Table 3.
Yields of a Testing Program Targeting Populations at Different Risks of Being Exposed to HCV in Mena Countries
| Country | Number of Individuals Needed to Be Tested to Identify One HCV Chronically Infected Individual (95% CI) | |||||
|---|---|---|---|---|---|---|
| People Who Inject Drugs | Populations With High‐Risk Health Care Exposures | Populations at Intermediate Risk | General Populations | Populations With Liver Conditions | Special Clinical Populations | |
| Afghanistan | 4.1 (3.2‐5.3) | NA* | 57.0 (36.3‐103.4) | 180.2 (143.4‐233.9) | NA* | NA* |
| Algeria | NA* | 7.5 (5.2‐11.9) | 26.9 (7.7‐ ‐‐†) | 1025.6 (459.8‐4444.4) | NA* | 1.9 (1.8‐2.0) |
| Bahrain | NA* | 2.4 (1.6‐5.1) | NA* | NA* | NA* | 16.3 (4.5‐ ‐‐†) |
| Djibouti | NA* | NA* | NA* | 476.2 (360.4‐634.9) | NA† | NA* |
| Egypt | 2.1 (1.8‐2.5) | 2.4 (2.2‐2.7) | 9.5 (7.3‐13.2) | 11.3 (10.6‐12.0) | 2.3 (2.0‐2.6) | 3.4 (2.9‐4.1) |
| Iran | 2.6 (2.3‐2.8) | 5.4 (4.5‐6.5) | 21.6 (13.9‐38.8) | 459.8 (360.4‐634.9) | 17.7 (11.7‐30.7) | 50.3 (36.9‐73.3) |
| Iraq | NA* | 6.8 (5.4‐8.8) | 105.8 (67.3‐196.1) | 740.7 (533.3‐1,025.6) | 19.1 (12.3‐34.5) | 48.1 (34.0‐74.5) |
| Jordan | NA* | 4.0 (3.2‐5.3) | 202 (36.9‐6,666.7) | 888.9 (533.3‐1,904.8) | NA* | 3.3 (2.7‐4.1) |
| Kuwait | NA* | 7.1 (3.6‐23.3) | 25.0 (9.3‐256.4) | 97.3 (32.9‐2,666.7) | 22.7 (5.7‐ ‐‐†) | 2.2 (1.7‐3.2) |
| Lebanon | 5.3 (2.4‐30.3) | 18.0 (11.7‐32.1) | 61.7 (24.9‐512.8) | 888.9 (533.3‐2,222.2) | 6.8 (4.6‐11.1) | NA† |
| Libya | 1.4 (1.4‐1.5) | 4.9 (3.6‐7.1) | 24.8 (12.4‐76.6) | 83.9 (75.8‐92.6) | NA* | 3.5 (2.6‐5.4) |
| Mauritania | NA* | NA* | NA* | 121.2 (45.8‐430.1) | NA* | NA* |
| Morocco | 2.5 (1.8‐4.0) | 3.5 (2.2‐7.1) | 34.4 (23.0‐57.5) | 205.1 (155.0‐283.7) | 3.5 (1.6‐36.0) | 14.8 (8.4‐34.5) |
| Oman | 2.8 (2.5‐3.1) | 4.0 (2.8‐6.4) | NA* | 177.8 (144.9‐222.2) | NA* | 15.2 (5.9‐144.9) |
| Pakistan | 2.5 (1.9‐3.7) | 4.1 (3.3‐5.3) | 10.3 (8.8‐12.3) | 21.7 (20.1‐23.5) | 2.4 (2.2‐2.8) | 5.4 (3.4‐10.6) |
| Palestine | 3.2 (2.8‐3.7) | 12.9 (8.2‐23.6) | NA* | 555.6 (444.4‐740.7) | NA* | NA* |
| Qatar | NA* | 3.0 (2.5‐3.7) | NA* | 70.2 (45.5‐122.3) | 4.0 (2.7‐7.2) | 14.8 (8.1‐31.8) |
| Saudi Arabia | 2.3 (1.4‐7.3) | 2.9 (2.6‐3.1) | 14.9 (8.6‐33.3) | 177.8 (162.6‐196.1) | 4.9 (3.9‐6.4) | 11.9 (8.9‐17.0) |
| Somalia | NA* | NA* | 78.0 (29.2‐1,333.3) | 124.6 (62.0‐416.7) | 6.6 (3.1‐29.5) | NA* |
