Global prevalence of hepatitis B virus serological markers among healthcare workers: A systematic review and meta-analysis
Gadji Mahamat, Sébastien Kenmoe, Etheline W. Akazong, Jean Thierry Ebogo‐Belobo, Donatien Serge Mbaga, Arnol Bowo‐Ngandji, Joseph Rodrigue Foe-Essomba, Marie Amougou‐Atsama, Chavely Gwladys Monamele, Chris André Mbongue Mikangue, Ginette Irma Kame‐Ngasse, Jeannette Nina Magoudjou‐Pekam, Cromwel Zemnou-Tepap, Dowbiss Meta‐Djomsi, Martin Maïdadi‐Foudi, Sabine Aimée Touangnou-Chamda, Audrey Gaelle Daha-Tchoffo, Abdel Aziz Selly-Ngaloumo, Rachel Audrey Nayang-Mundo, Jacqueline Félicité Yéngué, Jean Bosco Taya-Fokou, Lorraine K. M. Fokou, Raoul Kenfack‐Momo, Dimitri Tchami Ngongang, Atembeh Efietngab Noura, Hervé Raoul Tazokong, Cynthia Paola Demeni Emoh, Cyprien Kengne-Ndé, Jean Joël Bigna, Onana Boyomo, Richard Njouom
Abstract
BACKGROUND: The hepatitis B virus (HBV) infection is a global public health concern that affects about 2 billion people and causes 1 million people deaths yearly. HBV is a blood-borne disease and healthcare workers (HCWs) are a high-risk group because of occupational hazard to patients' blood. Different regions of the world show a highly variable proportion of HCWs infected and/or immunized against HBV. Global data on serologic markers of HBV infection and immunization in HCWs are very important to improve strategies for HBV control. AIM: To determine the worldwide prevalence of HBV serological markers among HCWs. METHODS: parameters. Heterogeneity' sources were explored through subgroup and metaregression analyses. This study is registered with PROSPERO, number CRD42019137144. RESULTS: We reviewed 14059 references, out of which 227 studies corresponding to 448 prevalence data among HCWs (224936 HCWs recruited from 1964 to 2019 in 71 countries) were included in this meta-analysis. The pooled seroprevalences of current HBsAg, current HBeAg, and acute HBV infection among HCWs were 2.3% [95% confidence interval (CI): 1.9-2.7], 0.2% (95%CI: 0.0-1.7), and 5.3% (95%CI: 1.4-11.2), respectively. The pooled seroprevalences of total immunity against HBV and immunity acquired by natural HBV infection in HCWs were 56.6% (95%CI: 48.7-63.4) and 9.2% (95%CI: 6.8-11.8), respectively. HBV infection was more prevalent in HCWs in low-income countries, particularly in Africa. The highest immunization rates against HBV in HCWs were recorded in urban areas and in high-income countries including Europe, the Eastern Mediterranean and the Western Pacific. CONCLUSION: New strategies are needed to improve awareness, training, screening, vaccination, post-exposure management and treatment of HBV infection in HCWs, and particularly in low-income regions.