Seroprevalence of hepatitis C virus infection in Cameroon: a systematic review and meta-analysis

Abstract

ObjectiveBetter knowledge of hepatitis C virus (HCV) seroprevalence at the national level can help to implement pertinent strategies to address the HCV-related burden. The aim of this paper was to estimate the seroprevalence of HCV infection in Cameroon.DesignSystematic review and meta-analysis.ParticipantsPeople residing in Cameroon.Data sourcesElectronic databases including PubMed/MEDLINE, AJOL, WHO-Afro Library, Africa Index Medicus, National Institute of Statistics and National AIDS Control Committee, Cameroon from 1 January 2000 to 15 December 2016 were searched. English and French languages papers were considered. Two independent investigators selected studies. The methodological quality of the studies was assessed using the Newcastle–Ottawa scale.Results31 studies including 36 407 individuals were finally considered. There was no national representative study. The overall pooled prevalence was 6.5% (95% CI 4.5% to 8.8%; I²=98.3%). A sensitivity analysis of individuals at low risk of HCV infection showed a pooled prevalence of 3.6% (95% CI 2.3% to 5.2%, I²=97.7%, 18 studies) among 22 860 individuals (general population, blood donors and pregnant women), which was higher than for a high-risk population (healthcare workers and people with other identified comorbidities), 12.2% (95% CI 4.9% to 22.2%; I²=98.3%, 13 studies); p=0.018. The prevalence was higher in the East region, in rural settings, and when using an enzyme immunoassay technique for detecting HCV antibodies. Sex, sites, study period, sample size, timing of data collection and methodological quality of studies were not sources of heterogeneity.LimitationOne-third of studies (29.0%) had a low risk bias in their methodology and most were facility-based (87.1%).ConclusionThe seroprevalence of HCV infection in Cameroon indicates the need for comprehensive and effective strategies to interrupt HCV transmission in the Cameroonian population. Specific attention is needed for the East region of the country, rural settings and high-risk populations. A national representative study is needed to provide better estimates.

Hepatitis C virus surveillance and identification of human pegivirus 2 in a large Cameroonian cohort

“…Furthermore, this study is the first to determine the prevalence of HCV RNA in a cohort from Cameroon, providing new insight towards developing appropriate diagnostic and treatment plans in the region. Notably, the prevalence of HCV RNA in our study (2.47%) was lower than the reported seroprevalence in Cameroon, which ranges from 3.6% in healthy cohorts to 12.2% in people who are ill, indicating that seroprevalence measurements may not predict the number of viremic infections. Nonetheless, the HCV RNA prevalence we observed (2.47%) is consistent with the 0.7% prevalence calculated by a recent prediction model and the measured 0.9% prevalence in the neighbouring Democratic Republic of Congo national survey when the two major biases of our study are taken into account.…”

“…Evidence‐based policymaking to ensure that DAAs are delivered to the appropriate recipients requires identification of infected patients through diagnostic testing and prevalence estimates to predict the cost of eradication efforts. HCV is endemic to Cameroon, with meta‐analysis prevalence estimates varying from 3.6% in low‐risk populations to 12.2% in high‐risk populations . A large study cohort is key to determining the actual burden of chronic HCV.…”

“…HCV is endemic to Cameroon, with meta-analysis prevalence estimates varying from 3.6% in low-risk populations to 12.2% in high-risk populations. 3,4 A large study cohort is key to determining the actual burden of chronic HCV. The Cameroon 2011 national health survey of dried blood spots from N = 14 150 residents reported the prevalence of anti-HCV-positive individuals to be 1.1%.…”

“…To date, estimates of HCV prevalence in Cameroon have relied entirely on the detection of anti-HCV antibodies. 3,4,6 Seroprevalence rates do not directly reflect the rates of chronic HCV infection since they include patients who have spontaneously cleared their infection, and antibody-negative acute infections can also be missed. In contrast, detection of viral components, such as HCV RNA or core antigen, provides a direct measurement of the prevalence of viremic HCV infections that can be cured by DAA treatment.…”

Seroprevalence of Hepatitis B and C Infections in Mokolo District Hospital, Northern Cameroon: The Value of a Screening Campaign

“…Furthermore, the recent systematic review conducted on the seroprevalence of HCV infection in Cameroon by Bigna et al had no representative data from northern Cameroon. 18 In addition to investigating seroprevalence, risk factors for HBV and HCV infections need to be identified in each setting so as to allow for the implementation of appropriate preventive interventions.…”