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Chronic hepatitis B prevalence among Aboriginal and Torres Strait Islander Australians since universal vaccination: A systematic review and meta-analysis

Title: Chronic hepatitis B prevalence among Aboriginal and Torres Strait Islander Australians since universal vaccination: A systematic review and meta-analysis
Authors: Graham, S; Guy, RJ; Cowie, B; Wand, HC; Donovan, B; Akre, SP; Ward, JS; Maher, Lisa
Source: urn:ISSN:1471-2334 ; BMC Infectious Diseases, 13, 1, 1-10
Publisher Information: BMC
Publication Year: 2013
Collection: UNSW Sydney (The University of New South Wales): UNSWorks
Subject Terms: 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; 42 Health Sciences; Hepatitis; Liver Disease; Digestive Diseases; Hepatitis - B; Infectious Diseases; 3 Good Health and Well Being; Australia; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Hepatitis B; Chronic; Humans; Vaccination; Australian Aboriginal and Torres Strait Islander Peoples; anzsrc-for: 32 Biomedical and Clinical Sciences; anzsrc-for: 3202 Clinical Sciences; anzsrc-for: 42 Health Sciences; anzsrc-for: 0605 Microbiology; anzsrc-for: 1103 Clinical Sciences; anzsrc-for: 1108 Medical Microbiology; anzsrc-for: 3207 Medical microbiology; anzsrc-for: 4206 Public health
Description: Background: In Australia, higher rates of chronic hepatitis B (HBsAg) have been reported among Aboriginal and Torres Strait Islander (Indigenous) compared with non-Indigenous people. In 2000, the Australian government implemented a universal infant/adolescent hepatitis B vaccination program. We undertook a systematic review and meta-analysis to assess the disparity of HBsAg prevalence between Indigenous and non-Indigenous people, particularly since 2000.Methods: We searched Medline, Embase and public health bulletins up to March 2011. We used meta-analysis methods to estimate HBsAg prevalence by Indigenous status and time period (before and since 2000).Results: There were 15 HBsAg prevalence estimates (from 12 studies) among Indigenous and non-Indigenous people; adults and pregnant women (n = 9), adolescents (n = 3), prisoners (n = 2), and infants (n = 1). Of these, only one subgroup (adults/pregnant women) involved studies before and since 2000 and formed the basis of the meta-analysis. Before 2000, the pooled HBsAg prevalence estimate was 6.47% (95% CI: 4.56-8.39); 16.72% (95%CI: 7.38-26.06) among Indigenous and 0.36% (95%CI:-0.14-0.86) in non-Indigenous adults/pregnant women. Since 2000, the pooled HBsAg prevalence was 2.25% (95% CI: 1.26-3.23); 3.96% (95%CI: 3.15-4.77) among Indigenous and 0.90% (95% CI: 0.53-1.28) in non-Indigenous adults/pregnant women.Conclusions: The disparity of HBsAg prevalence between Indigenous and non-Indigenous people has decreased over time; particularly since the HBV vaccination program in 2000. However HBsAg prevalence remains four times higher among Indigenous compared with non-Indigenous people. The findings highlight the need for opportunistic HBV screening of Indigenous people to identify people who would benefit from vaccination or treatment. © 2013 Graham et al.; licensee BioMed Central Ltd.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: https://hdl.handle.net/1959.4/unsworks_67241
DOI: 10.1186/1471-2334-13-403
Availability: https://hdl.handle.net/1959.4/unsworks_67241; https://unsworks.unsw.edu.au/bitstreams/0327bd29-80b4-4845-a6ff-a28ea6c80735/download; https://doi.org/10.1186/1471-2334-13-403
Rights: open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY ; https://creativecommons.org/licenses/by/4.0/ ; free_to_read
Accession Number: edsbas.C4F083F9
Database: BASE