Prevalence of hepatitis C virus among street children in Iran

Masoud Behzadifar, Hasan Abolghasem Gorji, Aziz Rezapour, Nicola Luigi Bragazzi

Street children are forced to spend a lot of time away from their homes and some of them do not have homes at all, due to economic and family problems, which makes them exposed to many health problems, such as the hepatitis C virus (HCV) infection. Iran, like many other countries in the world, experiences the burden of street children, however, the rate of HCV among street children is virtually unknown. This study aimed to determine the prevalence of HCV among street children in Iran. This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol of this review was registered in PROSPERO under identification term CRD42018082336. A comprehensive literature search was conducted to identify published studies reporting on the prevalence of HCV among street children in Iran. Several international scholarly databases, including Web of Science, PubMed®/MEDLINE®, Embase, Scopus®, Google Scholar and Directory of Open Access Journals, as well as Iranian databases such as MagIran and Barakathns were searched. Studies published between 1988 and December 2017 with any of the following keywords were selected: (street OR homeless OR labour) AND (children OR child OR infant) AND (hepatitis C OR hepatitis C virus OR HCV OR viral hepatitis OR hepatitis OR hepacivirus) AND Iran. Moreover, a grey literature search was performed in order to obtain other potentially relevant studies. The search was carried out without any language restrictions. Four studies, surveying a total of 1691 street children, conducted between 2006 and 2017 were found to be eligible for inclusion in the review and therefore analysed. Three studies were conducted in Tehran and one in Isfahan. The prevalence of HCV among street children in Iran was found to be high, at 2.4% (95% CI: 1.8-3.3). Since the prevalence of HCV among street children in Iran is quite high, health decision- and policy-makers should pay more attention to street children and widen support channels, both social and economic. Further studies should be conducted among street children in different cities of Iran to add to the knowledge base of HCV among street children in the country. The health system should provide facilities for street children to be screened to quickly diagnose illnesses and prevent them from developing complications.