Prevalence of hepatitis C viral infection in Ghana: a systematic review and meta-analysis

Background: Hepatitis C virus (HCV) infection remains a public health threat in Ghana. Current epidemiological data is imperative for shaping policy and designing evidence-driven interventions, with particular focus on advancing the STOP Hepatitis C initiative led by the Ghana Ministry of Health. Objective: This systematic review aimed to synthesize evidence on the HCV epidemiological data in Ghana from 2016 to 2025, highlighting population-level and regional variations, identifying high-risk groups, and examining changes in HCV prevalence over the years. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Joanna Briggs Institute methodology. The protocol was registered in the PROSPERO (CRD42024592505). A comprehensive search was conducted across PubMed, Embase (via Ovid), Web of Science, CINAHL and African Journals Online. Data extraction and quality assessment were performed using standardized tools. A total of 53 studies were used for this review with a combined sample size of 487,106 across 12 regions of Ghana. Results: Meta-analyses using random-effects models revealed an overall pooled national HCV prevalence of 6.04% (95% CI: 3.94% – 8.15%) with significant heterogeneity (I2 = 99.9%, P < .00001). Regional disparities were evident, with the Northern Region having the highest prevalence of 20.9% (95% CI: 10.7% – 31.1%) and the Central Region having the least (1.3%, 95% CI: 0.8% – 1.7%). Subgroup analyses indicated HCV prevalence of 10.9% (95% CI: 7.2% – 14.6%) among patients with liver diseases, 6.4% (95% CI: 5.2% – 7.4%) in blood donors, 1.9% (95% CI: 0.9% – 2.3%) in pregnant women and 1.4% (95% CI: 0.7%—2.1%) in PLHIV. Comparatively, the prevalence observed in our study (6.04%) is higher than previously reported in 2016 (3.0%). Conclusion: This systematic review provides a comprehensive update on the burden of HCV in Ghana, revealing significant regional and population-level disparities. Substantial financial intervention is required for the STOP Hep C campaign, along with the inclusion of HCV-RNA testing in the National Health Insurance Scheme (NHIS) to enhance access to diagnosis. These measures will greatly strengthen the drive towards eliminating hepatitis C by 2030.