Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study

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Term Occurence Count Dictionary
measles 1 infectiousdiseases
schistosomiasis 9 infectiousdiseases
urinary schistosomiasis 1 infectiousdiseases
ancylostomiasis 5 infectiousdiseases
hepatitis B 22 infectiousdiseases
hepatitis C 21 infectiousdiseases
hepatitis D 9 infectiousdiseases
hepatitis E 14 infectiousdiseases
hepatitis A 13 infectiousdiseases
leprosy 11 infectiousdiseases
malaria 2 infectiousdiseases
tuberculosis 4 infectiousdiseases
viral hepatitis 44 infectiousdiseases

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ancylostomiasis 3059 31.66% to 82.92%) in patients with acute hepatitis, 33.55% (95%CI: 14.44% to 60.16%) in patients with ancylostomiasis , 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis
ancylostomiasis 23805 which Delia S and his colleagues were presented with a higher frequency of HBsAg among patients with ancylostomiasis (33.33%) and with urinary schistosomiasis (25.92%) than among leprosy patients (9.67% in the L type
ancylostomiasis 41889 schistosomiasisNuti et al[[26]]1979671354Patients with schistosomiasisDelia et al[[22]]197715552103Patients with ancylostomiasis Delia et al[[22]]197715540115Patients with schistosomiasisDelia et al[[22]]197715515140Patients with
ancylostomiasis 43173 acute hepatitis patients was 60% (95%CI: 31.66% to 82.92%).One study was conducted on patients with ancylostomiasis . The pooled effect size for the prevalence of HBV infection among Somali ancylostomiasis patients was
ancylostomiasis 43262 patients with ancylostomiasis. The pooled effect size for the prevalence of HBV infection among Somali ancylostomiasis patients was 33.55% (95%CI: 14.44% to 60.16%).Four studies were conducted on leprosy patients. The pooled
hepatitis A 1681 Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis [ hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV):
hepatitis A 4908 globally. The most common types of viral hepatitis are six distinct types that have been identified as hepatitis A , B, C, D, E, G viruses, and they may present in acute form or chronic form, which causes substantial
hepatitis A 10323 clinical data on the seroprevalence of viral hepatitis in Somalia. The key words used were as follows: [“ hepatitis A ” AND (seroprevalence OR prevalence) AND “Somalia”], [“hepatitis B” AND (seroprevalence OR
hepatitis A 10781 “Somalia”]. We also reconducted the search using full written phrases, such as “Viral hepatitis”, “ hepatitis A ”, “hepatitis B” or “hepatitis B surface antigen”, “hepatitis C”, “hepatitis D”, “hepatitis
hepatitis A 18625 et al[[18]]19848678 (90.6)SomaliaLocalFigure 2Meta-analysis and forest plot presentation of the anti- hepatitis A virus antibody from 1984 to 1994.Despite the significant heterogeneity, the funnel plot displayed a
hepatitis A 19034 individual studies were of variable sample size.Figure 3Bias assessment plot of studies reporting of hepatitis A virus prevalence in Somalia from 1984 to 1994.Moreover, Duval and Tweedie’s trim and fill procedure
hepatitis A 19829 in Italy, with a prevalence of HAV of 95.8% (95%CI: 92.1% to 97.8%, Figure 4).Figure 4Forest plot of hepatitis A virus prevalence rates for studies conducted in Somalia from 1984 to 1992.Age pattern of HAV infectionCharacteristics
hepatitis A 20272 belonging to 4 major age groups. The quality of the included studies varied (Table 2).Table 2Age pattern of hepatitis A infectionAge groupAuthor/Publication yearTotalCasesTotalHealthySerology0-11 moMohamud et al 1992[[15]]52325220Anti-HAV1-11
hepatitis A 22745 sizes for the individual original studies and their 95%CI, as shown in Figure 5.Figure 5Forest plot of hepatitis A virus infection prevalence rates according to age groups from 1984 to 1994.Despite the significant heterogeneity,
hepatitis A 23193 the individual studies were of variable sample size.Figure 6Bias assessment plot of studies reporting hepatitis A virus and age groups.Moreover, the Duval and Tweedie’s trim and fill procedure for the detection of
