Table 1.
Country‐specific pooled mean proportion for each hepatitis C virus (HCV) genotype across the Middle East and North Africa (MENA)
| Studies | Samples | Proportion (actual studies) | Proportion (meta‐analysis) | Heterogeneity measures | |||
|---|---|---|---|---|---|---|---|
| Country | Total N | Total n | Range (%) | Mean (%) | 95%CI a | Q (P‐value) b | I 2 (confidence limits) c |
| Genotype 1 | |||||||
| Afghanistan | 3 | 71 | 0.0‐47.8 | 34.6 | 20.8‐49.5 | 1.7 (P = 0.440) | |
| Algeria | 7 | 3806 | 55.6‐88.8 | 78.0 | 70.2‐85.0 | 110.7 (P < 0.001) | 94.6 (91.1‐96.7) |
| Bahrain | 2 | 107 | 47.9‐55.6 | 48.6 | 39.3‐58.0 | ||
| Egypt | 47 | 5031 | 0.0‐25.0 | 2.5 | 1.3‐4.1 | 177.6 (P < 0.001) | 74.1 (65.5‐80.5) |
| Iran | 66 | 23 134 | 13.5‐100 | 56.3 | 52.9‐59.6 | 1022.4 (P < 0.001) | 93.6 (92.5‐94.6) |
| Iraq | 19 | 681 | 0.0‐71.4 | 34.7 | 22.6‐47.7 | 143.1 (P < 0.001) | 87.4 (81.8‐91.3) |
| Jordan | 4 | 71 | 0.0‐73.3 | 22.8 | 0.0‐66.8 | 31.8 (P < 0.001) | 90.6 (78.9‐95.8) |
| Kuwait | 1 | 108 | 27.8 | 20.2‐36.9 | |||
| Lebanon | 20 | 543 | 0.0‐100 | 38.9 | 30.4‐47.7 | 51.7 (P < 0.001) | 63.3 (40.6‐77.3) |
| Libya | 6 | 4236 | 28.6‐35.8 | 32.8 | 31.0‐34.7 | 8.5 (P = 0.132) | 41.0 (0.0‐76.6) |
| Morocco | 13 | 2636 | 35.6‐100 | 69.4 | 53.7‐83.2 | 386.4 (p < 0.001) | 96.9 (95.8‐97.7) |
| Oman | 1 | 33 | 54.5 | 38.0‐70.2 | |||
| Pakistan | 92 | 36 111 | 0.0‐64.1 | 9.1 | 7.4‐11.0 | 1962.9 (P < 0.001) | 95.4 (94.8‐95.9) |
| Palestine | 4 | 152 | 8.7‐50.0 | 19.9 | 7.4‐35.6 | 5.7 (P = 0.129) | 47.0 (0.0‐82.4) |
| Qatar | 1 | 400 | 19.8 | 16.1‐23.9 | |||
| Saudi Arabia | 23 | 2652 | 0.0‐75.0 | 34.4 | 27.5‐41.6 | 213.2 (P < 0.001) | 89.7 (85.8‐92.5) |
| Syria | 3 | 674 | 10.0‐60.7 | 33.5 | 12.1‐58.9 | 13.4 (P < 0.001) | 85.0 (55.8‐94.9) |
| Tunisia | 22 | 1578 | 50.0‐100 | 85.9 | 78.0‐92.5 | 196.2 (P < 0.001) | 89.3 (85.2‐92.3) |
| UAE | 4 | 233 | 26.9‐75.0 | 52.4 | 30.8‐73.7 | 23.5 (P < 0.001) | 87.2 (69.4‐94.7) |
| MENA | 338 | 82 257 | 0.0‐100 | 30.2 | 26.8‐33.8 | 31841 (P < 0.001) | 98.9 (98.9‐99.0) |
| Genotype 2 | |||||||
| Afghanistan | 3 | 71 | 0.0‐0.0 | 0.0 | 0.6 (P = 0.732) | ||
