Hepatitis C Virus in North Africa: An Emerging Threat

Daw, Mohamed A.; El-Bouzedi, Abdallah; Ahmed, Mohamed O.; Dau, Aghnyia A.; Agnan, Mohamed M.

doi:10.1155/2016/7370524

Cited by 26 publications

(19 citation statements)

References 70 publications

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“…Prevalence of HBV and HCV varies across the 22 countries in the region; HBV prevalence ranges from 16%-19% in Mauritania and Somalia to 0.5% in Bahrain (supplemental Table 4). HCV prevalence in Egypt exceeds 6% (4.4% in those aged less than 60 years), which is higher than in any other country in the world 203,[204][205][206][207][208][209] . 201,[210][211][212][213] Egypt also dominates the region with respect to DALYs attributable to viral hepatitis (figure 7a).…”

Section: Key Priorities For Actionmentioning

confidence: 99%

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Cooke

Andrieux-Meyer

Applegate

et al. 2019

The Lancet Gastroenterology & Hepatology

444

391

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investments to support countries with greatest burden of viral hepatitis All heavily burdened countries to have fully funded elimination plans by 2019 Recognition of need to focus on high burden countries and support for national policy development (All) Funding for national elimination plans Creation of fiscal space for new programmes with costed investment programmes Adopt domestic innovative finance tools where appropriate Support national policy makers in their activity (WHO, UNITAID, NGOs) Provide international support for financing measures (UNITAID, GFATM, bilaterial donors) Prevention Ensure all WHO elimination targets addressed in plans Address operational challenges in delivery of birth dose HBV vaccine Ensure provision of harm reduction services and engage with marginalised group (e.g. prisoners, PWIDs). Ensure clear public health messages to encourage testing and treatment Support countries to decriminalise injecting drug use and ensure equitable access to services for all (NGOs, WHO, civil society) Ensure appropriate funding for HBV vaccine, including birth dose (GAVI, WHO) Support R&D into HCV vaccine development (Research funders and pharma) Testing and Models of Care Focus on substantially scaling up testing for HBV and HCV Create and evaluate simplified care pathways relevant to local setting, integrating with existing services. Promote task sharing and decentralisation of care through capacity building, training and removal of Support operational research into simplified pathways (Research funders, UNITAID) requirements for specialised prescribing Diagnostics Ensure testing is integrated into the wider healthcare system, rather than centralised facilties Ensure access to quality diagnostics through Essential Diagnostic List and prequalification (WHO, funders) Support implementation science for models of care and R&D into novel diagnostics suitable for decentralised settings. (Research funders, FIND, industry) Access to treatment Ensure all Essential Medicines for viral hepatitis are included in national programmes, with an emphasis on pan-genotypic regimens Apply comprehensive policy approach to promoting access, including compulsory licensing Ensure all essential medicines are pre-qualified and either available through voluntary licensing or Medicines Patent Pool (WHO, NGOs, civil society, funders) Support shared procurement mechanisms for treatment (PAHO) Monitor Progress National plans need clearly defined, measurable objectives Develop new indices of national progress Progress of individual countries needs to be closely monitored towards elimination goals (Polaris, WHO, Creation of Elimination Index) Develop greater capacity for advocacy in high burden regions (all) Viral hepatitis is one of the leading causes of death in the world. 96% of those deaths are due to hepatitis B and C, which are the focus of this commission. Unlike many other major diseases, the tools exist to eliminate viral hepatitis. A highly effective vaccine is available to prevent hepatitis B, and a revolution in HCV treat...

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Section: Key Priorities For Actionmentioning

confidence: 99%

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Cooke

Andrieux-Meyer

Applegate

et al. 2019

The Lancet Gastroenterology & Hepatology

444

391

View full text Add to dashboard Cite

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“…Moreover, this prevalence rate is much lower when compared to the north neighboring country. Egypt is encountered with a huge HCV infection; it is reported to have a prevalence rate of 14.7% and 11.9% in recently published reviews (2016, 2018, respectively) [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan

