Effect of postpartum depression on exclusive breast-feeding practices in sub-Saharan Africa countries: a systematic review and meta-analysis

Abstract Background Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries. Methods PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Result A total of 1482 published articles and gray literatures were retrieved from different databases. Additional articles were identified from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30,021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). Conclusion In Sub Saharan Africa, the prevalence of postpartum depression was lower than the report of World Health Organization for developing Country in 2020. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.

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Effect of Postpartum Depression on Exclusive Breast-Feeding Practices in Sub-Saharan Africa Countries: Systematic Review and Meta-analysis

10.21203/rs.3.rs-86191/v1 ◽

2020 ◽

Author(s):

Demelash Woldeyohannes Handiso ◽

Yohannes Tekalegn Ifa ◽

Biniyam Sahiledengle Sahiledengle ◽

Dejene Ermias Makango ◽

Tekele Ejajo Wontamo ◽

...

Keyword(s):

Postpartum Depression ◽

Breast Feeding ◽

Meta Analysis ◽

Feeding Practices ◽

Sub Saharan Africa ◽

Cochrane Library ◽

Inclusion Criteria ◽

Exclusive Breast Feeding ◽

Wide Range ◽

Sub Saharan

Abstract Background: Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries.Methods: PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.Result: A total of 1482 published articles and Grey literatures were retrieved from different databases. Additional articles were from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). Conclusion: In Sub Saharan Africa, the prevalence of postpartum depression was higher than WHO report of 2018. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.

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Relationship between exclusive breast feeding and cardiorespiratory fitness in children and adolescents: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-023223 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023223 ◽

Cited By ~ 1

Author(s):

Carlos Berlanga-Macías ◽

Diana P. Pozuelo-Carrascosa ◽

Celia Álvarez-Bueno ◽

Jose Alberto Martínez-Hortelano ◽

Miriam Garrido-Miguel ◽

...

Keyword(s):

Systematic Review ◽

Quality Assessment ◽

Children And Adolescents ◽

Cardiorespiratory Fitness ◽

Breast Feeding ◽

Exclusive Breastfeeding ◽

Meta Analysis ◽

Cochrane Library ◽

Exclusive Breast Feeding

IntroductionBreast feeding has been considered important due to its short-term and long-term benefits on infant and maternal health. Regarding the long-term benefits, the influence of exclusive breastfeeding on cardiorespiratory fitness (CRF) during childhood and adolescence has been studied, although with controversial conclusions. This study protocol aims to provide a clear and standardised procedure for systematically reviewing the relationship between breast feeding, in terms of duration and exclusivity, and CRF in children and adolescents.Methods and analysisThis systematic review and meta-analysis protocol is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A literature search will be conducted in MEDLINE, EMBASE, Web of Science and Cochrane Library. Observational studies regarding the association between breast feeding and CRF in children and adolescents written in English or Spanish will be included. A Critical Appraisal Checklist for Analytical Cross Sectional Studies and The Newcastle-Ottawa Quality Assessment Scale for longitudinal studies will be used for quality assessment of included studies. Standardised mean differences of CRF by exclusive breastfeeding categories will be calculated as the primary outcome. Subgroup analyses and meta-regression will be performed based on the sources of heterogeneity.Ethics and disseminationThis evidence-based systematic review will summarise the relevant information on the association of exclusive breast feeding and CRF in children and adolescents. The results will be disseminated by publication in a peer-reviewed journal. Given that the data used for this systematic review will be exclusively extracted from published studies, ethical approval will not be required.PROSPERO registration numberCRD42018082642.

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Dengue Virus Infection in Sub-Saharan Africa Between 2010 and 2020: A Systematic Review and Meta-Analysis

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.678945 ◽

2021 ◽

Vol 11 ◽

Author(s):

Khalid Eltom ◽

Khalid Enan ◽

Abdel Rahim M. El Hussein ◽

Isam M. Elkhidir

Keyword(s):

