Prevalence of Chronic Hepatitis B Virus Infection in Sierra Leone, 1997–2022: A Systematic Review and Meta-Analysis

Abstract

Hepatitis B virus (HBV) infection is a major public health problem in Sierra Leone, yet reliable estimates of cases are lacking. This study aimed to provide an estimate of the national prevalence of chronic HBV infection in the general population and select groups in Sierra Leone. We used the electronic databases PubMed/MEDLINE, Embase, Scopus, ScienceDirect, Web of Science, Google Scholar, and African Journals Online to systematically review articles reporting hepatitis B infection surface antigen seroprevalence estimates in Sierra Leone during 1997–2022. We estimated pooled HBV seroprevalence rates and assessed potential sources of heterogeneity. Of 546 publications screened, 22 studies with a total sample size of 107,186 people were included in the systematic review and meta-analysis. The pooled prevalence of chronic HBV infection was 13.0% (95% CI, 10.0–16.0) (I2 = 99%; Pheterogeneity < 0.01). During the study period, the HBV prevalence rates were as follows: 17.9% (95% CI, 6.7–39.8) before 2015, 13.3% (95% CI, 10.4–16.9) during 2015–2019, and 10.7% (95% CI, 7.5–14.9) during 2020–2022. The use of the 2020–2022 HBV prevalence estimates corresponded to 870,000 cases of chronic HBV infection (uncertainty interval, 610,000–1,213,000), or approximately one in nine people. The highest HBV seroprevalence estimates were among adolescents aged 10–17 years (17.0%; 95% CI, 8.8–30.5), Ebola survivors (36.8%; 95% CI, 26.2–48.8), people living with HIV (15.9%; 95% CI, 10.6–23.0), and those in the Northern Province (19.0%; 95% CI, 6.4–44.7) and Southern Province (19.7%; 95% CI, 10.9–32.8) regions. These findings may help inform national HBV program implementation in Sierra Leone.

Impact of COVID-19 on hepatitis B screening in Sierra Leone: insights from a community pharmacy model of care

“…This is in contrast to a recent systematic review and meta-analysis by Yendewa et al. [19] , which estimated a national HBsAg prevalence of 13.0% for Sierra Leone and a regional prevalence of 11.2% for the Western Area, where the present study was conducted. There are several possible explanations for this observed difference.…”

“…Sierra Leone is a West African country with an estimated national prevalence of HBV surface antigen (HBsAg) of 13% [19] . While there have been notable strides to implement a national policy for combating HBV, the delivery of HBV care remains fragmented.…”

Impact of COVID-19 on Hepatitis B Screening in Sierra Leone: Insights from a Community Pharmacy Model of Care

“…The overall prevalence of HBsAg was 17.5%, with the highest prevalence (24.4%) observed among individuals aged 30-39 years. This is in contrast to a recent systematic review and meta-analysis by Yendewa et al [19], which estimated a national HBsAg prevalence of 13.0% for Sierra Leone and a regional prevalence of 11.2% for the Western Area, where the present study was conducted. There are several possible explanations for this observed difference.…”

Determinants of Hepatitis B Viral infection among pregnant women in Greater Monrovia, Liberia

“…The transmission of the virus typically occurs through vertical transmission from mother to child (MTCT) during the process of childbirth, during early infancy, and through contact with blood or other bodily fluids during sexual intercourse with an infected partner, injections, or exposure to contaminated sharp tools (3,4). Hepatitis B viral infection is of public health concern (1,5).The prevalence of chronic infections was estimated to be at 296 million individuals in 2019, with an annual incidence of 1.5 million new infections (6,7). Amongst these cases, it was observed that 68% resided in Africa and Western Pacific Asia (8,9).…”