Prevalence of HBsAg Amongst Healthy Children in Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Meta-Analysis

Abstract

Context: Infections caused by the hepatitis B virus (HBV) pose a major challenge to the public health and also results in high mortality and morbidity rates in different parts of the world, especially in children. This study performed a systematic review and a meta-analysis of cross-sectional studies conducted during the years 2000-16 to clarify the prevalence of hepatitis B surface antigen (HBsAg) in children and adolescents younger than 16 years of age in EMRO and Middle Eastern (E and M) countries. Evidence Acquisition: Scientific databases including PubMed, Ovid, Scopus, Google Scholar, and Persian databases were searched for relevant articles published from January 1, 2000 to October 31, 2016. Based on the results of homogeneity tests (a significant homogeneity test and a large I2 value) a random effects model was used to aggregate the collected data and calculate the pooled prevalence estimates. Results: We included 20 articles in our meta-analysis. The pooled HBsAg prevalence in children of E and M countries was 2.73% (95% CI: %1.73% - 3.72%). The prevalence rates in the EMRO and Middle Eastern countries were 1.85% (95% CI: 1.27% - 2.43%) and 2.66% (95% CI: 1.31% - 4.01%), respectively. The prevalence rates amongst children in nations considered in more than one study were 0.81% (95% CI: 0% - 1.74%) in Iran, 2.64% (95% CI: 1.63% - 3.64%) in Pakistan, and 5.83% (95% CI: 2.99% - 8.67%) in Turkey. Conclusions: Based on the world health organization classification of HBV prevalence, intermediate HBsAg prevalence rates were detected in children of E and M countries during 2000 - 2016. Nevertheless, the prevalence rates were low in several included countries in mentioned regions.