(Citations of studies used in the analysis from top to bottom: [9C12, 28, 32, 39, 49, 53C58, 64, 66C68, 98, 99]) Epidemiology of HAV, HDV and HEV An early statement of HAV antibody prevalence rates was 84 and 50% [46, 59], respectively among the general population and children. prevalence in HIV infected individuals was higher (5.5%, 95%CI: 3.8C7.8%, value indicates presence of heterogeneity) and and I squared (I2) (with I2? ?50% denoting substantial heterogeneity statistical tests) were conducted to test heterogeneity [22]. The subgroup analysis was performed among the community centered studies, blood donors, HIV infected individuals and additional organizations. The subgroup analysis was not regarded as for the screening packages used because of the observed homogeneity in the types of the packages (which include an immunoassay centered screening packages such as enzyme linked immunoassay, radioimmunoassay and chromatographic immunoassay) (Additional documents 1 and 2). Meta-regression analysis was used to determine potential confounders E 2012 such as mean age groups, study human population types, yr of study and geographical zones. The mean age group meta-regression was regarded as for those studies which only reported the mean age (Additional documents 1 and 2). The overall E 2012 fixed and random effects model with 95% confidence intervals (95% CIs) were INT2 determined and illustrated using a forest storyline graph demonstration. The meta-analysis was not regarded as for data extracted for HAV, HDV and HEV since the quantity of available studies was very small. Compressive meta-analysis software version 3.3., 2014 (www.meta-analysis.com) was used during the meta-analysis. Results Demographic and study human population characteristics The population of Ethiopia was 22 million at the time (1960s) when the 1st HBV seroprevalence data were reported. After 30?years, when many of the E 2012 seroepidemiological and few clinical reports of hepatitis viruses were available, the population steadily increased to 48 million [23]. Currently, having a human population of 94 million, the country is the second most populous in Africa. The total study human population size screened for hepatitis viruses and involved in this systematic review and meta-analysis were 79,931. Among these, 62,955 were screened for hepatitis viruses from the general human population. About 5,229 were from symptomatic individuals with acute (867) and chronic (1020) liver diseases, and outpatient division attendants (3,342). The rest 11,747 were from HIV infected individuals. Geographically, the majority of human population screened for hepatitis viruses were from central Ethiopia (primarily in Addis Ababa) (45,037), northern Ethiopia (16,071), southern Ethiopia (17, 207) and from Ethiopian immigrants to Israel (1616). Overall, 68 studies were eligible for the review and among these, 26 studies reported both HBV and anti-HCV seroprevalence and the rest 6 and 36 studies reported only HCV and HBV, respectively. The mean age group E 2012 of the study human population screened for HBV and HCV was 28.9??6.1 (range 14C48) and 28.2??7.3 (range 16C55) years old, respectively. The peak E 2012 prevalence was reported between the group of 24C39 and 20C37 years old, respectively to HBV and HCV (Additional documents 1 and 2). All the selected studies were used immunoassay based packages of various types as their main screening test. In addition, only four (6.1%) studies (two each for HBV and HCV) used PCR for measuring viraemia level (Additional documents 1 and 2). Epidemiology of HBV The 1st recorded HBsAg prevalence rate was 3.9% in 1968 [24]. Then later on the magnitude of the maximum HBsAg prevalence (10.8%) was available in 1986 and 1989 [25, 26] and then decreased to 6.2% in 2003 [27] and 5.3% in 2007 [28] from the community based studies (Fig.?2a). However, studies conducted in blood donors (Fig.?2b) reported a slightly higher median prevalence of 8.7% (IQR?=?4.6C16.9) than the 6.2% median (IQR?=?5.6C9.9) prevalence rate in the community based studies (Fig.?2a). Moreover, the reports from your blood donors of the same localities like in Bahir Dar (25 vs. 4.11%) [8, 13], Jimma (24.2 vs. 2.1%) [14, 15] and Gondar (14.4 vs. 4.7%) [16, 17] showed marked epidemiological discrepancies over time (Fig.?2b). The HBsAg was also reported among numerous segments of the society such as healthcare experts (7.3C9.0%) [29, 30], medical waste handlers (6.0C6.3%) [31, 32], outpatient and inpatient division attendants (4.7C7.4%) [33, 34], street dwellers (10.9%) [35], pregnant women (3.0C7.3%) [36C40], diabetic patients (3.7%) [41], HIV VCT centres clients (5.7%) [10, 42] and commercial sex workers (6.0%) [43] (Fig.?2c). The.