hepatitis A 79107 results indicate that HDV infection is endemic in Somalia.Although the number of prevalence studies of hepatitis A and E virus infections among Somali patients were also very low in Somalia due to the lack of government
hepatitis A 84719 several hundred million people globally. The most common types of viral hepatitis are six distinct types ( hepatitis A , B, C, D, E, G viruses), and they may present in acute form or chronic form causes substantial morbidity
hepatitis A 86441 combined sample size for each type of viral hepatitis were analyzed. The overall pooled prevalence rate of hepatitis A virus was 90.2%. The overall pooled prevalence of HBV was 18.9%. The overall pooled prevalence of HCV
hepatitis B 1712 Libya) with a combined sample size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus
hepatitis B 5213 carcinoma. The World Health Organization (WHO) estimates that 257 million people worldwide are infected with hepatitis B virus (HBV), which constitutes 3.5% of the population. Africa has the second-largest number of chronic
hepatitis B 10397 used were as follows: [“hepatitis A” AND (seroprevalence OR prevalence) AND “Somalia”], [“ hepatitis B ” AND (seroprevalence OR prevalence) AND “Somalia”], [“hepatitis C” AND seroprevalence OR prevalence)
hepatitis B 10800 reconducted the search using full written phrases, such as “Viral hepatitis”, “hepatitis A”, “ hepatitis B ” or “hepatitis B surface antigen”, “hepatitis C”, “hepatitis D”, “hepatitis E”, “epidemiology”,
hepatitis B 10821 using full written phrases, such as “Viral hepatitis”, “hepatitis A”, “hepatitis B” or “ hepatitis B surface antigen”, “hepatitis C”, “hepatitis D”, “hepatitis E”, “epidemiology”, and
hepatitis B 23565 the observed effect size.Epidemiology of HBVSomalia is classified among countries as having a high hepatitis B surface antigen (HBsAg) endemicity of more than 8%[[20],[21]]. The first study of HBV in the country
hepatitis B 30373 their 95%CI, as shown in Figure 7.Table 3Summary of studies of included studies on the prevalence of hepatitis B viral infection in a Somali population in Somalia and Somali immigrants (1977-2014) n (%)No.AuthorPublication
hepatitis B 31751 (76.1)37SomaliaLocal23Sebastiani et al[[18]]19848611 (12.7)75SomaliaLocalHBsAg: Hepatitis B surface antigen.Figure 7Forest plot of hepatitis B virus infection prevalence rates in Somalia in published and unpublished studies from 1977 to 2014.Despite
hepatitis B 32228 the individual studies were of variable sample size.Figure 8Bias assessment plot of studies reporting hepatitis B virus prevalence rate in Somalia from 1977 to 2014.Moreover, Duval and Tweedie’s trim and fill procedure
hepatitis B 33390 States, with a prevalence of HBV of 13.6% (95%CI: 3.0% to 45.0%) (Figure 9).Figure 9Forest plot of hepatitis B virus prevalence rates for studies conducted according to setting from 1977 to 2014.Meta-regression
hepatitis B 34507 23.1% (95%CI: 17.0% to 30.5%) and high heterogeneity (I2 = 92.8%) (Figure 10).Figure 10Forest plot of hepatitis B virus prevalence rates for studies conducted according to population from 1977 to 2014.Meta-regression
hepatitis B 35933 al[[29]]19875219 (37%)33MogadishuPregnant womenHBsAg: Hepatitis B surface antigen.Figure 11Forest plot of hepatitis B virus infection prevalence rates among pregnant women.HBV infection in childrenA total of six studies
hepatitis B 37207 al[[29]]19872614%25MogadishuNewborn babiesHBsAg: Hepatitis B surface antigen.Figure 12Forest plot of hepatitis B virus infection prevalence rates among Somali children.Hepatitis B in chronic liver disease (including
hepatitis B 37678 from 17.9% to 50%[[30],[32],[34],[36]-[38]] (Table 6). The pooled effect size for the prevalence of hepatitis B among chronic liver disease patients in Somali people was 39.2% (95%CI: 33.4% to 45.4%). The heterogeneity
hepatitis B 38355 (37.9)72SomaliaLocalAceti et al[[30]]199110452 (50)52SomaliaLocalHBsAg: Hepatitis B surface antigen.Figure 13Forest plot of hepatitis B virus infection prevalence rates among patients with chronic liver disease, including hepatocellular