| Algeria | 7 | 3806 | 8.6‐37.0 | 15.3 | 9.6‐22.0 | 98.8 (P < 0.001) | 93.9 (89.9‐96.4) |
| Bahrain | 2 | 107 | 9.2‐33.3 | 11.2 | 6.5‐18.6 | ||
| Egypt | 47 | 5031 | 0.0‐55.6 | 0.2 | 0.0‐1.1 | 230.2 (P < 0.001) | 80.0 (74.0‐84.7) |
| Iran | 66 | 23 134 | 0.0‐38.0 | 0.4 | 0.0‐1.0 | 575.1 (P < 0.001) | 88.7 (86.3‐90.6) |
| Iraq | 19 | 681 | 0.0‐6.0 | 0.0 | 0.0‐0.0 | 12.2 (P = 0.838) | 0.0 (0.0‐24.5) |
| Jordan | 4 | 71 | 0.0‐0.0 | 0.0 | 0.0‐1.1 | 0.4 (P = 0.933) | |
| Kuwait | 1 | 108 | 0.0 | 0.0‐3.4 | |||
| Lebanon | 20 | 543 | 0.0‐80.0 | 7.4 | 1.1‐16.8 | 127.6 (P < 0.001) | 85.1 (78.3‐89.8) |
| Libya | 6 | 4236 | 13.9‐21.2 | 17.7 | 15.3‐20.0 | 21.7 (P < 0.001) | 76.9 (48.5‐89.7) |
| Morocco | 13 | 2636 | 0.0‐63.2 | 16.7 | 4.3‐34.4 | 614.8 (P < 0.001) | 98.0 (97.5‐98.5) |
| Oman | 1 | 33 | 9.1 | 3.1‐23.6 | |||
| Pakistan | 92 | 36 111 | 0.0‐50.8 | 4.1 | 2.6‐5.8 | 3041.6 (P < 0.001) | 97.0 (96.7‐97.3) |
| Palestine | 4 | 152 | 0.0‐4.4 | 0.0 | 0.0‐1.8 | 3.9 (P = 0.271) | 23.3 (0.0‐88.3) |
| Qatar | 1 | 400 | 0.5 | 0.1‐1.8 | |||
| Saudi Arabia | 23 | 2652 | 0.0‐7.4 | 1.4 | 0.4‐2.8 | 49.3 (P < 0.001) | 55.3 (28.6‐72.1) |
| Syria | 3 | 674 | 0.0‐0.8 | 0.0 | 0.0‐0.2 | 0.1 (P = 0.928) | |
| Tunisia | 22 | 1578 | 0.0‐37.5 | 5.1 | 1.5‐9.9 | 128.7 (P < 0.001) | 83.7 (76.4‐88.7) |
| UAE | 4 | 233 | 0.0‐33.3 | 1.2 | 0.0‐6.5 | 7.1 (P = 0.067) | 58.0 (0.0‐86.0) |
| MENA | 338 | 82 257 | 0.0‐63.2 | 2.5 | 1.6‐3.5 | 11940.7 (P < 0.001) | 97.2 (97.0‐97.3) |
| Genotype 3 | |||||||
| Afghanistan | 3 | 71 | 52.2‐100 | 65.4 | 50.5‐79.2 | 1.7 (P = 0.437) | 0.0 (0.0‐87.5) |
| Algeria | 7 | 3806 | 0.0‐10.4 | 3.0 | 1.6‐4.9 | 25 (P < 0.001) | 76.0 (49.3‐88.6) |
| Bahrain | 2 | 107 | 0.0‐20.4 | 18.7 | 12.4‐27.1 | ||
| Egypt | 47 | 5031 | 0.0‐33.3 | 0.0 | 0.0‐0.5 | 164.4 (P < 0.001) | 72.0 (62.6‐79.1) |
| Iran | 66 | 23 134 | 0.0‐65.7 | 38.8 | 35.7‐41.9 | 878.9 (P < 0.001) | 92.6 (91.3‐93.7) |
| Iraq | 19 | 681 | 0.0‐21.7 | 0.2 | 0.0‐3.3 | 68.8 (P < 0.001) | 73.8 (58.9‐83.3) |
| Jordan | 4 | 71 | 0.0‐0.0 | 0.0 | 0.0‐1.1 | 0.4 (P = 0.933) | 0.0 (0.0‐0.0) |
| Kuwait | 1 | 108 | 25.0 | 17.8‐33.9 | |||
| Lebanon | 20 | 543 | 0.0‐58.6 | 7.8 | 2.3‐15.3 | 78.6 (P < 0.001) | 75.8 (62.8‐84.3) |
