title: Hepatitis viruses in Ethiopia: a systematic review and meta-analysis.
abstract: The existing seroepidemiological data on viral hepatitis in Ethiopia showed a wide variation in prevalence pattern and the clinical and public health burden have been underestimated. The aim of this systematic review and meta-analysis was to provide a clear and comprehensive estimation of viral hepatitis epidemiology and the potential clinical burdens in Ethiopia.
  
  
  
  A comprehensive literature search was carried out from five decades (1968-2015) published studies from biomedical databases; PubMed, Google scholar, Medline and Web of Science.
  
  
  
  The overall pooled prevalence of hepatitis B virus (HBV) was 7.4% (95%CI: 6.5-8.4). The pooled prevalence among subgroups showed 5.2% (95%CI: 3.7-7.4) in human immunodeficiency virus (HIV) infected individuals, 8.0% (95%CI: 5.9-10.7) in community based studies, 8.4% (95%CI: 5.4-12.7) in blood donors, 11.0% (95%CI: 7.5-15.9) in immigrants and 6.9% (95%CI: 5.6-8.5) in other groups. Among study parameters considered during meta-regression analysis, only study years were associated with a decreasing HBV prevalence rate over time. The overall pooled prevalence of anti-hepatitis C virus antibody (anti-HCV) was 3.1% (95%CI: 2.2-4.4). Unlike HBV, the anti-HCV prevalence in HIV infected individuals was higher (5.5%, 95%CI: 3.8-7.8%, p = 0.01) than the prevalence observed in the other subgroup of study population. Although relatively few data were available, hepatitis virus A (HAV), D (HDV) and E (HEV) were also circulated in Ethiopia.
  
  
  
  This review indicates that all types of viral hepatitis origins are endemic in Ethiopia. Adapting a recommended diagnostic and treatment algorithm of viral hepatitis in the routine healthcare systems and implementing prevention and control policies in the general population needs an urgent attention.
authors.affiliation: Institute of Virology, Faculty of Medicine, Leipzig University, Leipzig, Germany. belyhun@gmail.com.|School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. belyhun@gmail.com.
authors.forename: Yeshambel
authors.initials: Y
authors.lastname: Belyhun
authors.affiliation: Institute of Virology, Faculty of Medicine, Leipzig University, Leipzig, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Maier
authors.affiliation: Institute of Virology, Faculty of Medicine, Leipzig University, Leipzig, Germany.|School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Andargachew
authors.initials: A
authors.lastname: Mulu
authors.affiliation: Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Ermias
authors.initials: E
authors.lastname: Diro
authors.affiliation: Institute of Virology, Faculty of Medicine, Leipzig University, Leipzig, Germany.
authors.forename: Uwe Gerd
authors.initials: UG
authors.lastname: Liebert
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D001782:Blood Donors / Q000706:statistics & numerical data; D060085:Coinfection / Q000453:epidemiology; D005002:Ethiopia / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology / Q000821:virology; D006515:Hepatitis B virus / Q000276:immunology / Q000472:pathogenicity; D006526:Hepatitis C / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000097:blood; D006518:Hepatitis Viruses / Q000472:pathogenicity; D006525:Hepatitis, Viral, Human / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008875:Middle Aged; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies
keywords: Ethiopia; HBV; HCV; Meta-analysis; Systematic review; viral hepatitis