, not many have investigated the burden of these viruses in jaundiced patients. Among the few studies, hepatitis E is the least studied among jaundiced patients. This study was aimed at describing the frequency, distribution and risk of the different hepatitis viruses among jaundiced patients reporting to the second largest teaching hospital in Ghana.MethodsFrom November, 2015 to April, 2016, a cross-sectional study was conducted among jaundiced patients attending the Komfo Anokye Teaching Hospital. Between 3–5 ml of blood was collected from each patient and screened for viral hepatitis agents using both serologic and molecular-based assays.ResultsIn the 155 patients recruited, hepatitis B was the most prevalent [54.2% (95% CI = 46.0%–62.2%)] followed by hepatitis E [32.9% (95% CI = 25.6–40.9%)]. Most cases of hepatitis E occurred as co-infections with hepatitis B (18%), with the predominant clinical feature being hepatocellular carcinoma. Risk factor variable analysis showed middle and older aged individuals were more at risk of hepatitis B exposure whereas younger age groups (<18 years) were more at risk of hepatitis E virus infection.ConclusionHepatitis viruses are still important in the viral aetiology of jaundice in Ghana. Hepatitis B and hepatitis E co-infections could play significant roles in causing severe disease. A more aggressive approach needs to be adopted in order to reduce the morbidity and mortality associated with hepatitis causing viruses in Ghana and other developing countries.

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Section: Discussionsupporting

confidence: 90%

Aetiology of viral hepatitis among jaundiced patients presenting to a tertiary hospital in Ghana

et al. 2018

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“…This systematic review showed a high pooled prevalence rate of HAV, which is 90.2%, and this prevalence rate was close to the individual estimation rates of old reports in Somalia[ 15 , 16 , 18 , 19 ]. We also indicate that the estimates of HEV infection in previous reports in Somalia may quite high, ranging between 4.5% and 88.2%[ 45 - 47 ], which is similar to estimates for the Ghanaian population of anti-HEV, with their range of 5.8% and 71.55%[ 65 ]. However, this review showed a pooled prevalence rate of HEV of 46.86%, which is also high among Somali patients.…”

Section: Discussionsupporting

confidence: 85%

“…An older report demonstrated that the attack rate was higher with increasing age, from 5%, 13% and 20% for the age groups of 1-4 years, 5-15 years and above 15 years old, respectively. Meanwhile, pregnant women had a high fatality rate, estimated to be 13.8%[ 46 ], in comparison to the rates in other African countries, such Ghana, (66.7%)[ 65 ], Sudan (31.1%)[ 66 ] and the Central African Republic (14.3%)[ 67 ]. However, the fatality rate of pregnant women was higher than that of our older report in the country[ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study