| Libya | 6 | 4236 | 6.0‐21.0 | 13.7 | 9.1‐19.1 | 112.7 (P < 0.001) | 95.6 (92.6‐97.3) |
| Morocco | 13 | 2636 | 0.0‐50.0 | 3.2 | 0.4‐7.9 | 124.6 (P < 0.001) | 90.4 (85.4‐93.7) |
| Oman | 1 | 33 | 9.1 | 3.1‐23.6 | |||
| Pakistan | 92 | 36 111 | 0.0‐100 | 81.4 | 77.9‐84.8 | 4410.5 (P < 0.001) | 97.9 (97.7‐98.1) |
| Palestine | 4 | 152 | 0.0‐8.7 | 0.0 | 0.0‐7.7 | 6.7 (P = 0.081) | 55.5 (0.0‐85.3) |
| Qatar | 1 | 400 | 15.8 | 12.5‐19.6 | |||
| Saudi Arabia | 23 | 2652 | 0.0‐33.3 | 0.8 | 0.0‐2.3 | 75.2 (P < 0.001) | 70.7 (55.4‐80.8) |
| Syria | 3 | 674 | 0.0‐1.7 | 0.3 | 0.0‐1.2 | 0.2 (P = 0.903) | 0.0 (0.0‐0.0) |
| Tunisia | 22 | 1578 | 0.0‐25.0 | 0.7 | 0.0‐3.4 | 100.3 (P < 0.001) | 79.1 (68.9‐85.9) |
| UAE | 4 | 233 | 0.0‐33.6 | 11.8 | 0.1‐33.1 | 32 (P < 0.001) | 90.6 (79.0‐95.8) |
| MENA | 338 | 82 257 | 0.0‐100 | 26.8 | 22.4‐31.5 | 60629.7 (P < 0.001) | 99.4 (99.4‐99.5) |
| Genotype 4 | |||||||
| Afghanistan | 3 | 71 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 0.6 (P = 0.732) | 0.0 (0.0‐66.6) |
| Algeria | 7 | 3806 | 0.0‐7.4 | 1.4 | 0.6‐2.4 | 14.1 (P = 0.028) | 57.5 (1.5‐81.6) |
| Bahrain | 2 | 107 | 11.1‐22.4 | 21.5 | 14.8‐30.2 | ||
| Egypt | 47 | 5031 | 22.2‐100 | 93.1 | 89.8‐95.9 | 432.6 (P < 0.001) | 89.4 (86.7‐91.5) |
| Iran | 66 | 23 134 | 0.0‐25.0 | 0.0 | 0.0‐0.1 | 238.1 (P < 0.001) | 72.7 (65.2‐78.6) |
| Iraq | 19 | 681 | 21.4‐100 | 60.0 | 46.3‐73.1 | 157.9 (P < 0.001) | 88.6 (83.7‐92.0) |
| Jordan | 4 | 71 | 26.7‐100 | 77.2 | 33.2‐100 | 31.8 (P < 0.001) | 90.6 (78.9‐95.8) |
| Kuwait | 1 | 108 | 47.2 | 38.1‐56.6 | |||
| Lebanon | 20 | 543 | 0.0‐100 | 31.5 | 20.6‐43.4 | 102.6 (P > 0.001) | 81.5 (72.4‐87.6) |
| Libya | 6 | 4236 | 27.6‐45.3 | 35.3 | 30.2‐40.6 | 63.96 (P < 0.001) | 92.2 (85.7‐95.7) |
| Morocco | 13 | 2636 | 0.0‐18.8 | 0.9 | 0.0‐2.8 | 44.4 (P < 0.001) | 72.9 (52.9‐84.5) |
| Oman | 1 | 33 | 27.3 | 15.1‐44.2 | |||
| Pakistan | 92 | 36 111 | 0.0‐17.1 | 0.1 | 0.0‐0.6 | 1188.6 (P < 0.001) | 92.3 (91.2‐93.4) |
| Palestine | 4 | 152 | 50.0‐85.7 | 75.0 | 66.9‐82.3 | 1.6 (P = 0.652) | 0.0 (0.0‐71.8) |
| Qatar | 1 | 400 | 64.0 | 59.2‐68.6 | |||