hepatitis B 40055 (I2 = 0%) but was very high for the below-20 age group (I2 = 91.1%) (Figure 15).Table 7Age pattern of hepatitis B virus infection n (%)Age groupAuthorPublication yearTotalHBsAgHealthy0-20Sebastiani et al[[40]]198521925
hepatitis B 40704 al[[18]]1984111 (9.1)10Total16019 (11.8)141HBsAg: Hepatitis B surface antigen.Figure 15Forest plot of hepatitis B virus infection prevalence rates among age groups.The funnel plot indicated little evidence to support
hepatitis B 41587 belonging to 7 major risk groups. The quality of the included studies also varied.Table 8Risk groups and hepatitis B virusAuthorYearTotalCasesHealthyPopulationNuti et al[[24]]197913533102Patients with leprosyNuti et al[[24]]1979871077Patients
hepatitis B 44150 for the individual original studies and their 95%CIs, as shown in Figure 17.Figure 17Forest plot of hepatitis B virus infection prevalence rates among risk groups.Despite the significant heterogeneity, the funnel
hepatitis B 85497 objective of this study is to determine the prevalence of all viral hepatitis in Somalia especially hepatitis B virus (HBV) and hepatitis C virus (HCV), and to inform public health practitioners, researchers and
hepatitis B 87011 perspectivesViral hepatitis in Somalia demonstrated a high rate in its all types of hepatitis especially hepatitis B virus and C, while hepatitis B determined the common cause of chronic liver disease in Somalia. According
hepatitis B 87042 Somalia demonstrated a high rate in its all types of hepatitis especially hepatitis B virus and C, while hepatitis B determined the common cause of chronic liver disease in Somalia. According to this systematic review
hepatitis C 1743 size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The
hepatitis C 5566 6.1% and 6.2%, respectively. It is estimated that approximately 71 million people were living with hepatitis C virus (HCV) infection, which accounts for 1% of the world’s population, in 2015. The regions with
hepatitis C 10471 prevalence) AND “Somalia”], [“hepatitis B” AND (seroprevalence OR prevalence) AND “Somalia”], [“ hepatitis C ” AND seroprevalence OR prevalence) AND “Somalia”], [“hepatitis D” AND (seroprevalence OR prevalence)
hepatitis C 10856 “Viral hepatitis”, “hepatitis A”, “hepatitis B” or “hepatitis B surface antigen”, “ hepatitis C ”, “hepatitis D”, “hepatitis E”, “epidemiology”, and “Somali immigrants.” We searched
hepatitis C 46716 of the prevalence of HCV infection (Table 9).Table 9Summary of studies on the overall prevalence of hepatitis C viral infection in a Somali population in Somalia and Somali immigrants (1970-2016)YearTotalCasesTotalHealthySettingPopulationDaw
hepatitis C 47416 al[[34]]19931242912495SomaliaLocalBile et al[[16]]19925969596587SomaliaLocalBile et al[[16]]19927607676SomaliaLocalTable 10Studies on hepatitis C virus among risk groups in SomaliaAuthorYearTotalCasesTotalHealthySettingPopulationAceti et al[[42]]19932870287278MogadishuHospitalized
hepatitis C 48963 original studies and their 95%CI, as shown in Figure 19.Figure 19Forest plot of studies reporting chronic hepatitis C virus infection prevalence in Somalia.Despite the significant heterogeneity, the funnel plot displayed
hepatitis C 49375 the individual studies were of variable sample size.Figure 20Funnel plot of studies reporting chronic hepatitis C virus infection prevalence in Somalia.Moreover, Duval and Tweedie’s trim and fill procedure for the
hepatitis C 50517 Libya with a prevalence of HCV of 8.15% (95%CI: 0.89% to 46.60%) (Figure 21).Figure 21Forest plot of hepatitis C virus infection for studies conducted in Somalia and Outside of Somalia.Meta-regression analysisExamining
hepatitis C 51639 9.13%) and high heterogeneity (I2 = 90.3%) (Figure 22).Figure 22Forest plot of studies reporting chronic hepatitis C virus prevalence amongst the local population and Somali immigrants.Meta-regression analysisWhen examining
hepatitis C 52538 total of 466 Somali blood donors. The quality of the included studies also varied.Table 11Studies on hepatitis C among blood donorsAuthorYearTotalCasesHealthyTownGroupNur et al[[33]]20001571156MogadishuBlood donorsAceti
