Seroprevalence of Hepatitis C in Ethiopia: First National Study Based on the 2016 Ethiopian Demographic and Health Survey

Hepatitis C virus (HCV) is hypothesised to be a public health problem in Ethiopia, and systematic review evidence suggested 1%-3% seroprevalence. We aimed to estimate the seroprevalence of HCV overall and across regions of Ethiopia. We estimated HCV seroprevalence using the 2016 Ethiopian Demographic and Health Survey (EDHS-2016). EDHS-2016 is a nationwide household survey conducted using two-stage cluster sampling methods. We tested all 26,753 samples from participating adult women (15-49 years) and men (15-59 years) using HCV Enzyme Immunoassay. Descriptive analyses were performed based on the Guide to Demographic Health Survey statistics. We applied sample weighting to derive representative estimates. Of the total tested, more than half (54.40%) were aged 15-29 years and 51.59% were women. Overall HCV seroprevalence was 0.18% (95% Confidence Interval: 0.10-0.32). Higher seroprevalences were found in Afar (0.92%) and South Nations Nationality Peoples Region (0.43%); people living with HIV (PLWH) (0.62%); the poorest wealth index (0.35%); people having multiple lifetime sexual partners (0.31%); and widowed/divorced individuals (0.30%). In stratified analyses by sex and residency, we found higher seroprevalences in non-Christian and non-Muslim males (1.98%) and rural population (1.00%), male PLWH (1.67%), rural PLWH (1.45%), widowed/divorced males (0.97%), and in all groups from the Afar region: males (1.30%), females (0.61%), urban (1.07%), and rural (0.86%). HCV seroprevalence among the general population in Ethiopia is much lower than from previous estimates. General population screening is unlikely to be cost-effective, and so screening programs targeted to people at greater risk of HCV will be required.