| Saudi Arabia | 23 | 2653 | 9.4‐90.9 | 56.6 | 49.0‐64.0 | 225.9 (P < 0.001) | 90.3 (86.7‐92.9) |
| Syria | 3 | 674 | 39.3‐60.0 | 53.8 | 40.3‐67.1 | 4.1 (P = 0.127) | 51.5 (0.0‐86.0) |
| Tunisia | 22 | 1578 | 0.0‐19.4 | 1.7 | 0.0‐5.3 | 128 (P < 0.001) | 83.6 (76.3‐88.7) |
| UAE | 4 | 233 | 0.0‐46.3 | 21.3 | 5.4‐42.8 | 25.6 (P < 0.001) | 88.3 (72.5‐95.0) |
| MENA | 338 | 82 257 | 0.0‐100 | 17.3 | 14.1‐20.6 | 43318.8 (P < 0.001) | 99.2 (99.2‐99.3) |
| Genotype 5 | |||||||
| Afghanistan | 3 | 71 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 0.6 (P = 0.732) | 0.0(0.0‐66.6) |
| Algeria | 7 | 3806 | 0.0‐0.9 | 0.0 | 0.0‐0.0 | 6.3 (P = 0.389) | 5.0 (0.0‐72.3) |
| Bahrain | 2 | 107 | 0.0‐0.0 | 0.0 | 0.0‐3.5 | ||
| Egypt | 47 | 5031 | 0.0‐31.6 | 0.0 | 0.0‐0.0 | 45.2 (P = 0.507) | 0.0 (0.0‐32.6) |
| Iran | 66 | 23 134 | 0.0‐3.5 | 0.0 | 0.0‐0.0 | 89.7 (P = 0.023) | 27.5 (1.2‐46.8) |
| Iraq | 19 | 681 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 3.9 (P = 0.100) | 0.0 (0.0‐0.0) |
| Jordan | 4 | 71 | 0.0‐0.0 | 0.0 | 0.0‐1.1 | 0.4 (P = 0.933) | 0.0 (0.0‐0.0) |
| Kuwait | 1 | 108 | 0.0 | 0.0‐3.4 | |||
| Lebanon | 20 | 543 | 0.0‐3.0 | 0.0 | 0.0‐0.3 | 4.8 (P = 0.100) | 0.0 (0.0‐0.0) |
| Libya | 6 | 4236 | 0.0‐0.1 | 0.0 | 0.0‐0.1 | 1.0 (P = 0.959) | 0.0 (0.0‐0.0) |
| Morocco | 13 | 2636 | 0.0‐0.1 | 0.0 | 0.0‐0.0 | 3.7 (P = 0.988) | 0.0 (0.0‐0.0) |
| Oman | 1 | 33 | 0.0 | 0.0‐10.4 | |||
| Pakistan | 92 | 36 111 | 0.0‐4.1 | 0.0 | 0.0‐0.0 | 192.6 (P < 0.001) | 52.7 (40.0‐62.8) |
| Palestine | 4 | 152 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 1.2 (P < 0.751) | 0.0 (0.0‐62) |
| Qatar | 1 | 400 | 0.0 | 0.0‐1.0 | |||
| Saudi Arabia | 23 | 2652 | 0.0‐5.1 | 0.0 | 0.0‐0.0 | 31.1 (P < 0.094) | 29.3 (0.0‐57.6) |
| Syria | 3 | 674 | 0.0‐30.0 | 7.6 | 0.0‐23.0 | 9.1 (P < 0.010) | 78.1 (29.4‐93.2) |
| Tunisia | 22 | 1578 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 7.9 (P < 0.996) | 0.0 (0.0‐0.0) |
| UAE | 4 | 233 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 0.7 (P < 0.875) | 0.0 (0.0‐33.7) |
| MENA | 338 | 82 257 | 0.0‐31.6 | 0.0 | 0.0‐0.0 | 706.8 (P < 0.001) | 52.3 (45.9‐57.8) |
| Genotype 6 | |||||||
