Abstract
BackgroundHepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. The aim of this study was to quantitatively evaluate the prevalence of HCV among Iranian prisoners conducting a systematic review and meta-analysis.MethodsWe searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Sciences, the Cochrane library, Scopus, CINAHL, and PsycINFO as well as Iranian bibliographic thesauri (namely, Barakatns, MagIran, and SID) up to December 2017. The Newcastle Ottawa Scale (NOS) was used to assess the quality of the studies included. HCV prevalence rate with its 95% confidence interval (CI) was estimated using the DerSimonian-Laird random-effects model, with Freeman-Tukey double arcsine transformation. Egger’s regression test was used to evaluate publication bias.ResultsFinally, 17 articles were selected based on inclusion and exclusion criteria. Overall, 18,693 prisoners were tested. Based on the random-effects model, the prevalence of HCV among Iranian prisoners was 28% (CI 95% 21–36) with heterogeneity of I2 = 99.3% (p = 0.00). All studies used an ELISA test for the evaluation of HCV antibodies. The findings of this study showed that the highest prevalence rate (53%) was among prisoners who inject drugs.ConclusionThe findings of our study showed that the prevalence of HCV among Iranian prisoners is dramatically high. Managing this issue in Iran’s prisons requires careful attention to the availability of health facilities and instruments, such as screening, and harm reduction policies, such as giving sterile syringes and needles to prisoners. An integrated program of training for prisoners, prison personnel and medical staff is also needed to improve the level of health condition in prisons.
Highlights
Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries
Data extraction Two authors independently extracted relevant information from the articles, including the surname of the first author, the location of the study, the year of publication, the sample size, the mean age of the participants, the diagnostic test used for HCV screening, the reported prevalence, the number of people living with HCV, and the duration of imprisonment
The findings of this study showed that the prevalence of HCV among Iranian prisoners was 28% (CI 95% 21– 36)
Summary
Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries, leading to acute and chronic hepatitis [1]. The prevalence of HCV has been computed to be approximately 0.6% in the Prison represents a high-risk environment for prisoners, in that it is characterized by risky behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. IDU represents a major risk factor, with 52% of 11.7 million people injecting drugs worldwide living with HCV [5]. Prisoners are more likely to develop HCV and to die of its complications [10,11,12]
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