Prevalence of Hepatitis B and C in prisons worldwide: A meta-analysis during the years 2005-2015

Abstract
Background: Viral hepatitis is still considered as a major cause of burden of disease in the world, and is the most common cause of cirrhosis and liver cancer. Prisoners are one of the groups most at risk for hepatitis. This study aimed to investigate the prevalence of hepatitis B and C in prisons worldwide during the years 2005-2015. Method: In order to find relevant articles published from 2005 to 2015, two members of the research team searched the databases of PubMed, Scopus, and Web of Science. The study was conducted using the random effects model and the fixed effects model. In order to examine heterogeneity, Cochran Q test was used at an error level of less than 10%; its quantity was estimated using the I2 indicator. The publication bias was measured using Begg’s rank correlation test and Egger’s linear regression method. After extracting the required data, the meta-analysis was performed using the software Stata 12. Results: A total of 43 studies which met the inclusion criteria were analyzed. The results showed that the overall prevalence of hepatitis B in prisoners was 5.17% (95% CI: 2.19-9.30). The highest prevalence, that is, 13.14% (95% CI: 11.99-14.36), was observed in Africa. According to the World Health Organization (WHO) classification, the highest prevalence, that is, 5.04% (95% CI: 4.45-5.67), was observed in the Western Pacific region. The prevalence of hepatitis B in men and women were, respectively, 6.70% (95% CI: 6.52-6.88) and 4.34% (95% CI: 3.98-4.79). The results showed that the overall prevalence of hepatitis C in prisoners was 13.22% (95% CI: 8.95- 8.16). The highest prevalence, that is, 26.4% (95% CI: 25.05-27.87), was observed in Australia. According to the WHO classification, the highest prevalence of hepatitis C, that is, 24.26% (95% CI: 21.6-27.02), was observed in the Southeast Asia region. The prevalence of hepatitis B in men and women were, respectively, 9.33% (95% CI: 1.56-1.98) and 6.25% (95% CI: 5.78-6.74). Conclusion: The prevalence of hepatitis B and C in prisoners was greater than that in the general population, and the prevalence in men was greater than that in women. Appropriate and effective interventions to reduce transmission of hepatitis B and C in the prisons worldwide is essential.