AUTHOR=Quintas Angelina Edna , Cuboia Nelson , Cordeiro Lemuel , Sarmento António , Azevedo Luís 

TITLE=Seroprevalence of Hepatitis B virus surface antigen among African blood donors: a systematic review and meta-analysis

JOURNAL=Frontiers in Public Health

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1434816

DOI=10.3389/fpubh.2024.1434816

ISSN=2296-2565

ABSTRACT=<sec id="sec1"><title>Background</title><p>Transfusion Transmitted Infections (TTIs) are still a growing public health problem in Africa. Studies that synthesize the available evidence on the seroprevalence of Hepatitis B Surface Antigen (HBsAg) among African blood donors are scarce. Therefore, this study aimed to synthesize qualitatively and quantitatively the seroprevalence of Hepatitis B Virus Surface Antigen (HBsAg) among blood donors in Africa.</p></sec><sec id="sec2"><title>Methods</title><p>We conducted a systematic review and meta-analysis where we included all studies that reported the seroprevalence of HBsAg among blood donors in Africa. The references were searched from electronic databases: PubMed, Web of Science, Cochrane, Scopus, WHO research database-HINARI, Global Index Medicus and <ext-link xlink:href="https://clinicaltrials.gov" ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>. We further analyzed the full list of references of all included studies. The pooled seroprevalence was estimated through random effect model. The heterogeneity was assessed through Cochrane’s <italic>Q</italic> test and <italic>I</italic><sup>2</sup>, respectively. Meta-regression, subgroup and sensitivity analyses were conducted.</p></sec><sec id="sec3"><title>Results</title><p>We obtained 124 studies that met our inclusion criteria, comprising 3,573,211 blood donors tested for HBsAg. The pooled seroprevalence of HBsAg among blood donors in Africa was 6.93% (95% CI: 5.95–7.97%; <italic>I</italic><sup>2</sup> = 100%; <italic>p</italic> &lt; 0.001). We found that the heterogeneity was explained by the study performed country and, African region. The higher prevalence was observed in Western 10.09% (95% CI: 8.75–11.50%), Central 7.81% (95% CI: 5.34–10.71%), and Eastern African region 4.87% (95% CI: 3.77–6.11%) and lower prevalence were observed in Southern 2.47% (95% CI: 0.54–5.75%) followed by Northern Africa region with 1.73% (95% CI: 0.45–3.79%). Additionally, based on the date of publication, we found that the highest prevalence was observed in studies published between 2001 and 2010 (9.41, 95% CI: 7.19–11.90) and the lowest prevalence was observed in studies published between 2011 and 2024 (6.26%; 95% CI: 5.19–7.42).</p></sec><sec id="sec4"><title>Conclusion</title><p>The seroprevalence of HBsAg among blood donors in Africa is still very high and heterogeneous. Therefore, intensifying the screening and vaccination of the population for Hepatitis B is critical to ensure blood safety toward eliminating Hepatitis B in Africa.</p></sec><sec id="sec5"><title>Systematic review registration</title><p><uri xlink:href="https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395616" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395616</uri>, PROSPERO CRD42023395616.</p></sec>