Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study

Table 1 Hepatitis A virus of overall prevalence at Somali population in Somalia and Somali immigrants n (%)

Author	Publication year	Total	Hepatitis A virus	Setting	Population
Faustini et al[19]	1994	213	204 (96)	Italy	Immigrants
Bile et al[16]	1992	596	572 (96)	Somalia	Local
Bile et al[16]	1992	76	45 (59.2)	Somalia	Local
Mohamud et al[15]	1992	593	534 (90)	Somalia	Local
Sebastiani et al[18]	1984	86	78 (90.6)	Somalia	Local

Table 2 Age pattern of hepatitis A infection

Age group	Author/Publication year	Total	Cases	Total	Healthy	Serology
0-11 mo	Mohamud et al 1992[15]	52	32	52	20	Anti-HAV
1-11 yr	Mohamud et al 1992[15]	189	176	189	13	Anti-HAV
	Sebastiani et al 1984[18]	35	33	35	2	Anti-HAV
	Faustini et al 1994[19]	213	186	213	27	Anti-HAV
	Bile et al 1992[16]	234	220	234	14	Anti-HAV
	Total	723	647	723	76	Anti-HAV
11-19 yr	Mohamud et al 1992[15]	62	58	62	4	Anti-HAV
	Sebastiani et al 1984[18]	21	20	21	1	Anti-HAV
	Bile et al 1992[16]	362	353	362	9	Anti-HAV
	Total	445	431	445	14	Anti-HAV
20-39 yr	Mohamud et al 1992[15]	164	153	164	11	Anti-HAV
	Sebastiani et al 1984[18]	19	16	19	3	Anti-HAV
	Total	183	169	183	14	Anti-HAV
40+ yr	Mohamud et al 1992[15]	126	111	126	15	Anti-HAV
	Sebastiani et al 1984[18]	11	9	11	2	Anti-HAV
	Total	137	120	137	17	Anti-HAV

HAV: Hepatitis A virus.

Table 3 Summary of studies of included studies on the prevalence of hepatitis B viral infection in a Somali population in Somalia and Somali immigrants (1977-2014) n (%)

No.	Author	Publication year	Total	HBsAg	Healthy	Setting	Population
1	Padovese et al[39]	2014	500	31 (6.2)	469	Italy	Immigrants
2	Kadle et al[38]	2012	156	61 (39.1)	95	Somalia	Local
3	Shire et al[36]	2012	1109	151 (13.6)	958	United States	Immigrants
4	Khadjio et al[37]	2011	147	59 (40.1)	88	Somalia	Local
5	Aweis et al[35]	2001	439	25 (5.6)	414	United Kingdom	Immigrants
6	Nur et al[33]	2000	198	34 (17.1)	164	Somalia	Local
7	Faustini et al[19]	1994	213	7 (3.2)	206	Italy	Immigrants
8	Bile et al[34]	1993	124	29 (13.5)	95	Somalia	Local
9	Bile et al[16]	1992	596	95 (15.9)	501	Somalia	Local
10	Mohamud et al[15]	1992	1272	134 (10.5)	1138	Somalia	Local
11	Bile et al[32]	1991	232	67 (28.8)	165	Somalia	Local
12	Aceti et al[31]	1989	1138	220 (19.3)	918	Somalia	Local
13	Bile et al[40]	1991	158	3 (1.9)	155	Somalia	Local
14	Aceti et al[30]	1991	104	52 (50)	52	Somalia	Local
15	Jama et al[29]	1987	218	49 (22.4)	169	Somalia	Local
16	Bile et al[28]	1987	946	78 (8.2)	868	Somalia	Local
17	Sebastiani et al[27]	1985	383	46 (12)	337	Somalia	Local
18	Nuti et al[26]	1979	102	49 (48)	58	Somalia	Local
19	Nuti et al[25]	1979	157	22 (14)	135	Somalia	Local
20	Nuti et al[24]	1978	101	24 (23.7)	77	Somalia	Local
21	Nuti et al[23]	1979	222	80 (36)	142	Somalia	Local
22	Delia et al[22]	1977	155	118 (76.1)	37	Somalia	Local
23	Sebastiani et al[18]	1984	86	11 (12.7)	75	Somalia	Local

HBsAg: Hepatitis B surface antigen.

Table 4 Hepatitis B virus infection prevalence rates among pregnant women

Author	Year	Total	HBsAg	Healthy	Setting	Population
Bile et al[28]	1987	135	14 (10.3%)	121	Mogadishu	Pregnant women
Jama et al[29]	1987	52	19 (37%)	33	Mogadishu	Pregnant women

HBsAg: Hepatitis B surface antigen.