Systematic Review ◽

Dengue Virus ◽

Subgroup Analysis ◽

Meta Analysis ◽

Denv Infection ◽

Sub Saharan Africa ◽

Cochrane Library ◽

The Past ◽

Sub Saharan ◽

Infection Markers

Dengue virus (DENV) infection has garnered a global interest in the past few decades. Nevertheless, its epidemiology in certain developing and low-income regions remains poorly understood, due to the absence of comprehensive surveillance and reporting systems. This systematic review and meta-analysis aimed to determine the prevalence of DENV infection in the population of Sub-Saharan Africa using DENV infection markers, and to track any changes in its prevalence during the past ten years. It was conducted in accordance with the PRISMA guidelines, targeting the literature available at MEDLINE/PubMed, ScienceDirect, Cochrane library and Google Scholar. All articles published in English language between January 2010 and June 2020 were screened for eligibility. Random effects model was used to calculate the pooled prevalence of all infection markers. The Inconsistency Index (I2) was used to assess the level of heterogeneity between studies. Subgroup analysis according to country and time-frame of studies was conducted to provide possible explanations to substantial heterogeneity. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies. A total of 84 articles, covering 21 countries, were included in this review. Quantitative meta-analysis estimated a pooled IgG prevalence of 25% (95% CI: 21-29%, I2 = 99%), a pooled IgM prevalence of 10% (95% CI: 9-11%, I2 = 98%) and a pooled DENV RNA prevalence of 14% (95% CI: 12-16%, I2 = 99%). Evidence for possible publication bias was also found in all three meta-analyses. Subgroup analysis according to the time of sample collection was performed to closely track the changing prevalence of DENV infection markers between 2010 and 2019. This meta-analysis estimates a high prevalence of DENV infection in Sub-Saharan Africa. More cost-efficient vector control strategies should be designed and implemented in order to adapt to the low-resource nature of this region.

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A systematic review and meta-analysis reveal that Campylobacter spp. and antibiotic resistance are widespread in humans in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0245951 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245951

Author(s):

Delfina F. Hlashwayo ◽

Betuel Sigaúque ◽

Emília V. Noormahomed ◽

Sónia M. S. Afonso ◽

Inácio M. Mandomando ◽

...

Keyword(s):

Antibiotic Resistance ◽

Meta Analysis ◽

Random Effect ◽

Research Priorities ◽

Sub Saharan Africa ◽

Cochrane Library ◽

African Countries ◽

Pooled Prevalence ◽

Sub Saharan ◽

The Impact

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.

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Prevalence of Syphilis among Pregnant Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/4562385 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Siraj Hussen ◽

Birkneh Tilahun Tadesse

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Screening Program ◽

Meta Analysis ◽

Relevant Literature ◽

Sub Saharan Africa ◽

Cochrane Library ◽

Forest Plot ◽

Pooled Prevalence ◽

Sub Saharan

Objective. Syphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women. Design. Systematic review and meta-analysis. Data Sources. Databases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women. Data Extraction. Our search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included. Results. The pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period. Conclusion. This review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.

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Determinants and Effects of Adolescent Substance Use in Africa: A Systematic Review Protocol

10.21203/rs.3.rs-37924/v1 ◽

2020 ◽

Author(s):

Sandra Jumbe ◽

Tony Mwenda-Kamninga ◽

Isaac Mwalwimba ◽

Ukwuori-Gisela Kalu

Keyword(s):

Systematic Review ◽

Substance Use ◽

Associated Factors ◽

Sub Saharan Africa ◽

World Health ◽

Adolescent Substance Use ◽

Health Concern ◽

Cochrane Library ◽

Adolescent Substance ◽

Sub Saharan

Abstract Background: Substance use among adolescents continues to be a growing major public health concern in Africa. Recent studies infer an overall estimated prevalence of 42% among adolescents in sub-Saharan Africa. Unfortunately, this phenomenon is not adequately documented across many settings in the continent despite known negative health and social consequences on affected individuals and their communities. Little is known about the social context of substance use in Africa among this population. Our aim is to conduct a systematic review to explore determinants and associated factors that influence adolescent substance use and the effects of substance use in sub-Saharan Africa.Methods: The Cochrane Library, PubMed, EMBASE, African Journals Online, Google Scholar, Scopus, Global Health, PsychINFO, Web of Science, and the World Health Organization (WHO) regional databases will be searched for population-based observational studies reporting on the prevalence of substance use of adolescents (age 10 - 19 years) across Africa. Search dates will be from January 2000 to December 2019. Data will be extracted from eligible publications, using a data extraction tool developed for this study. A random effects meta-analysis will be conducted to pool determinants and effects (at 95% confidence interval) of estimated substance abuse among adolescents. Alternative visual and statistical approaches will be adopted instead of traditional meta-analytic approaches where necessary.Discussion: This systematic review will describe the range of determinants and associated factors that have been found to significantly influence substance use in this population group over the last two decades. Additionally, the review will also describe the possible effects of substance use among adolescents. Documenting this evidence is important as it can potentially be used to inform comprehensive interventions and treatment programmes that are targeted at adolescents and their parents in these settings.Systematic review registration: registered on PROSPERO; registration number tbc.

