Fifty five studies were excluded seven due to small sample size, five among drug users, one among prison inmates and one among MSM, from Brazil, Puerto Rico and Mexico. Only seven studies from the LILACS and one from the SciELO database were included as most of the citations were already found in PubMed.
#RAFAEL AMAYA DROGAS FULL#
Fifty-three full text citations were included. Most of them were excluded after revising the abstracts. We performed analyses stratified by geographic area and year of field work.Ī total of 3400 references were identified in the three databases (Fig. Subgroup analyses were conducted for results controlling (either by standardization or statistical adjustments) for risk group of infection and country. We calculated prediction intervals (PI) to evaluate the dispersion of the estimated prevalence’s. Random effects models were used, taking into account the possibility of heterogeneity between studies, which was tested with the Cochrane Q test and I2 test. Prevalence was reported by 95 % confidence intervals (CIs).
#RAFAEL AMAYA DROGAS SOFTWARE#
Meta-analysis was performed using STATA 12 Software Version 12.0. The country having (1) the lowest prevalence and (2) more than one data point was selected as reference. For country, dummy variables were created. The analysis was applied within population groups if at least 5 data points were available. Linear and multiple regression analysis evaluated the influence of year of field work on prevalence, using R statistical language and environment (R Core Team 2011). The flow chart of the systematic review and meta-analysis is shown in Fig. The sample size cutoff criteria (75 participants or greater) were decided given the paucity of studies in the region. Exclusion criteria were studies with a sample size <75 and studies that did not mention the testing markers.
If several publications were based on the same study, only one of the publications was included. We defined key populations as both most-at-risk populations and vulnerable populations according to the 2013 WHO classification for HIV (WHO 2013a, b). The inclusion criteria consisted of the following: primary sources published between and with data on Hepatitis C prevalence in one or more of the following populations from LAC countries: Sex workers, MSM, transgender populations, prison inmates and drug users. A second expert conducted data extraction on a random sample of studies. One reviewer screened all abstracts and full texts for the inclusion criteria and conducted the data extraction. We also screened the references of retrieved articles. Searches included original articles in English, Spanish, French or Portuguese. Search terms (all fields) for the PubMed, LILACS and SciELO databases were: “hepatitis OR HAV OR HBV OR HCV OR HDV OR HEV” and “prevalence OR epidemiology” and, for the PubMed search only, a combination of the names of regions, countries and big cities in LAC (Electronic Supplemental Material, Table 1 presents the search terms used for the review). This study aims to summarize available information on prevalence of hepatitis C infection in drug users, injecting and non-injecting, MSM, sex workers, male to female transgender populations and prison inmates in LAC.Ī systematic review and meta-analysis on hepatitis C prevalence in different population groups in LAC was conducted according to the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) (Moher et al. To effectively respond to viral hepatitis C through provision of appropriate treatment and care services, it is critical to document a disproportionate impact and burden of disease among different population groups in LAC. No systematic review has been conducted on HCV infection prevalence among specific population groups in LAC. 2006a, b), and men who have sex with men (MSM) (Pando et al. 2001) as well as in other vulnerable populations, such as sex workers (Pando et al.
2003) and prison inmates (Guimaraes et al. Several studies from Latin America and the Caribbean (LAC) have reported a high prevalence among injecting drug users (Weissenbacher et al. The burden of HCV varies geographically and among subpopulations (Szabo et al. Furthermore, Brazil and Mexico together may have 4 million people with HCV (Szabo et al. Recent estimates for Central, South America and the Caribbean indicate HCV population prevalence levels between 1.5 and 3.5 % (Mohd Hanafiah et al. Hepatitis C causes chronic infection in almost 3 % of the world population and, since its discovery in 1989, has emerged as a worldwide public health concern (WHO 2010). Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (Perz et al.
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