Seroprevalence of Hepatitis C in Ethiopia: First National Study Based on the 2016 Ethiopian Demographic and Health Survey

Getahun Molla Kassa; Atsbeha Gebreegziabxier Weldemariam; Saro Abdella Abrahim; Clare E French; Dawit Wolday; Emebet Dagne; Andargachew Mulu; Aynishet Adane; Sarah K Inglis; Andrew Radley; Geremew Tasew; Peter Vickerman; Elias Ali Yesuf; Ora Paltiel; Mesay Hailu; Wondwossen Amogne; John F Dillon; Matthew Hickman; Aaron G Lim; Josephine G Walker; DESTINE NIHR Global Health Research Group

doi:10.1111/jvh.14037

Seroprevalence of Hepatitis C in Ethiopia: First National Study Based on the 2016 Ethiopian Demographic and Health Survey

J Viral Hepat. 2024 Nov 21. doi: 10.1111/jvh.14037. Online ahead of print.

Authors

Getahun Molla Kassa^{1

2}, Atsbeha Gebreegziabxier Weldemariam^{3

4}, Saro Abdella Abrahim⁵, Clare E French^{1

6}, Dawit Wolday^{3

7}, Emebet Dagne⁸, Andargachew Mulu⁹, Aynishet Adane¹⁰, Sarah K Inglis¹¹, Andrew Radley¹², Geremew Tasew³, Peter Vickerman¹, Elias Ali Yesuf¹³, Ora Paltiel¹⁴, Mesay Hailu³, Wondwossen Amogne¹⁵, John F Dillon⁴, Matthew Hickman¹, Aaron G Lim¹, Josephine G Walker¹; DESTINE NIHR Global Health Research Group

Collaborators

Affiliations

¹ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
² Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
³ Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
⁴ Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK.
⁵ Health Laboratory Services, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
⁶ NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, Bristol, UK.
⁷ Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.
⁸ Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia.
⁹ Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
¹⁰ Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
¹¹ Tayside Clinical Trials Unit, University of Dundee, Dundee, UK.
¹² Division of Public Health and Genomics, School of Medicine, University of Dundee, Dundee, UK.
¹³ Department of Health Policy and Management, Institute of Health, Jimma University, Jimma, Ethiopia.
¹⁴ Department of Hematology and Braun School of Public Health, Hadassah-Hebrew University Faculty of Medicine, Jerusalem, Israel.
¹⁵ Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

PMID: 39569765
DOI: 10.1111/jvh.14037

Abstract

Hepatitis C virus (HCV) is hypothesised to be a public health problem in Ethiopia, and systematic review evidence suggested 1%-3% seroprevalence. We aimed to estimate the seroprevalence of HCV overall and across regions of Ethiopia. We estimated HCV seroprevalence using the 2016 Ethiopian Demographic and Health Survey (EDHS-2016). EDHS-2016 is a nationwide household survey conducted using two-stage cluster sampling methods. We tested all 26,753 samples from participating adult women (15-49 years) and men (15-59 years) using HCV Enzyme Immunoassay. Descriptive analyses were performed based on the Guide to Demographic Health Survey statistics. We applied sample weighting to derive representative estimates. Of the total tested, more than half (54.40%) were aged 15-29 years and 51.59% were women. Overall HCV seroprevalence was 0.18% (95% Confidence Interval: 0.10-0.32). Higher seroprevalences were found in Afar (0.92%) and South Nations Nationality Peoples Region (0.43%); people living with HIV (PLWH) (0.62%); the poorest wealth index (0.35%); people having multiple lifetime sexual partners (0.31%); and widowed/divorced individuals (0.30%). In stratified analyses by sex and residency, we found higher seroprevalences in non-Christian and non-Muslim males (1.98%) and rural population (1.00%), male PLWH (1.67%), rural PLWH (1.45%), widowed/divorced males (0.97%), and in all groups from the Afar region: males (1.30%), females (0.61%), urban (1.07%), and rural (0.86%). HCV seroprevalence among the general population in Ethiopia is much lower than from previous estimates. General population screening is unlikely to be cost-effective, and so screening programs targeted to people at greater risk of HCV will be required.

Keywords: EDHS; Ethiopia; HCV; seroprevalence; survey.

Grants and funding

NIHR133208/NIHR