hepatitis C 53354 original studies and their 95%CIs, as shown in Figure 23.Figure 23Forest plot of studies reporting chronic hepatitis C virus prevalence among blood donors in Somalia.HCV infection in different genotypesCharacteristics of
hepatitis C 53679 infection among different genotypes (Table 12)[[36],[43]].Table 12Studies on distribution genotypes of hepatitis C virus infection in SomaliaType of genotypeAuthor/Publication YearTotalCasesHealthySerologyGenotype 1Daw
hepatitis C 56256 95%CIs, as shown in Figure 24.Figure 24Forest plot of studies reporting on distribution genotypes of hepatitis C virus infection in Somalia.Despite the significant heterogeneity, the funnel plot displayed a symmetric
hepatitis C 56697 sample size.Figure 25Bias assessment plot of studies reporting among the distribution of genotypes of hepatitis C virus.Moreover, Duval and Tweedie’s trim and fill procedure for the detection of publication bias
hepatitis C 57972 original studies and their 95%CIs, as shown in Figure 26.Figure 26Forest plot of studies reporting chronic hepatitis C virus prevalence among risk groups in Somalia.As expected from the low heterogeneity, the funnel plot
hepatitis C 59020 total of 1001 Somali participants. The quality of the included studies also varied.Table 13Studies on hepatitis C virus infection among Somali childrenAuthorYearTotalCasesTotalHealthySettingPopulationBile et al[[16]]19925969596587Mogadishu
hepatitis C 60183 original studies and their 95%CIs, as shown in Figure 28.Figure 28Forest plot of studies reporting chronic hepatitis C virus prevalence among Somali children.As expected from the low heterogeneity, the funnel plot displayed
hepatitis C 61241 total of 505 Somali participants. The quality of the included studies also varied.Table 14Studies on hepatitis C virus infection among patients with chronic liver disease, including hepatocellular carcinoma, in SomaliaAuthorYearTotalCasesTotalHealthySettingPopulationShire
hepatitis C 62368 original studies and their 95%CIs, as shown in Figure 30.Figure 30Forest plot of studies reporting chronic hepatitis C virus prevalence among patients with chronic liver disease, including hepatocellular carcinoma, in Somalia.Despite
hepatitis C 85525 to determine the prevalence of all viral hepatitis in Somalia especially hepatitis B virus (HBV) and hepatitis C virus (HCV), and to inform public health practitioners, researchers and policy makers, and to be a baseline
hepatitis D 1774 hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The overall pooled prevalence rate
hepatitis D 10544 prevalence) AND “Somalia”], [“hepatitis C” AND seroprevalence OR prevalence) AND “Somalia”], [“ hepatitis D ” AND (seroprevalence OR prevalence) AND “Somalia”], [“hepatitis E” AND (seroprevalence OR
hepatitis D 10875 hepatitis”, “hepatitis A”, “hepatitis B” or “hepatitis B surface antigen”, “hepatitis C”, “ hepatitis D ”, “hepatitis E”, “epidemiology”, and “Somali immigrants.” We searched unpublished studies
hepatitis D 65222 of the included studies also varied (Table 15).Table 15Summary of studies on overall prevalence of hepatitis D viral infection of HBsAg-positive carriers in the Somali population in Somalia and Somali immigrants
hepatitis D 66286 original studies and their 95%CIs, as shown in Figure 32.Figure 32Forest plot of studies reporting hepatitis D virus infection prevalence in Somalia.Despite the significant heterogeneity, the funnel plot displayed
hepatitis D 66702 individual studies were of variable sample size.Figure 33Bias assessment plot of studies reporting of hepatitis D virus infection in Somalia.Moreover, Duval and Tweedie’s trim and fill procedure for the detection
hepatitis D 68347 for the individual original studies and their 95%CIs, as shown in Figure 34.Figure 34Forest plot of hepatitis D virus infection prevalence rates among patients with chronic liver disease in Somalia.The funnel plot
hepatitis D 68782 individual studies were of variable sample size.Figure 35Bias assessment plot of studies reporting of hepatitis D virus infection among chronic liver disease in Somalia.Moreover, Duval and Tweedie’s trim and fill
