title: Epidemiology of hepatitis A virus in Africa among persons aged 1-10 years: a systematic review protocol.
abstract: BACKGROUND
  Africa is considered an area of high endemicity for hepatitis A virus infection. However, in the past two decades, tremendous progress has been made in improving water sources and sanitation which are risk factors for hepatitis A virus infection. Recent studies suggest that several African countries could be in epidemiological transitions due to the evident socio-economic development. As a result, there may be a decrease in the exposure to and infection with hepatitis A virus at an early age. Understanding and mapping the shifting epidemiology is vital in developing control measures against the disease. We are conducting a comprehensive systematic review study to document the current burden of hepatitis A virus infection in Africa.
  
  
  METHODS
  Our population of interest is children between 1 and 10 years in any African country. We will select cross-sectional, case-control, and cohort studies that have tested hepatitis A virus infection by serological confirmation of antibodies against the virus. We will search for eligible studies published without language restrictions from PubMed, Scopus, Africa-wide, Web of Science, and WHOLIS as well as the reference lists of the relevant articles. Two authors will independently review the search outputs, select eligible articles, and extract pre-defined study outcomes. Inconsistencies will be resolved by discussion and consensus among the authors. Data will be extracted using a standardised data collection form. Trends in the prevalence and/or incidence will be evaluated by urban and rural setting if sufficient data is available. Where there is sufficient homogeneity between studies, meta-analysis will also be conducted, otherwise the results will be presented in a narrative format.
  
  
  CONCLUSIONS
  The systematic review will generate up-to-date information on the current burden of hepatitis A virus in Africa. This information may have implications on policy for hepatitis A vaccination on individual African countries.
  
  
  BACKGROUND
  CRD42015023764.
authors.affiliation: Vaccines for Africa Initiative, Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. tjk77@cornell.edu.
authors.forename: Tiwonge J
authors.initials: TJ
authors.lastname: Kanyenda
authors.affiliation: Vaccines for Africa Initiative, Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. leylaz@live.co.za.
authors.forename: Leila H
authors.initials: LH
authors.lastname: Abdullahi
authors.affiliation: Vaccines for Africa Initiative, Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. gregory.hussey@uct.ac.za.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Hussey
authors.affiliation: Vaccines for Africa Initiative, Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. bm.kagina@uct.ac.za.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Kagina
mesh_terms: D000349:Africa / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006506:Hepatitis A / Q000453:epidemiology*; D017957:Hepatitis A Virus, Human; D006801:Humans; D015994:Incidence; D007223:Infant; D015201:Meta-Analysis as Topic; D015995:Prevalence; D012107:Research Design; D012424:Rural Population / Q000639:trends*; D000078202:Systematic Reviews as Topic; D014505:Urban Population / Q000639:trends*