| Afghanistan | 3 | 71 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 0.6 (P = 0.732) | 0.0 (0.0‐66.6) |
| Algeria | 7 | 3806 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 2.4 (P = 0.882) | 0.0 (0.0‐26.2) |
| Bahrain | 2 | 107 | 0.0‐0.0 | 0.0 | 0.0‐3.5 | ||
| Egypt | 47 | 5031 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 20.3 (P = 0.100) | 0.0 (0.0‐0.0) |
| Iran | 66 | 23 134 | 0.0‐0.7 | 0.0 | 0.0‐0.0 | 38.8 (P = 0.100) | 0.0 (0.0‐0.0) |
| Iraq | 19 | 681 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 3.9 (P = 0.100) | 0.0 (0.0‐0.0) |
| Jordan | 4 | 71 | 0.0‐0.0 | 0.0 | 0.0‐1.1 | 0.4 (P = 0.933) | 0.0 (0.0‐0.0) |
| Kuwait | 1 | 108 | 0.0 | 0.0‐3.4 | |||
| Lebanon | 20 | 543 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 5.0 (P = 0.999) | 0.0 (0.0‐0.0) |
| Libya | 6 | 4236 | 0.0‐0.1 | 0.0 | 0.0‐0.1 | 0.3 (P = 0.100) | 0.0 (0.0‐0.0) |
| Morocco | 13 | 2636 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 6.5 (P = 0.888) | 0.0 (0.0‐20.1) |
| Oman | 1 | 33 | 0.0 | 0.0‐10.4 | |||
| Pakistan | 92 | 36 111 | 0.0‐3.4 | 0.0 | 0.0‐0.0 | 161 (P < 0.001) | 43.5 (27.5‐55.9) |
| Palestine | 4 | 152 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 1.2 (P < 0.751) | 0.0 (0.0‐62.0) |
| Qatar | 1 | 400 | 0.0 | 0.0‐1.0 | |||
| Saudi Arabia | 23 | 2652 | 0.0‐0.9 | 0.0 | 0.0‐0.0 | 8.2 (P < 0.997) | 0.0 (0.0‐0.0) |
| Syria | 3 | 674 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 1.3 (P < 0.524) | 0.0 (0.0‐83.9) |
| Tunisia | 22 | 1578 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 7.9 (P < 0.996) | 0.0 (0.0‐0.0) |
| UAE | 4 | 233 | 0.0‐0.0 | 0.0 | 0.0‐0.0 | 0.7 (P < 0.875) | 0.0 (0.0‐33.7) |
| MENA | 338 | 82 257 | 0.0‐3.4 | 0.0 | 0.0‐0.0 | 317.3 (P < 0.001) | 0.0 (0.0‐7.4) |
Djibouti, Mauritania, Somalia, Sudan, and Yemen excluded due to either no studies available or small sample size.
a
CI: Confidence interval.
b
Q: The Cochran Q statistic is a measure assessing the existence of heterogeneity in effect size (proportion of each genotype).
c
I2: A measure assessing the magnitude of between‐study variation that is due to differences in effect size (proportion of each genotype) across studies rather than chance.