hepatitis D 86612 18.9%. The overall pooled prevalence of HCV was estimated as 4.84%. The overall pooled prevalence of hepatitis D virus was 28.99%. The overall pooled prevalence of hepatitis E virus was 46.86%.Research conclusionsThis
hepatitis E 1807 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The overall pooled prevalence rate of HAV was 90.2% (95%CI: 77.8% to
hepatitis E 5888 while the prevalence in Africa was 1.0%. Hepatitis D virus (HDV) affects nearly 15 million people, and hepatitis E virus (HEV) annually infects 20 million people, with over 3.3 million symptomatic cases of hepatitis
hepatitis E 5991 hepatitis E virus (HEV) annually infects 20 million people, with over 3.3 million symptomatic cases of hepatitis E and 44600 hepatitis E-related deaths being recorded[[1]] Hepatitis E is one of the leading causes of
hepatitis E 6013 annually infects 20 million people, with over 3.3 million symptomatic cases of hepatitis E and 44600 hepatitis E -related deaths being recorded[[1]] Hepatitis E is one of the leading causes of major outbreaks of acute
hepatitis E 6761 Approximately 96% of these deaths resulted from complications of chronic HBV (66%) and HCV (30%), although hepatitis E and HAV infections accounted for 3.3% and 0.8% of these deaths, respectively[[1]]. HBV (887000 deaths)
hepatitis E 10618 prevalence) AND “Somalia”], [“hepatitis D” AND (seroprevalence OR prevalence) AND “Somalia”], [“ hepatitis E ” AND (seroprevalence OR prevalence) AND “Somalia”]. We also reconducted the search using full
hepatitis E 10894 A”, “hepatitis B” or “hepatitis B surface antigen”, “hepatitis C”, “hepatitis D”, “ hepatitis E ”, “epidemiology”, and “Somali immigrants.” We searched unpublished studies from other sources,
hepatitis E 69163 identical to the observed effect size.Epidemiology of HEV infectionIt is believed that more than 50% of hepatitis E cases in developing countries are unrelated to HAV or HBV infection, and a high proportion of these
hepatitis E 69495 villages in the lower Shabeli region of southern Somalia examined the presence of antibodies to the hepatitis E antigen, and it was found that the prevalence of anti-HEV ranged from 77.8% to 94.0% among the three
hepatitis E 71167 participants were examined. The quality of included studies also varied (Table 17).Table 17Studies on hepatitis E virus in Somalia n (%)AuthorYearTotalHepatitis E virusHealthySettingPopulationBurans et al[[47]]19943120
hepatitis E 72055 original studies and their 95%CIs, as shown in Figure 36.Figure 36Forest plot of studies reporting hepatitis E virus infection prevalence in Somalia.Because the significant heterogeneity, the funnel plot displayed
hepatitis E 72520 The study by Mushahwar et al[[45]] is clearly an outlier.Figure 37Funnel plot of studies reporting hepatitis E virus infection prevalence in Somalia.Moreover, Duval and Tweedie’s trim and fill procedure for the
hepatitis E 73042 prevalence if the balance was to be restored (Figure 38).Figure 38Bias assessment plot of studies reporting hepatitis E virus prevalence in Somalia.DISCUSSIONViral hepatitis is major public health problem in the world, especially
hepatitis E 86675 4.84%. The overall pooled prevalence of hepatitis D virus was 28.99%. The overall pooled prevalence of hepatitis E virus was 46.86%.Research conclusionsThis study demonstrates a high prevalence of all forms of viral
leprosy 3125 14.44% to 60.16%) in patients with ancylostomiasis, 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis patients. The overall pooled prevalence of HCV
leprosy 23883 HBsAg among patients with ancylostomiasis (33.33%) and with urinary schistosomiasis (25.92%) than among leprosy patients (9.67% in the L type and 6.89% in the T type), and the overall prevalence among these patients
leprosy 24127 (118/155) being observed among patients who were HBsAg positive and 11.11% of the controls. In the leprosy patients with schistosomiasis, the frequency was 40.0%[[22]]. Another study conducted in 1978 showed
leprosy 24509 (77/101)[[23]].In 1979, Nuti et al [[24]] studied 222 Somalian patients with the lepromatous form of leprosy (LL; n = 135 patients) and the tuberculoid form of the disease (TT; n = 87 patients) for HBV markers.