Hassan-Kadle¹,

Osman²,

Ogurtsov³

2018

WJG

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AIMTo provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia.METHODSA systematic review and meta-analysis was conducted as Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African Index Medicus and the Africa Journals Online databases, as well as on the Ministry of Health website. We also captured unpublished articles that were not available on online systems.RESULTSTwenty-nine studies from Somalia and Somali immigrants (United Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The overall pooled prevalence rate of HAV was 90.2% (95%CI: 77.8% to 96%). The HAV prevalence among different age groups was as follows: < 1 year old, 61.54% (95%CI: 40.14% to 79.24%); 1-10 years old, 91.91% (95%CI: 87.76% to 94.73%); 11-19 years old, 96.31% (95%CI: 92.84% to 98.14%); 20-39 years old, 91.3% (95%CI: 83.07% to 95.73%); and > 40 years old, 86.96% (95%CI: 75.68% to 93.47%). The overall pooled prevalence of HBV was 18.9% (95%CI: 14% to 29%). The overall pooled prevalence among subgroups of HBV was 20.5% (95%CI: 5.1% to 55.4%) in pregnant women; 5.7% (95%CI: 2.7% to 11.5%) in children; 39.2% (95%CI: 33.4% to 45.4%) in patients with chronic liver disease, including hepatocellular carcinoma (HCC); 7.7% (95%CI: 4.2% to 13.6%), 12.4% (95%CI: 6.3% to 23.0%) and 11.8% (95%CI: 5.3% to 24.5%) in age groups < 20 years old, 20-39 years old and > 40 years old, respectively. The HBV prevalence among risk groups was 20% (95%CI: 7.19% to 44.64%) in female prostitutes, 21.28% (95%CI: 7.15% to 48.69%) in hospitalized adults, 5.56% (95%CI: 0.99% to 25.62%) in hospitalized children, 60% (95%CI: 31.66% to 82.92%) in patients with acute hepatitis, 33.55% (95%CI: 14.44% to 60.16%) in patients with ancylostomiasis, 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis patients. The overall pooled prevalence of HCV was estimated as 4.84% (95%CI: 3.02% to 7.67%). The prevalence rates among blood donors, risk groups, children and patients chronic liver disease (including HCC) was 0.87% (95%CI: 0.33% to 2.30%), 2.43% (95%CI: 1.21% to 4.8%), 1.37% (95%CI: 0.76% to 2.46%) and 29.82% (95%CI: 15.84% to 48.98%), respectively. The prevalence among genotypes of HCV was 21.9% (95%CI: 15.36% to 30.23%) in genotype 1, 0.87% (95%CI: 0.12% to 5.9%) in genotype 2, 25.21% (95%CI: 18.23% to 33.77%) in genotype 3, 46.24% (95%CI: 37.48% to 55.25%) in genotype 4, 2.52% (95%CI: 0.82% to 7.53%) in genotype 5, and 1.19% (95%CI: 0.07% to 16.38%) in genotype 6. The overall pooled prevalence of HDV was 28.99% (95%CI: 16.38% to 45.96%). The HDV prevalence rate am...

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“…Hence, HEV is a major global health problem with a disproportionately high disease burden among pregnant women. Despite the fact that HEV could have dire consequencies for maternal and infant health in LIMCs, data on the epidemiolgy of HEV in Ghana is limited [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Sero-prevalence and risk factors for hepatitis E virus infection among pregnant women in the Cape Coast Metropolis, Ghana

et al. 2018

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BackgroundHepatitis E virus is an emerging infection in Africa with poor maternal and foetal outcomes. There is scanty data on the sero-prevalence of HEV infection among pregnant women in Ghana. This study highlighted the prevalence and risk factors associated with HEV infection among pregnant women in Cape Coast Metropolis, Central Region of Ghana.MethodsA multicenter (3 selected sites) analytical cross sectional study involving 398 pregnant women in the Cape Coast metropolis was conducted. HEV (Anti-HEV IgG and Anti-HEV IgM) ELISA was performed. Sero-positive women had liver chemistries done and data collected on maternal and neonatal outcomes. Data analyses were performed using Stata version 13 software (STATA Corp, Texas USA).ResultsMean age was 28.01 (± 5.93) years. HEV sero-prevalence was 12.2% (n = 48) for IgG and 0.2% (n = 1) for IgM with overall of 12.3%. The odds of being HEV sero-positive for women aged 26–35 years was 3.1 (95% CI: 1.1–8.1), p = 0.02 and ≥36 years it was 10.7 (95% CI; 3.4–33.5), p = 0.0001. Living in urban settlement was associated with lowest odds of HEV infection {OR 0.4 (95% CI; 0.2–0.8), p = 0.01}. Factors with no statistical evidence of association include main source of drinking water and history of blood transfusion. The sero-prevalence of HEV IgG increased progressively across trimesters with the highest among women in their third trimester (55.3%). None of the 49 HEV sero-positive women had elevated ALT level. Ten (N = 41) of the neonates born to sero-positive women developed jaundice in the neonatal period. The mean birth weight was 3.1kg (SD 0.4).ConclusionHEV sero-prevalence among pregnant women in the Cape Coast Metropolis is high enough to deserve more attention than it has received so far. It is therefore important to conduct further research on the potential impact on maternal and neonatal mortality and morbidity in Ghana.

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Hepatitis E infection among Ghanaians: a systematic review

Cited by 6 publications

References 38 publications

Aetiology of viral hepatitis among jaundiced patients presenting to a tertiary hospital in Ghana

Aetiology of viral hepatitis among jaundiced patients presenting to a tertiary hospital in Ghana

Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study

Sero-prevalence and risk factors for hepatitis E virus infection among pregnant women in the Cape Coast Metropolis, Ghana

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