| Sudan | NA* | 7.2 (4.3‐15.8) | 190.5 (107.5‐459.8) | 98.0 (57.7‐211.6) | 18.2 (7.8‐105.8) | 25.6 (7.8‐ ‐‐†) |
| Syria | 3.4 (1.7‐19.0) | 3.1 (2.2‐5.1) | 44.7 (30.0‐75.3) | 325.2 (283.7‐370.4) | 128.2 (36.1‐1,025.6) | 2.8 (1.9‐4.8) |
| Tunisia | 1.6 (1.5‐1.7) | 5.3 (4.4‐6.6) | 21.2 (9.3‐101.8) | 222.2 (168.8‐303.0) | 5.9 (3.5‐13.3) | 12.5 (4.3‐476.2) |
| United Arab Emirates | NA* | 5.6 (4.4‐6.9) | 8.5 (3.9‐37.2) | 66.0 (45.0‐106.7) | NA* | NA* |
| Yemen | NA* | 3.0 (2.3‐4.0) | 81.8 (36.9‐341.9) | 82.8 (60.6‐119.0) | 5.3 (3.7‐8.5) | 12.9 (8.7‐21.4) |
| Yields of a testing programs based on pooling all measures | ||||||
| Countries with a generalized epidemic‡ | 2.5 (1.9‐3.5) | 2.7 (2.5‐3.1) | 10.0 (8.8‐11.5) | 14.2 (13.5‐14.9) | 2.4 (2.2‐2.6) | 3.9 (3.2‐4.9) |
| Countries with a concentrated epidemic§ | 2.8 (2.5‐3.1) | 5.1 (4.6‐5.6) | 32.2 (25.5‐42.1) | 222.2 (208.3‐242.4) | 8.6 (7.0‐10.8) | 18.1 (14.4‐23.6) |
| All countries | 2.7 (2.5‐3.0) | 4.4 (4.1‐4.8) | 20.2 (17.6‐23.5) | 54.6 (52.1‐57.2) | 3.8 (3.4‐4.3) | 8.5 (6.8‐11.0) |
| Sensitivity analysis‐Yields of a testing program based on pooling all measures with population size weighting | ||||||
| Countries with a generalized epidemic‡ | 2.5 (1.9‐3.6) | 2.7 (2.5‐3.0) | 10.0 (8.9‐11.4) | 13.2 (12.7‐13.8) | 2.3 (2.1‐2.6) | 3.9 (3.2‐5.0) |
| Countries with a concentrated epidemic§ | 2.8 (2.5‐3.1) | 5.1 (4.6‐5.7) | 32.8 (25.3‐44.6) | 182.6 (175.4‐193.2) | 8.6 (7.1‐10.7) | 19.0 (16.1‐22.7) |
| All countries | 2.7 (2.5‐3.0) | 4.4 (4.1‐4.8) | 20.3 (18.0‐23.0) | 46.1 (44.0‐48.7) | 3.8 (3.5‐4.3) | 8.7 (6.8‐11.5) |
The yield in a testing program is defined as the number of individuals needed to be tested to identify one HCV chronically infected individual.28
*
NA indicates that no estimates were available because no prevalence studies were identified.
†
Estimate could not be calculated as either HCV prevalence or the limit for its CI is 0 or too close to 0, indicating the need for an infinite number of tests.
‡
Classification based on the pooled mean HCV antibody prevalence in the general population being ≥3% (includes Egypt and Pakistan).
§
Classification based on the pooled mean HCV antibody prevalence in the general population being <3% (includes all MENA countries other than Egypt and Pakistan).