leprosy 24661 form of the disease (TT; n = 87 patients) for HBV markers. The results showed that the proportion of leprosy and tuberculoid patients presenting with HBsAg was 24.4% (54/222) and 11.5% (26/222), respectively,
leprosy 41683 and hepatitis B virusAuthorYearTotalCasesHealthyPopulationNuti et al[[24]]197913533102Patients with leprosy Nuti et al[[24]]1979871077Patients with leprosyNuti et al[[23]]197854846Patients with schistosomiasisNuti
leprosy 41730 virusAuthorYearTotalCasesHealthyPopulationNuti et al[[24]]197913533102Patients with leprosyNuti et al[[24]]1979871077Patients with leprosy Nuti et al[[23]]197854846Patients with schistosomiasisNuti et al[[26]]1979671354Patients with schistosomiasisDelia
leprosy 42005 ancylostomiasisDelia et al[[22]]197715540115Patients with schistosomiasisDelia et al[[22]]197715515140Patients with leprosy Delia et al[[22]]197715511144Patients with leprosyNuti et al[[25]]1979553322Patients with acute viral
leprosy 42055 schistosomiasisDelia et al[[22]]197715515140Patients with leprosyDelia et al[[22]]197715511144Patients with leprosy Nuti et al[[25]]1979553322Patients with acute viral hepatitisJama et al[[29]]1987851768Female ProstitutesNur
leprosy 43355 Somali ancylostomiasis patients was 33.55% (95%CI: 14.44% to 60.16%).Four studies were conducted on leprosy patients. The pooled effect size for the prevalence of HBV infection among Somali leprosy patients was
leprosy 43445 conducted on leprosy patients. The pooled effect size for the prevalence of HBV infection among Somali leprosy patients was 12.34% (95%CI: 7.24% to 20.26%). The heterogeneity was high (I2 = 85.3%). Another indication
malaria 6520 1.34 million deaths in 2015 compared to deaths from tuberculosis (from 1.67 to 1.37 million deaths), malaria (from 0.86 to 0.44 million deaths) and human Immunodeficiency virus (from 1.46 to 1.06 million deaths)
malaria 47964 transmitted disease patientsNur et al[[33]]20005745753MogadishuHospitalized adults with tuberculosis, malaria , acute respiratory infections, and unknown diagnosis (no clinically evident case of hepatitis)Aceti
measles 47743 al[[41]]19942364236232Mogadishu, Marka, KismayoFemale prostitutesNur et al[[33]]20004214241MogadishuHospitalized children with measles , tuberculosis, anemia and other febrile illnessesWatts et al[[41]]19948028078Mogadishu, Marka, KismayoSexually
schistosomiasis 3173 ancylostomiasis, 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis patients. The overall pooled prevalence of HCV was estimated as 4.84% (95%CI: 3.02% to 7.67%). The prevalence
schistosomiasis 23847 presented with a higher frequency of HBsAg among patients with ancylostomiasis (33.33%) and with urinary schistosomiasis (25.92%) than among leprosy patients (9.67% in the L type and 6.89% in the T type), and the overall
schistosomiasis 24149 observed among patients who were HBsAg positive and 11.11% of the controls. In the leprosy patients with schistosomiasis , the frequency was 40.0%[[22]]. Another study conducted in 1978 showed that HBsAg was found in 14.8%of
schistosomiasis 25358 patients were HBsAg-positive for the overall prevalence of their study, but in patients with bladder schistosomiasis and in controls, the prevalence was 19.4% (13/67) and 10% (9/90), respectively[[26]].In 1985, a study
schistosomiasis 41776 al[[24]]197913533102Patients with leprosyNuti et al[[24]]1979871077Patients with leprosyNuti et al[[23]]197854846Patients with schistosomiasis Nuti et al[[26]]1979671354Patients with schistosomiasisDelia et al[[22]]197715552103Patients with ancylostomiasisDelia
schistosomiasis 41831 leprosyNuti et al[[23]]197854846Patients with schistosomiasisNuti et al[[26]]1979671354Patients with schistosomiasis Delia et al[[22]]197715552103Patients with ancylostomiasisDelia et al[[22]]197715540115Patients with
schistosomiasis 41947 schistosomiasisDelia et al[[22]]197715552103Patients with ancylostomiasisDelia et al[[22]]197715540115Patients with schistosomiasis Delia et al[[22]]197715515140Patients with leprosyDelia et al[[22]]197715511144Patients with leprosyNuti
schistosomiasis 43670 heterogeneity was the Q-statistic [Q (degrees of freedom = 3) = 20.38].Three studies were conducted on schistosomiasis patients. The pooled effect size for the prevalence of HBV infection among Somali schistosomiasis patients
schistosomiasis 43768 on schistosomiasis patients. The pooled effect size for the prevalence of HBV infection among Somali schistosomiasis patients was 20.19% (95%CI: 11.28% to 33.49%). The heterogeneity was low (I2 = 36%). Another indication
tuberculosis 6471 has increased from 1.10 million deaths in 2000 to 1.34 million deaths in 2015 compared to deaths from tuberculosis (from 1.67 to 1.37 million deaths), malaria (from 0.86 to 0.44 million deaths) and human Immunodeficiency
tuberculosis 45119 patients from a sexually transmitted disease clinic (2% or 2/80), male soldiers (1.3% or 1/79), and tuberculosis patients (2.3% or 1/43), while the overall prevalence showed that 1.8% (8/438) were anti-HCV positive[[41]].Another
tuberculosis 47752 Marka, KismayoFemale prostitutesNur et al[[33]]20004214241MogadishuHospitalized children with measles, tuberculosis , anemia and other febrile illnessesWatts et al[[41]]19948028078Mogadishu, Marka, KismayoSexually transmitted
tuberculosis 47950 KismayoSexually transmitted disease patientsNur et al[[33]]20005745753MogadishuHospitalized adults with tuberculosis , malaria, acute respiratory infections, and unknown diagnosis (no clinically evident case of hepatitis)Aceti
urinary schistosomiasis 23839 were presented with a higher frequency of HBsAg among patients with ancylostomiasis (33.33%) and with urinary schistosomiasis (25.92%) than among leprosy patients (9.67% in the L type and 6.89% in the T type), and the overall
viral hepatitis 56 Title: World Journal of GastroenterologyEpidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis studyMohamed Abdulkadir Hassan-KadleCenter For the study
viral hepatitis 941 RussiaPublication date (ppub): 9/2018Publication date (epub): 9/2018AbstractAIMTo provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia.METHODSA systematic review and meta-analysis was
viral hepatitis 1207 Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African
viral hepatitis 1664 immigrants (United Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis
viral hepatitis 4204 46.86% (95%CI: 5.31% to 93.28%).CONCLUSIONOur study demonstrates a high prevalence of all forms of viral hepatitis in Somalia and it also indicates that chronic HBV was the commonest cause of chronic liver disease.