Table 5 Hepatitis B infection prevalence rates among Somali children

Author	Year	Total	Cases	HBsAg	Healthy	Setting	Population
Sebastiani et al[27]	1985	219	25	11%	194	Jowhar, Bur-Hakaba, Kismaio and Afgoy	Children living in four villages
Bile et al[16]	1992	596	95	16%	501	Mogadishu area	Children in government-operated residence for abandoned children in Shebeli
Bile et al[16]	1992	76	3	4%	73	Mogadishu	Children in government-operated residences for abandoned children in SOS institution
Bile et al[40]	1991	106	0	0%	106	Lower Shabelle	Children living in Mukay Dumis
Nur et al[30]	2000	36	2	6%	34	Mogadishu	Hospitalized children
Bile et al[28]	1987	428	11	3%	417	Mogadishu	Children living in Mogadishu
Jama et al[29]	1987	26	1	4%	25	Mogadishu	Newborn babies

HBsAg: Hepatitis B surface antigen.

Table 6 Studies among patients with chronic liver disease (including hepatocellular carcinoma) in Somalia n (%)

Author	Year	Total	HBsAg	Healthy	Setting	Population
Shire et al[36]	2012	30	5 (17.9)	25	United States	Immigrants
Kadle et al[38]	2012	156	61 (39.1)	95	Somalia	Local
Khadija et al[37]	2011	147	59 (40.1)	88	Somalia	Local
Bile et al[34]	1993	62	23 (37.1)	39	Somalia	Local
Bile et al[32]	1991	116	44 (37.9)	72	Somalia	Local
Aceti et al[30]	1991	104	52 (50)	52	Somalia	Local

HBsAg: Hepatitis B surface antigen.

Table 7 Age pattern of hepatitis B virus infection n (%)

Age group	Author	Publication year	Total	HBsAg	Healthy
0-20	Sebastiani et al[40]	1985	219	25 (11)	194
	Bile et al[28]	1987	428	11 (6)	417
	Bile et al[40]	1991	119	1 (1)	118
	Bile et al[16]	1992	596	95 (16)	501
	Sebastiani et al[18]	1984	56	7 (13)	49
		Total	1418	139 (9.8)	1279
20-39	Sebastiani et al[40]	1985	94	13 (14)	81
	Bile et al[28]	1987	442	62 (14)	380
	Bile et al[40]	1991	36	2 (6)	34
	Sebastiani et al[18]	1984	19	3 (16)	16
		Total	591	80 (14)	511
40+	Sebastiani et al[40]	1985	70	8 (11)	62
	Bile et al[28]	1987	76	10 (13)	66
	Bile et al[40]	1991	3	0 (0)	3
	Sebastiani et al[18]	1984	11	1 (9.1)	10
		Total	160	19 (11.8)	141

HBsAg: Hepatitis B surface antigen.

Table 8 Risk groups and hepatitis B virus

Author	Year	Total	Cases	Healthy	Population
Nuti et al[24]	1979	135	33	102	Patients with leprosy
Nuti et al[24]	1979	87	10	77	Patients with leprosy
Nuti et al[23]	1978	54	8	46	Patients with schistosomiasis
Nuti et al[26]	1979	67	13	54	Patients with schistosomiasis
Delia et al[22]	1977	155	52	103	Patients with ancylostomiasis
Delia et al[22]	1977	155	40	115	Patients with schistosomiasis
Delia et al[22]	1977	155	15	140	Patients with leprosy
Delia et al[22]	1977	155	11	144	Patients with leprosy
Nuti et al[25]	1979	55	33	22	Patients with acute viral hepatitis
Jama et al[29]	1987	85	17	68	Female Prostitutes
Nur et al[33]	2000	36	2	34	Hospitalized children
Nur et al[33]	2000	47	10	37	Hospitalized adult

Table 9 Summary of studies on the overall prevalence of hepatitis C viral infection in a Somali population in Somalia and Somali immigrants (1970-2016)

	Year	Total	Cases	Total	Healthy	Setting	Population
Daw et al[43]	2016	2012	164	2012	1848	Libiya	Immigrants
Padovese et al[39]	2014	500	3	500	497	Italy	Immigrants
Kadle et al[38]	2012	156	30	156	126	Somalia	Local
Shire et al[36]	2012	854	78	854	776	United States	Immigrants
Khadjio et al[37]	2011	147	15	147	132	Somalia	Local
Nur et al[33]	2000	256	6	256	250	Somalia	Local
Faustini et al[19]	1994	213	5	213	208	Italy	Immigrants
Watts et al[41]	1994	438	8	430	90	Somalia	Local
Aceti et al[42]	1993	885	35	885	850	Somalia	Local
Bile et al[34]	1993	124	29	124	95	Somalia	Local
Bile et al[16]	1992	596	9	596	587	Somalia	Local
Bile et al[16]	1992	76	0	76	76	Somalia	Local

