# Hepatitis B Virus Infection Among Tribal Populations in India: A Systematic Review and Meta-Analysis

## TL;DR

This study finds high Hepatitis B virus prevalence among tribal populations in India, especially in the north, and highlights the need for targeted vaccination strategies.

## Contribution

The study provides the first comprehensive meta-analysis of HBV prevalence specifically among India's tribal populations.

## Key findings

- The pooled HBV prevalence among Indian tribes was 9.99%, with significant regional variation.
- Northern India had the highest HBV prevalence at 19.60% among tribal populations.
- High heterogeneity (I2 > 98%) was observed across all regions, indicating variability in study results.

## Abstract

The introduction of the Hepatitis B virus (HBV) vaccine has significantly reduced the disease’s burden. Tribes comprise approximately 8.6% of the Indian population, making it pertinent to investigate the epidemiology of HBV among these individuals. We synthesized the prevalence of HBV among tribes in India.

We searched the Medline (via the PubMed search engine), Embase, and CINAHL databases, in addition to the first 10 pages of Google Scholar. We included original observational studies that screened tribal populations for HBV infection, reported the prevalence of HBsAg (our main preference), and/or other markers. The risk of bias was assessed using the Appraisal Tool for Cross-Sectional Studies. The pooled prevalence was presented after conducting a meta-analysis (PROSPERO registration ID: CRD42022334938).

A total of 24 studies were selected for this study. The pooled prevalence of HBV (as measured by the proportion of individuals testing positive for hepatitis B surface antigen) was estimated to be 9.99% (95% confidence interval (CI) 6.07–14.75, I2 = 98.7%, p < 0.01). The highest HBV prevalence was noted in the northern zone of the country (19.60%, 95% CI 15.09–24.54, I2 = 84.4%, p < 0.01), followed by the northeastern zone (13.43%, 95% CI 6.09–23.08, I2 = 98.4%, p < 0.01), and the southern zone (10.44%, 95% CI 4.75–18.01, I2 = 98.9%, p < 0.01).

A considerable prevalence of HBV was observed in tribal communities in India, a fact that cannot be overlooked. This information may be useful for planning HBV vaccination strategies among tribes in India.