viral hepatitis 4516 controlling the burden of the disease.Core tip: This is the first article reviewing epidemiology of viral hepatitis in Somalia with systematic review and meta-analysis of the published and unpublished reports from 1977
viral hepatitis 4676 meta-analysis of the published and unpublished reports from 1977 to 2016 among prevalence of all types’ viral hepatitis in Somalia.INTRODUCTIONViral hepatitis is a major public health problem affecting several hundred million
viral hepatitis 4840 major public health problem affecting several hundred million people globally. The most common types of viral hepatitis are six distinct types that have been identified as hepatitis A, B, C, D, E, G viruses, and they may
viral hepatitis 6129 E-related deaths being recorded[[1]] Hepatitis E is one of the leading causes of major outbreaks of acute viral hepatitis worldwide, especially in developing nations[[2]]. Hepatitis A virus (HAV) infection spans the entire
viral hepatitis 6353 with specifically high prevalence rates in older children and adults[[3]].The number of deaths from viral hepatitis has increased from 1.10 million deaths in 2000 to 1.34 million deaths in 2015 compared to deaths from
viral hepatitis 7104 (720000 deaths) account for more deaths than hepatocellular carcinoma (470000 deaths)[[1]].In Somalia, viral hepatitis , especially HBV, is of significant public health importance. Somalia is an area of the world with a
viral hepatitis 7468 our knowledge, there is no meta-analysis to provide an overall estimation of the prevalence of all viral hepatitis infections in this country. A recent report explored the reasons for such a dearth of data[[4]]. In
viral hepatitis 7912 considered to be a country that has no national strategy for the surveillance, prevention and control of viral hepatitis [[5]]. The provision of high-quality epidemiological data for viral hepatitis in Somalia could help motivate
viral hepatitis 7989 prevention and control of viral hepatitis[[5]]. The provision of high-quality epidemiological data for viral hepatitis in Somalia could help motivate the drafting of action at the policy level. To synthesize such high-quality
viral hepatitis 8277 systematic review and meta-analysis of studies that reported the population-level prevalence of each type of viral hepatitis (A, B, C, D and E) in Somalia. We also aimed to understand the burden of viral hepatitis in Somalia,
viral hepatitis 8366 each type of viral hepatitis (A, B, C, D and E) in Somalia. We also aimed to understand the burden of viral hepatitis in Somalia, especially HBV and HCV, and to inform public health practitioners, researchers and policy
viral hepatitis 10255 unpublished studies from 1977 to 2016 with epidemiological and/or clinical data on the seroprevalence of viral hepatitis in Somalia. The key words used were as follows: [“hepatitis A” AND (seroprevalence OR prevalence)
viral hepatitis 11586 published in peer-reviewed journals between 1977 and 2016, and unpublished primary data of each type of viral hepatitis in Somalia qualified for inclusion in the review, according to the PRISMA flow diagram[[9]], which excludes
viral hepatitis 13368 conducted among Somali populations outside of Somalia), total sample size, and cases of each type of viral hepatitis in each study.Statistical analysisCalculation of pooled prevalence: The prevalence of viral hepatitis
viral hepatitis 13470 viral hepatitis in each study.Statistical analysisCalculation of pooled prevalence: The prevalence of viral hepatitis was extracted from every individual observational study by dividing the number of patients who tested
viral hepatitis 24940 was 36% (80/222)[[24]]. Another study published in this year revealed that among patients with acute viral hepatitis who were tested for the presence of HBsAg and the e-antigen and its corresponding antibodies, HBsAg
viral hepatitis 42108 leprosyDelia et al[[22]]197715511144Patients with leprosyNuti et al[[25]]1979553322Patients with acute viral hepatitis Jama et al[[29]]1987851768Female ProstitutesNur et al[[33]]200036234Hospitalized childrenNur et al[[33]]2000471037Hospitalized
viral hepatitis 69360 proportion of these cases seems to be enterically transmitted[[44]]. Studies on the outbreak of an acute viral hepatitis occurring in three villages in the lower Shabeli region of southern Somalia examined the presence of
viral hepatitis 73352 and meta-analysis study that has attempted to thoroughly summarize evidence on the different types of viral hepatitis infection in Somalia. The aim of this review was to understand the burden of viral hepatitis, especially