Badawi¹,

Atif

Mustafa

2018

Virol J

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Viral hepatitis constitutes a global health problem; previous studies have affirmed a considerable morbidity and mortality from both acute infections and chronic complications. On the other hand, Human Immunodeficiency Virus (HIV) infection is also of known burden. Determining prevalence measures of these viruses is crucial for establishing appropriate country specific strategies regarding prevention, diagnosis, and containment. This systematic review was aimed to provide pooled seroprevalence estimates of the three viruses in Sudan. Structured review of the literature was conducted to obtain relevant studies published in both national and international databases. After assessment of quality and bias in all proposed studies, 57 prevalence studies were included. Meta-analysis was conducted for all studies and subgroup analysis was also approached. The total sample size of participants in included studies providing HIV antibodies prevalence was 15,479. Based on information retrieved from these studies, HIV prevalence ranged from 0 to 18.3% among different study populations. However, pooled prevalence estimate for HIV antibodies was 1%. Kassala, Eastern Sudan was the most endemic State (4.18%). The HBV reported seroprevalence rates ranged from 5.1 up to 26.81% among different populations and the overall pooled prevalence was 12.07%. For HCV antibodies; 2.74% was determined to be the pooled prevalence. Khartoum State was the most endemic State of both HBV and HCV with seroprevalence of 12.69% and 6.78%, respectively.Based on data reviewed and synthesized; there is no evidence for an HIV endemic in the general population of Sudan. However, both HBV and HCV seroprevalence rates are indicating otherwise. Reducing the overall burden of HIV, HBV and HCV infections will require new measures and national strategies and the recognition of the infections as one of the country’s priority issues.Electronic supplementary materialThe online version of this article (10.1186/s12985-018-1060-1) contains supplementary material, which is available to authorized users.

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“…North African countries have a unique geographical location facing the European Union. They act as a focus of African immigrants heading to Europe [ 21 ]. HDV is considered endemic in this region and viral screening for HDV or specific clinical targeting is rarely practiced.…”

Section: Introductionmentioning

confidence: 99%

The Epidemiology of Hepatitis D Virus in North Africa: A Systematic Review and Meta-Analysis

Daw

Sifennasr

et al. 2018

The Scientific World Journal

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Background Hepatitis D virus (HDV) infection has been considered a serious neglected pandemic, particularly in developing countries. The virus causes a more severe disease than mono infection with hepatitis B virus (HBV). The epidemiology of HDV is not well documented in North Africa, which is known to be endemic for HBV. In this study, we explored the prevalence of HDV infection and also attempted to identify factors associated with hepatitis D positive status among chronic hepatitis B patients in North Africa. Methods The electronic databases PubMed, Embase, Scopus, Science Direct, Web of Science, and Google Scholar were comprehensively searched for all papers published between January 1, 1998, and December 31, 2017, using appropriate strategies containing all related keywords, including North Africa, names of countries in the region, and all permutations of hepatitis D virus. The estimated prevalence of HDV in North Africa was calculated as an average of the pooled infection prevalence in each country weighted by the ratio of the country's hepatitis D virus population to the study's sample size in the survey data analysis. Findings A total of 312 studies were identified and 32 were included in this study, with a total sample of 4907 individuals screened for HDV. There was considerable variability in the prevalence estimates of HDV within the countries of the region. The overall prevalence of HDV in the general population of North Africa was 5·01% (95% CI: 1·25–8·27) and in liver disease patients it was 20.7% (95% CI:9.87–44.53). Genotype-1 was the most prominent genotype reported in five published studies. Ten studies reported on HDV RNA in participants who were seropositive for HDV, and four studies highlighted the impact of demographic factors (sex and age). No study showed the impact of risk factors on the prevalence of HDV in North Africa. Interpretation This review provides a comprehensive assessment of the burden of HDV in Northern Africa. There were significant differences in seroprevalence, study population, and diagnostic testing between the countries in the region. The results presented here will alert health professionals to implement clear policies based on evidence to diminish the burden of HDV infection. Such measures may include but are not restricted to improving the laboratory diagnostic tests and initiating patient data registries and blood screening. Further epidemiological and research studies are needed to explore the risk factors, coinfections, and approaches to increase testing for HDV, particularly in high-risk subpopulations, such as intravenous drug users and immigrants, and to define the consequences of HDV infection in North Africa.

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Hepatitis C Virus in North Africa: An Emerging Threat

Cited by 26 publications

References 70 publications

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan

The Epidemiology of Hepatitis D Virus in North Africa: A Systematic Review and Meta-Analysis

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