National and Regional Burden of Hepatitis C in Ethiopia: A Secondary Analysis of the Global Burden of Disease Study 2023
TL;DR
The national and regional burden of hepatitis C infection in Ethiopia between 2019 and 2023 using findings from the Global Burden of Disease Study 2023 showed an increase in prevalence and incidence, and the highest prevalence was observed in the 55+ years age group.
Abstract
Background Hepatitis C infection virus (HCV) infection is still a major public health concern in Ethiopia, contributing significantly to an increased risk of cirrhosis, hepatocellular carcinoma, and chronic liver disease. This study aimed to assess the national and regional burden of hepatitis C infection in Ethiopia between 2019 and 2023 using findings from the Global Burden of Disease Study 2023. Methods A secondary ecological analysis was conducted using population‐level modeled estimates from the Global Burden of Diseases (GBD) 2023 study. The analysis included national and regional estimates from 2019 to 2023. Key metrics assessed were prevalence, incidence, deaths, mortality rates, Years Lived with Disability (YLDs), Years of Life Lost (YLLs), and Disability‐Adjusted Life Years (DALYs). The Cause of Death Ensemble model (CODEm) was used to estimate cause‐specific mortality, and DisMod‐MR 2.1 was used to model nonfatal outcomes. Descriptive statistical analyses were performed, and results were presented using numbers, rates, and percentages. All analyses were conducted using SPSS Version 27. Results The prevalence of hepatitis C infection in Ethiopia increased from 1,525,506 (UI): 1,233,554–1,882,997) in 2019 to 1,653,765 (UI: 1,332,884–2,039,588) in 2023, an increase of almost 8.5%. Correspondingly, the age‐standardized prevalence rate (ASPR) increased steadily from 1647 per 100,000 population (UI: 1482–1812) in 2019 to 1750 per 100,000 (UI: 1575–1925) in 2023. The incidence increased from 188,080 (UI: 148,692–240,059) in 2019 to 200,228 (UI: 157,812–258,693) in 2023, increased by 6.5%. The age‐standardized incidence rate (ASIR) followed a consistent upward trajectory, increasing from 250 per 100,000 (UI: 225–275) in 2019 to 264 per 100,000 (UI: 238–290) in 2023. The number of deaths increased from 7019 (UI: 4614–10,075) in 2019 to 7623 (UI: 4879–11,225) in 2023 with an 8.6% increase. The crude mortality rate decreased from 7.26 per 100,000 (UI: 6.39–8.13) in 2019 to 7.13 per 100,000 (UI: 6.27–7.99) in 2023. The age‐standardized mortality rate (ASMR), however, increased from 447 per 100,000 (UI: 393–501) in 2019 to 500 per 100,000 (UI: 440–560) in 2023. DALYs increased from 259,112 (UI: 165,317–381,194) in 2019 to 287,140 (UI: 176,866–437,025) in 2023. The age‐standardized DALY rate inclined from 426 per 100,000 (UI: 383–469) in 2019 to 457 per 100,000 (UI: 411–503) in 2023. The age‐standardized YLL rate increased from 418 per 100,000 (UI: 376–460) in 2019 to 450 per 100,000 (UI: 405–495) in 2023. The age‐standardized YLD rate remained stable, from 7.3 per 100,000 (UI: 6.6–8.0) in 2019 to 7.3 per 100,000 (UI: 6.6–8.0) in 2023. Prevalence and incidence were higher in females than males. The highest prevalence was observed in the 55+ years age group. Incidence was highest among children and adolescents (5–24 years). Regionally, Oromia, Amhara, and Southern Nations, Nationalities, and Peoples’ Region (SNNPs) recorded the highest burden. Conclusion The burden of HCV in Ethiopia increased substantially between 2019 and 2023, with premature mortality representing the predominant component of overall health loss. Marked disparities were observed by age, sex, and geographic region. The findings highlight the need to strengthen HCV infection prevention and control.