viral hepatitis 73445 types of viral hepatitis infection in Somalia. The aim of this review was to understand the burden of viral hepatitis , especially HBV and HCV, in Somalia and to inform public health practitioners, researchers and policy
viral hepatitis 73646 researchers and policy makers in the development of national strategies for the prevention and control of viral hepatitis . The findings of this review clearly show the burden of the viral hepatitis in the country, particularly
viral hepatitis 73722 prevention and control of viral hepatitis. The findings of this review clearly show the burden of the viral hepatitis in the country, particularly HBV. The estimation prevalence of HBV in most African countries was 5%-20%[[48]],
viral hepatitis 81863 limitation is that to the best of our knowledge, this review is the first that focuses on all types of viral hepatitis infection in Somalia. The second limitation of this review is the relatively small number of studies
viral hepatitis 82007 second limitation of this review is the relatively small number of studies identified on all types of viral hepatitis in the country before and after the civil war. This lack of studies highlights the fact that research
viral hepatitis 82146 and after the civil war. This lack of studies highlights the fact that research and knowledge of the viral hepatitis infection burden in Somalia are less developed than in other African and Arab countries. The third limitation
viral hepatitis 83092 potential limitation of the review. However, the results of this review indicate that all types of viral hepatitis infection are common among Somalis, particularly HBV, which is more prevalent and endemic. This study
viral hepatitis 83676 Preventive measures include increasing awareness and knowledge about the transmission of all forms of viral hepatitis , screening all donated blood, targeting high-risk groups, providing treatment for affected persons,
viral hepatitis 84029 Somali health system include the establishment of a national blood policy and prevention and control viral hepatitis policy. Additionally, further studies are needed to fully understand the population factors underlying
viral hepatitis 84181 studies are needed to fully understand the population factors underlying the high prevalence of all forms viral hepatitis , particularly in underrepresented regions and among adults, children, blood donors and high-risk groups,
viral hepatitis 84351 adults, children, blood donors and high-risk groups, to offer better perspectives on all forms of the viral hepatitis burden in Somalia. The generation of up-to-date data is recommended, especially regarding the magnitude
viral hepatitis 84679 major public health problem affecting several hundred million people globally. The most common types of viral hepatitis are six distinct types (hepatitis A, B, C, D, E, G viruses), and they may present in acute form or chronic
viral hepatitis 84955 (including chronic hepatitis, cirrhosis and hepatocellular carcinoma).Research motivationIn the field of viral hepatitis , there is a lack of researches last three decades in country and all articles about viral hepatitis
viral hepatitis 85055 viral hepatitis, there is a lack of researches last three decades in country and all articles about viral hepatitis published and unpublished are scattered. In this systematic review and meta-analysis the authors aim
viral hepatitis 85208 scattered. In this systematic review and meta-analysis the authors aim to provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia according to the related documents published and
viral hepatitis 85459 last decades.Research objectivesThe main objective of this study is to determine the prevalence of all viral hepatitis in Somalia especially hepatitis B virus (HBV) and hepatitis C virus (HCV), and to inform public health
viral hepatitis 85906 Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African
viral hepatitis 86372 immigrants (United Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis were analyzed. The overall pooled prevalence rate of hepatitis A virus was 90.2%. The overall pooled
viral hepatitis 86782 hepatitis E virus was 46.86%.Research conclusionsThis study demonstrates a high prevalence of all forms of viral hepatitis in Somalia and it also indicates that chronic HBV was the commonest cause of chronic liver disease.Research
viral hepatitis 87235 this systematic review and meta-analysis, further studies are needed in order to search out data about viral hepatitis in different regions of the country, risk factors and its complications

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