Hepatitis C virus viremic rate in the Middle East and North Africa: Systematic synthesis, meta-analyses, and meta-regressions
Manale Harfouche,Hiam Chemaitelly,Silva P. Kouyoumjian,Sarwat Mahmud,Karima Chaabna,Zaina Al-Kanaani,Laith J. Abu-Raddad +6 more
TLDR
Though there is extensive variation in study-specific measures of HCV viremic rate, pooled mean estimates are similar regardless of risk population or subpopulation, country/subregion, HCV antibody prevalence in the background population, or sex.Abstract:
Objectives To estimate hepatitis C virus (HCV) viremic rate, defined as the proportion of HCV chronically infected individuals out of all ever infected individuals, in the Middle East and North Africa (MENA). Methods Sources of data were systematically-gathered and standardized databases of the MENA HCV Epidemiology Synthesis Project. Meta-analyses were conducted using DerSimonian-Laird random-effects models to determine pooled HCV viremic rate by risk population or subpopulation, country/subregion, sex, and study sampling method. Random-effects meta-regressions were conducted to identify predictors of higher viremic rate. Results Analyses were conducted on 178 measures for HCV viremic rate among 19,593 HCV antibody positive individuals. In the MENA region, the overall pooled mean viremic rate was 67.6% (95% CI: 64.9-70.3%). Across risk populations, the pooled mean rate ranged between 57.4% (95% CI: 49.4-65.2%) in people who inject drugs, and 75.5% (95% CI: 61.0-87.6%) in populations with liver-related conditions. Across countries/subregions, the pooled mean rate ranged between 62.1% (95% CI: 50.0-72.7%) and 70.4% (95% CI: 65.5-75.1%). Similar pooled estimates were further observed by risk subpopulation, sex, and sampling method. None of the hypothesized population-level predictors of higher viremic rate were statistically significant. Conclusions Two-thirds of HCV antibody positive individuals in MENA are chronically infected. Though there is extensive variation in study-specific measures of HCV viremic rate, pooled mean estimates are similar regardless of risk population or subpopulation, country/subregion, HCV antibody prevalence in the background population, or sex. HCV viremic rate is a useful indicator to track the progress in (and coverage of) HCV treatment programs towards the set target of HCV elimination by 2030.read more
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References
More filters
Journal ArticleDOI
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
TL;DR: Moher et al. as mentioned in this paper introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses, which is used in this paper.
Journal ArticleDOI
Measuring inconsistency in meta-analyses
TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Journal Article
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement [in Spanish]
David Moher,Alessandro Liberati,Jennifer Tetzlaff,Douglas G. Altman,Gerd Antes,David C. Atkins,Virginia Barbour,N Barrowman,Jesse A. Berlin,J Clark,Mike Clarke,Deborah J. Cook,Roberto D'Amico,Jonathan J Deeks,Philip J. Devereaux,Kay Dickersin,M Egger,E Ernst,P C Gøtzsche,Jeremy M. Grimshaw,G Guyatt,Julian P T Higgins,Ioannidis Jpa.,Jos Kleijnen,Tom Lang,N Magrini,D McNamee,Lorenzo Moja,C Mulrow,M Napoli,Andrew D Oxman,B Pham,Drummond Rennie,Margaret Sampson,Kenneth F. Schulz,Paul G. Shekelle,David Tovey,Peter Tugwell +37 more
Journal ArticleDOI
A basic introduction to fixed‐effect and random‐effects models for meta‐analysis
TL;DR: This paper explains the key assumptions of each model, and outlines the differences between the models, to conclude with a discussion of factors to consider when choosing between the two models.
Journal ArticleDOI
Transformations Related to the Angular and the Square Root
Murray F. Freeman,John W. Tukey +1 more
TL;DR: In this paper, an empirical study of a number of approximations for variance stabilization is presented, some intended for significance and confidence work and others for variance stabilisation for Poisson data.