Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Feb 28, 2022; 10(1): 12-24
Published online Feb 28, 2022. doi: 10.13105/wjma.v10.i1.12
Hepatitis C virus among blood donors and general population in Middle East and North Africa: Meta-analyses and meta-regressions
Sarwat Mahmud, Hiam Chemaitelly, Ahmed S Alaama, Joumana G Hermez, Laith Abu-Raddad
Sarwat Mahmud, Hiam Chemaitelly, Laith Abu-Raddad, Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
Ahmed S Alaama, Joumana G Hermez, Department of Communicable Diseases, HIV/Hepatitis/ STIs Unit, World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
Author contributions: Mahmud S conducted data extraction and analysis, and wrote the first draft of the paper; Abu-Raddad L conceived and led the design of the study, analyses, and drafting of the article; All authors contributed to data collection and acquisition, and/or database development, and/or discussion and interpretation of the results, and to the writing of the manuscript.
Supported by National Priorities Research Program (NPRP) grant from the Qatar National Research Fund (a member of Qatar Foundation), No. 12S-0216-190094; and the Biostatistics, Epidemiology, and Biomathematics Research Core at Weill Cornell Medicine-Qatar.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The methodology used for these reviews was informed by the Cochrane Collaboration Handbook, and all findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Laith Abu-Raddad, PhD, Professor, Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Education City, PO Box, Doha 24144, Qatar. lja2002@qatar-med.cornell.edu
Received: August 5, 2021
Peer-review started: August 5, 2021
First decision: September 4, 2021
Revised: September 16, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: February 28, 2022
ARTICLE HIGHLIGHTS
Research background

The Middle East and North Africa (MENA) Region is the most affected by hepatitis C virus (HCV) infection, with approximately 20% of the global chronically infected individuals residing in this region. Despite this, only three countries conducted national population-based surveys to delineate HCV infection levels in the general population.

Research motivation

HCV infection in blood donors have been used as a proxy for HCV infection levels in the general population. However, it is unclear how comparable blood donors are to the general population in countries in MENA and whether they are a suitable proxy population.

Research objectives

To delineate HCV epidemiology in blood donors and in the general population in MENA.

Research methods

The MENA HCV Epidemiology Synthesis Project Database was used as a data source. Studies reporting HCV in blood donors and in the general population were retrieved, and random-effects meta-analyses and random-effects meta-regressions were performed. For regional comparison, similar analyses were performed for countries in Europe, using the Hepatitis C Prevalence Database from the European Centre for Disease Prevention and Control (ECDC).

Research results

A total of 1213 HCV Ab prevalence measures and 84 viremic rate measures were retrieved from the MENA HCV Epidemiology Synthesis Project, and 377 HCV Ab prevalence measures were retrieved from the ECDC. The pooled mean prevalence in MENA was 1.58% [95% confidence interval (CI): 1.48%–1.69%] in blood donors and 4.49% (95%CI: 4.10%–4.90%) in the general population, and in Europe was 0.11% (95%CI: 0.10%–0.13%) among blood donors and 1.59% (95%CI: 1.25%–1.97%) in the general population. In MENA, the prevalence in the general population was 1.72-fold (95%CI: 1.50–1.97) higher than that in blood donors, and in Europe it was 15.10-fold (95%CI: 11.48–19.86) higher. HCV prevalence appeared to be declining by 4% annually in both MENA and Europe.

Research conclusions

Blood donor data in MENA (but not in Europe) appears to be comparable with that in the general population and therefore can be used as a useful proxy for HCV infection levels and trends in the general population, at least in countries where effective blood donor selection and blood donor management programs are not yet firmly in place. Blood donor data may be used to estimate HCV infection and disease burden and to assess, track, and validate progress toward World Health Organization elimination goals for this infection.

Research perspectives

With the lack of nationally representative population-based surveys in most countries in MENA and beyond, blood donor data, which are readily available, can be easily used to assess levels and trends of this infection in the wider population. The study rationalizes and facilitates generation of estimates at low costs and demands for resources, even in resource-limited settings where population-level data are most scarce. While these findings are specific for MENA, they may also apply and be of relevance to other global regions.