Hepatitis B and C Virus Among Prisoners in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

ObjectiveTo estimate the pooled prevalence and identify transmission drivers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among incarcerated populations in sub-Saharan Africa.MethodsA systematic review and meta-analysis was conducted following a search encompassing Medical Subject Headings (MeSH) and free-text terms from database inception through February 2025. Data were synthesized from 26 studies involving 77,760 prisoners across sub-Saharan Africa. A random-effects model was used to calculate pooled prevalence estimates, assess regional variation, and evaluate odds ratios (OR) for potential transmission risk factors.ResultsThe overall pooled prevalence was 13.0% for HBV and 8.0% for HCV among prisoners. Significant regional disparities were observed, with West Africa presenting the highest HBV burden (16.3%) and East Africa showing the highest HCV burden (8.8%). Key independent predictors of infection included sharing sharp objects (OR, 1.98), tattooing (OR, 1.92), and intravenous drug use (OR, 1.38).ConclusionIncarcerated populations in sub-Saharan Africa experience a high burden of viral hepatitis driven by parenteral exposure and high-risk sexual interactions. Addressing these gaps requires targeted screening, comprehensive harm reduction, condom provision, and integrating prison health services into national elimination strategies.