Community-based Sero-prevalence of Hepatitis B and C Infections in South Omo Zone, Southern Ethiopia

Abstract

16Background: Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are the leading causes of 17 liver-related morbidity and mortality throughout the world. The magnitude of HBV and HCV 18 infections in Ethiopia has not been well studied at community level. This study aimed at 19 investigating the sero-prevalence and associated risk factors of HBV and HCV among HBV 20 unvaccinated community members in South Omo Zone, Southern Ethiopia. 21 Methods: A community-based cross-sectional study was conducted in three districts from March 22 to May 2018. Structured questionnaire was used to collect relevant clinical and socio-23 demographic data. Three milliliter of blood sample was collected from each study participant and 24 screened for HBV and HCV using one step hepatitis B surface antigen (HBsAg) test strip and one 25 step HCV test strip, respectively. Samples found positive for HBsAg were further tested using 26 immunoassay of Alere Determine TM HBsAg (Alere Inc., USA). Data was analyzed using SPSS 27 version 25.0. 28 Results: A total of 625 (51.4% males, age 6-80 years, mean age ± SD = 30.83 ± 13.51 years) 29 individuals participated in the study. The sero-prevalence for HBV infection was 8.0% as 30 detected using one step HBsAg test strip, while it was 7.2% using Alere Determine TM HBsAg 31 test. The sero-prevalence for HCV infection was 1.9%. Two (0.3%) of the participants were 32 seropositive for both HBV and HCV infections. High sero-prevalence for HBV infection was 33 associated with weakness and fatigue (AOR = 5.20; 95% CI: 1.58, 17.15), while high sero-34 prevalence of HCV infection was associated with age group between 46 and 65 years (AOR = 35 13.02; 95% CI: 1.11, 152.41).36 Conclusion: this study revealed higher-intermediate endemicity level of HBV infection and low 37 to intermediate endemicity level of HCV infection in the study area. Clinical symptoms like 38 weakness and fatigue were found to be indictors for HBV infection, while individuals in the age 39 group between 46 and 65 years were at higher risk for HCV infection. Provision of community-40 based health education, vaccination, mass screening and providing treatment would have utmost 41 importance in reducing the transmission of these diseases in the present study area. 42 2 43 E viruses. Among these, hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most 48 common causes of viral hepatitis [2]. 49 Both HBV and HCV can be transmitted through sexual, blood or vertically from mother-to-child 50 [3]. Thus, individuals who require blood transfusion, those who have multiple sexual partners 51 and infants born to HBV or HCV infected mothers are at a high-risk for acquiring HBV or 52 HCV infection [4]. Both viruses can cause acute and chronic infection of the liver [5, 6]. Chronic 53 HBV and HCV infections are the leading causes of liver-related morbidity and mortality [7, 8]. 54 Between 15% and 40% of chronically infected individuals can develop serious liver disease and 55 transmit the viruses to others [9, 10]. Globally, about 257 m...

Undiagnosed Seroprevalence of Hepatitis B and C Virus Infections in the Community of Wolaita Zone, Southern Ethiopia

“…Overall anti-HCV seroprevalence was 1.9% (95% CI: 0.9%, 3.0%), which is considered low endemicity by WHO. 22 , 23 The results were consistent with the results of the previous studies conducted on the general population in the South Omo Zone, 1.9%, 20 the recent pooled national prevalence of 2%, 34 the 2% prevalence reported from Gambella, Ethiopia 18 and 1.4% among community members in southern Ethiopia 19 However, the seroprevalence was less than that of 3.1% of the previous national pooled prevalence, 17 4.3% in previous studies reported from Northwest Ethiopia, 35 3.0% prevalence found in sub-Saharan Africa, 36 , 37 3.4% Africa, 4.8% Somalia, 6.2% Pakistan, 6.5% Cameron, and 11.9% Egypt. 38–42 On the contrary, it is greater than the 1.0% prevalence reported in Gojjam, Ethiopia; 28 0.64% prevalence reported in Nekemite, Ethiopia, 43 0.4% in Iraq, 44 0.3% in Djibouti, 0.9% in Somalia, and 1.0% in Sudan 36 among the general populations.…”

“… 45–48 In current study, coinfection was 0.3% among the general population in the community of Wolaita. This was in line with 0.3% prevalence among community members in South Omo Zone, 20 0.2% prevalence in Hawassa University Comprehensive Specialized Hospital, Hawassa City, Southern Ethiopia, 49 0.4% prevalence among hemodialysis patients in Addis Ababa, Ethiopia 50 and 0.43% prevalence among surgical patients in Lahore. 51 HBV seroprevalence was determined by using viral antigen (HBsAg) as a serologic marker, and HCV infection by antibody (anti-HCV antibody), both confirmed by ELISA.…”

“…Accordingly, recent viral transmission may result in higher HBsAg seroprevalence (5.6%) than anti-HCV prevalence (1.9%), thereby diluting the effect of coinfection. 20 Besides geographic variation, the more recent transmission of HBV might explain the low coinfection rate in the current study area through the sexual route. The study also assessed risk factors associated with HBsAg and anti-HCV infections to identify the adult populations with the risks in a community.…”

“…HBsAg seroprevalence was similar to that of 6.1% of the entire African region 9 and within the range of 5–10% reported in sub-Saharan African countries. 24 Similarly, the prevalence was 7.4% for the previous national pooled prevalence and 8.0% for the community-based prevalence, 17 7.2% for the South Omo Zone community prevalence, 20 and 6.9% for Madagascar. 25 However, the prevalence in our study is lower than 9.5% in the community of Southern Ethiopia, 19 9% in the adult community of Southwest Ethiopia, 21 17.6% in a community-based study of Northern Uganda 26 and similar study population in Pakistan (9.33%).…”

A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination

“…Available studies are clinic-based and represent different subpopulations. Two general population-based studies in northwest (2015) 10 and southern (2018) 11 Ethiopia found the prevalence of HCV infection to be 1.0% and 1.9%, respectively. The prevalence of HCV infection in blood donors ranges from 0.3% 2 to 1.3%, 12 with wider variations among different cities.…”