Table 10 Studies on hepatitis C virus among risk groups in Somalia

Author	Year	Total	Cases	Total	Healthy	Setting	Population
Aceti et al[42]	1993	287	0	287	278	Mogadishu	Hospitalized children with diseases other than hepatitis
Watts et al[41]	1994	236	4	236	232	Mogadishu, Marka, Kismayo	Female prostitutes
Nur et al[33]	2000	42	1	42	41	Mogadishu	Hospitalized children with measles, tuberculosis, anemia and other febrile illnesses
Watts et al[41]	1994	80	2	80	78	Mogadishu, Marka, Kismayo	Sexually transmitted disease patients
Nur et al[33]	2000	57	4	57	53	Mogadishu	Hospitalized adults with tuberculosis, malaria, acute respiratory infections, and unknown diagnosis (no clinically evident case of hepatitis)
Aceti et al[42]	1993	179	4	179	175	Mogadishu	Mixed populations (98 prisoners and 81 psychiatric patients)

Table 11 Studies on hepatitis C among blood donors

Author	Year	Total	Cases	Healthy	Town	Group
Nur et al[33]	2000	157	1	156	Mogadishu	Blood donors
Aceti et al[42]	1993	309	3	306	Mogadishu	Blood donors

Table 12 Studies on distribution genotypes of hepatitis C virus infection in Somalia

Type of genotype	Author/Publication Year	Total	Cases	Healthy	Serology
Genotype 1	Daw et al[43] /2016	78	18	60	Anti-HCV
Genotype 1	Shire et al[36] / 2012	41	8	33	Anti-HCV
Genotype 2	Daw et al[43] /2016	78	0	78	Anti-HCV
Genotype 2	Shire et al[36] / 2012	41	0	41	Anti-HCV
Genotype 3	Daw et al[43] /2016	78	20	58	Anti-HCV
Genotype 3	Shire et al[36] / 2012	41	10	31	Anti-HCV
Genotype 4	Daw et al[43] /2016	78	38	40	Anti-HCV
Genotype 4	Shire et al[36] / 2012	41	17	24	Anti-HCV
Genotype 5	Daw et al[43] /2016	78	2	76	Anti-HCV
Genotype 5	Shire et al[36] / 2012	41	1	10	Anti-HCV
Genotype 6	Shire et al[36] / 2012	41	0	40	Anti-HCV

Table 13 Studies on hepatitis C virus infection among Somali children

Author	Year	Total	Cases	Total	Healthy	Setting	Population
Bile et al[16]	1992	596	9	596	587	Mogadishu area	Children in government-operated residences for abandoned children in Shebeli
Bile et al[16]	1992	76	0	76	76	Mogadishu area	Children in government-operated residence for abandoned children in SOS institution
Nur et al[33]	2000	42	1	42	41	Mogadishu	Hospitalized children
Aceti et al[42]	1993	287	0	287	278	Mogadishu	Hospitalized children with diseases other than hepatitis

Table 14 Studies on hepatitis C virus infection among patients with chronic liver disease, including hepatocellular carcinoma, in Somalia

Author	Year	Total	Cases	Total	Healthy	Setting	Population
Shire et al[36]	2012	30	22	30	8	United States	Immigrants
Kadle et al[38]	2012	156	30	156	126	Somalia	Local
Khadija et al[37]	2011	147	15	147	132	Somalia	Local
Bile et al[34]	1993	62	25	62	37	Somalia	Local
Aceti et al[42]	1993	110	28	110	82	Somalia	Local

Table 15 Summary of studies on overall prevalence of hepatitis D viral infection of HBsAg-positive carriers in the Somali population in Somalia and Somali immigrants (1970-2016) n (%)

Author	Year	Total	Hepatitis D virus	Healthy	Setting	Population
Aceti et al[31]	1989	220	37 (16.8)	138	Somalia	Local
Bile et al[32]	1991	67	20 (30)	47	Somalia	Local
Aceti et al[30]	1991	52	26 (50)	26	Somalia	Local
Bile et al[34]	1993	29	10 (34.4)	19	Somalia	Local
Faustini et al[19]	1994	7	0 (0)	7	Italy	Immigrants
Total		375	93 (24.8)	237

Table 16 Studies among patients with chronic liver disease (including hepatocellular carcinoma) in Somalia n (%)

Author	Year	Total	Hepatitis D virus	Total	Healthy	Setting	Population
Bile et al[34]	1993	23	9 (39.1)	23	14	Somalia	Local
Bile et al[32]	1991	44	17 (38.6)	44	27	Somalia	Local
Aceti et al[30]	1991	52	26 (50)	52	26	Somalia	Local
Total		119	52 (43.6)	119	67

Table 17 Studies on hepatitis E virus in Somalia n (%)

Author	Year	Total	Hepatitis E virus	Healthy	Setting	Population
Burans et al[47]	1994	31	20 (64.5)	11	Somalia	Local
Mushahwar et al[45]	1993	111	5 (4.5)	106	Somalia	Local
Bile et al[46]	1994	145	128 (88.2)	17	Somalia	Local
Total		287	153 (53.3)	134