Prevalence of Epstein-Barr virus infection in North African cancer patients - a systematic review and meta-analysis protocol

Sep 22, 2026

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Epstein-Barr virus (EBV) is an oncogenic virus linked to multiple malignancies, yet its prevalence and impact among North African cancer patients remain insufficiently characterized. This protocol addresses that gap by outlining a systematic review and meta-analysis to clarify EBV infection’s role in regional cancer pathogenesis. The work supports improved prevention, early detection, and more tailored treatment approaches.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Background

Methods

Discussion

Systematic review registration

Introduction

Souiden et al. Systematic Reviews (2026) 15:230 [https://doi.org/10.1186/s13643-026-03257-z](https://doi.org/10.1186/s13643-026-03257-z) Systematic Reviews PROTOCOL Open Access Prevalence of Epstein-Barr virus infection in North African cancer patients: a systematic review and meta-analysis protocol Yosra Souiden1* , Imen Ayouni2,3, Sarra Mestiri 1, Sihem Hmissa 1 and Nabiha Missaoui 1 Abstract Background Epstein-Barr virus (EBV) is a well-recognized oncogenic virus associated with the development of various malignancies. In North Africa, EBV-related cancers, such as nasopharyngeal carcinoma, gastric cancer, and lymphomas, present a significant health challenge due to their high mortality rates. Despite the common occurrence of these malignancies, the prevalence and impact of EBV infection in this context remain largely unexamined. Addressing this knowledge gap is crucial for understanding the virus’s role in cancer pathogenesis and for informing effective prevention and treatment strategies. Methods Electronic databases will be searched for literature published up to 2025 using a Boolean search approach combining common terms and Medical Subject Headings (MeSH) for EBV infection, cancer, and North Africa. Thereview will only include studies carried out in North Africa that assess the prevalence of EBV infection in patients with cancer. Using the Joanna Briggs Institute (JBI) critical appraisal tools, the quality and potential risk of bias of all selected full-text articles will be evaluated. Discussion This protocol outlines a systematic review and meta-analysis aiming to evaluate the prevalence of EBV infection in cancer patients in North Africa to better understand its role in the region’s cancer burden. Insights from this study will support improved prevention, early detection, and more personalized treatment strategies, ultimately aiding the reduction of cancer mortality in the region. Systematic review registration This protocol has been published in the PROSPERO International Prospective Register of Systematic Reviews ([http://www.crd.york.ac.uk/PROSPERO](http://www.crd.york.ac.uk/PROSPERO)), under the registration number CRD42024594373 . Keywords Epstein-Barr virus, EBV, HHV-4, Cancer, Malignancies, Prevalence, North Africa *Correspondence: Yosra Souiden[yosra.souidene@gmail.com](yosra.souidene@gmail.com) 1 LR21ES03, Oncogenesis and Tumor Progression, Faculty of Medicine of Sousse, University of Sousse, Sousse 4002, Tunisia 2 Department of Epidemiology, Hospital of Farhat Hached, Sousse 4002, Tunisia 3 Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of CapeTown, Cape Town 7700, South Africa Introduction Cancer poses a significant global health burden, accounting for approximately 20 million new cases and nearly 10 million deaths worldwide in 2022, according to the latest GLOBOCAN data from the International Agency for Research on Cancer (IARC) [1]. In Africa, cancer is becoming a serious health concern that requires urgent action to address rising incidence and mortality. Despite a relatively low incidence rate—1,185,216 new cancer cases in Africa, representing only 5.9% of all cancer cases worldwide—the continent faces a disproportionately high mortality rate. In 2022, 763,843 cancer-related deaths © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The imag

FAQs

What is the main goal of this protocol?

To evaluate the prevalence of Epstein-Barr virus (EBV) infection in cancer patients in North Africa using a systematic review and meta-analysis.

How will eligible studies be selected?

Electronic databases will be searched up to 2025 with Boolean terms and MeSH for EBV infection, cancer, and North Africa. Included studies must be conducted in North Africa and assess EBV prevalence in cancer patients.

How will study quality and bias be assessed?

Quality and potential risk of bias of all selected full-text articles will be evaluated using Joanna Briggs Institute (JBI) critical appraisal tools.

Sep 22, 2026

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