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Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010–2015)

BMJ Open ◽

10.1136/bmjopen-2016-014145 ◽

2017 ◽

Vol 7 (10) ◽

pp. e014145 ◽

Cited By ~ 23

Author(s):

Abukari Ibrahim Issaka ◽

Kingsley Emwinyore Agho ◽

Andre MN Renzaho

Keyword(s):

West Africa ◽

Breast Feeding ◽

Southern Africa ◽

Meta Analysis ◽

Central Africa ◽

Early Initiation ◽

Bottle Feeding ◽

Demographic And Health Surveys ◽

Exclusive Breast Feeding ◽

Sub Saharan

ObjectivesTo carry out a meta-analysis to assess the prevalence of four key breastfeeding indicators in four subregions of 29 sub-Saharan African countries.Design, settings and participantsThe 29 countries were categorised into four subregions, and using cross-sectional data from the most recent Demographic and Health Surveys (2010–2015) of these countries prevalence of each of four key breastfeeding indicators was estimated for each of the subregions by carrying out a meta-analysis. Due to the presence of significant heterogeneity among the various surveys (I2>50%), a random-effect analytic model was used, and sensitivity analysis was performed to examine the effects of outliers.Main outcome variablesEarly initiation of breast feeding, exclusive breast feeding, predominant breast feeding and bottle feeding.ResultsThe overall prevalence ofearly initiation of breast feedingvaried between a lowest of 37.84% (95% CI 24.62 to 51.05) in Central Africa to a highest of 69.31% (95% CI 67.65 to 70.97) in Southern Africa; the overall prevalence ofexclusive breast feedingranged between a lowest of 23.70% (95% CI 5.37 to 42.03) in Central Africa to a highest of 56.57% (95% CI 53.50 to 59.95) in Southern Africa; the overall prevalence ofpredominant breast feedingranged between a lowest of 17.63% (95% CI 12.70 to 22.55) in East Africa and a highest of 46.37% (95% CI 37.22 to 55.52) in West Africa; while the prevalence ofbottle feedingvaried between a lowest of 8.17% (95% CI 5.51 to 10.84) in West Africa and a highest of 30.05% (95% CI 28.42 to 31.69) in Southern Africa.ConclusionsWest Africa and Central Africa recorded lower overall prevalence ofearly initiation of breast feedingandexclusive breast feedingthan the WHO’s recommended target of 50% by the year 2025. Intervention for improved breastfeeding practices in sub-Saharan Africa should target West and Central Africa, while intervention to minimise bottle feeding should target Southern Africa.

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Health financing for universal health coverage in Sub-Saharan Africa: a systematic review

Global Health Research and Policy ◽

10.1186/s41256-021-00190-7 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Susan C. Ifeagwu ◽

Justin C. Yang ◽

Rosalind Parkes-Ratanshi ◽

Carol Brayne

Keyword(s):

Systematic Review ◽

Health Services ◽

Universal Health Coverage ◽

Health Financing ◽

Sub Saharan Africa ◽

World Health ◽

Cochrane Library ◽

Health Coverage ◽

Sub Saharan ◽

Universal Health

Abstract Background Universal health coverage (UHC) embedded within the United Nations Sustainable Development Goals, is defined by the World Health Organization as all individuals having access to required health services, of sufficient quality, without suffering financial hardship. Effective strategies for financing healthcare are critical in achieving this goal yet remain a challenge in Sub-Saharan Africa (SSA). This systematic review aims to determine reported health financing mechanisms in SSA within the published literature and summarize potential learnings. Methods A systematic review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. On 19 to 30 July 2019, MEDLINE, EMBASE, Web of Science, Global Health Database, the Cochrane Library, Scopus and JSTOR were searched for literature published from 2005. Studies describing health financing approaches for UHC in SSA were included. Evidence was synthesised in form of a table and thematic analysis. Results Of all records, 39 papers were selected for inclusion. Among the included studies, most studies were conducted in Kenya (n = 7), followed by SSA as a whole (n = 6) and Nigeria (n = 5). More than two thirds of the selected studies reported the importance of equitable national health insurance schemes for UHC. The results indicate that a majority of health care revenue in SSA is from direct out-of-pocket payments. Another common financing mechanism was donor funding, which was reported by most of the studies. The average quality score of all studies was 81.6%, indicating a high appraisal score. The interrater reliability Cohen’s kappa score, κ=0.43 (p = 0.002), which showed a moderate level of agreement. Conclusions Appropriate health financing strategies that safeguard financial risk protection underpin sustainable health services and the attainment of UHC. It is evident from the review that innovative health financing strategies in SSA are needed. Some limitations of this review include potentially skewed interpretations due to publication bias and a higher frequency of publications included from two countries in SSA. Establishing evidence-based and multi-sectoral strategies tailored to country contexts remains imperative.

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Effect of HIV-related knowledge on utilisation of voluntary HIV testing service among university students in Sub-Saharan Africa: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2020-045748 ◽

2021 ◽

Vol 11 (7) ◽

pp. e045748

Author(s):

Gedefaw Diress ◽

Amanuel Addisu ◽

Melese Linger Endalifer

Keyword(s):

Systematic Review ◽

University Students ◽

Hiv Testing ◽

Meta Analysis ◽

Preventive Measure ◽

Sub Saharan Africa ◽

Cochrane Library ◽

Service Utilisation ◽

Testing Service ◽

Sub Saharan

IntroductionVoluntary HIV testing is a vital preventive measure to reduce HIV transmission. Existing evidence on the association between HIV-related knowledge and HIV testing service utilisation shows inconsistent findings. Therefore, the aim of this review is to assess whether knowledge of HIV is related to improvement in voluntary HIV testing service utilisation among university students in Sub-Saharan Africa.Methods and analysisA systematic review of studies on the association of HIV-related knowledge and voluntary HIV testing service utilisation among university students will be conducted. We will search several electronic databases, including PubMed/MEDLINE, African Journals Online, Web of Science and Cochrane Library, for all study types looking at the association between HIV-related knowledge and voluntary HIV testing service utilisation. Two reviewers will independently screen all retrieved records and full-text articles and extract data. The Higgins I2 test will be used to assess heterogeneity between studies. Random-effects meta-analysis will be conducted, if feasible and appropriate. Additional analyses will be performed to explore potential sources of heterogeneity. Stata statistical software (V.14) will be used to analyse the data.Ethics and disseminationFormal ethical approval is not required because the systematic review relies on primary studies. The results will be disseminated through a peer-reviewed publication, conference presentation and the popular press.

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Human T-lymphotropic virus type I and breastfeeding; systematic review and meta-analysis of the literature

Iranian Journal of Neurology ◽

10.18502/ijnl.v17i4.589 ◽

2019 ◽

Cited By ~ 1

Author(s):

Reza Boostani ◽

Ramin Sadeghi ◽

Amir Sabouri ◽

Ali Ghabeli-Juibary

Keyword(s):

Systematic Review ◽

Breast Feeding ◽

Virus Type ◽

Transmission Rate ◽

Meta Analysis ◽

Bottle Feeding ◽

Cochrane Library ◽

Type I ◽

Exclusive Breast Feeding ◽

Short Period

Background: The human T-cell lymphotropic virus type-I (HTLV-I) is the first identified pathogenic human retrovirus. Breastfeeding has been reported to be the predominant route of vertical transmission of HTLV-I. The objective of this systematic review was to pool and evaluate the data on the transmission of HTLV-I with different infant-feeding practices on children born to HTLV-I-positive mothers. We conducted a systematic review of comparison of HTLV-I transmission risk to breastfed and bottle-fed babies. Methods: We searched the following databases: MEDLINE, SID, Magiran, and Cochrane Library. The search strategy was limited to articles in English. Initial screening identified 254 citations; of these, 96 potentially relevant articles were identified. After reviewing the 96 full-text articles in detail, 7 reports met the inclusion criteria for this review. Results: Pooled odds ratio (OR) and risk difference (RD) of HTLV-I transmission in the breastfed group compared to the bottle-fed infants were [OR = 3.48, 95% confidence interval (CI): 1.58-7.64, P = 0.0020, Cochran’s Q = 27.7, P = 0.0010, and I2 = 67.5%] and (RD = 17.1%, 95% CI: 7.5%-26.7%, P < 0.0001, Cochran’s Q = 106, P < 0.0001, and I2 = 91.5%). So, we have evidence to support that exclusive breast feeding more than 6 months in comparison to bottle feeding highly increases transmission rate of HTLV-I infection. We have also enough evidence to support that exclusive breast feeding up to 6 months compared to bottle feeding does not increase transmission rate of HTLV-I infection (pooled OR = 0.912, CI: 0.45-1.80; OR: 3.83, CI: 1.80-8.10, respectively). Conclusion: The current meta-analysis showed that short period (less than 6 months) of breastfeeding did not increase risk of HTLV-I infection transmission from mother to child among breastfeeders and more than 6 months of breastfeeding significantly increased the risk of HTLV-I infection. However, our meta-analysis shows that refraining from breastfeeding can decrease the risk of vertical HTLV-I transmission.

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