scholarly journals A systematic review and meta-analysis of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa: A challenge for malaria elimination efforts

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248245
Author(s):  
Yonas Yimam ◽  
Mehdi Nateghpour ◽  
Mehdi Mohebali ◽  
Mohammad Javad Abbaszadeh Afshar

Background In Sub-Saharan Africa (SSA), where malaria transmission is stable, malaria infection in pregnancy adversely affects pregnant women, fetuses, and newborns and is often asymptomatic. So far, a plethora of primary studies have been carried out on asymptomatic malaria infection in pregnant women in SSA. Nevertheless, no meta-analysis estimated the burden of asymptomatic malaria infection in pregnant women in SSA, so this meta-analysis was carried out to bridge this gap. Methods PubMed, Web of Science, Scopus, Embase, and ProQuest were systematically searched for relevant studies published until 4 August 2020, and also the expansion of the search was performed by October 24, 2020. We assessed heterogeneity among included studies using I-squared statistics (I2). Publication bias was assessed by visual inspection of the funnel plot and further quantitatively validated by Egger’s and Begg’s tests. The pooled prevalence and pooled odds ratio (OR) and their corresponding 95% Confidence Interval (CI) were estimated using the random-effects model in Stata 15 software. Results For this meta-analysis, we included 35 eligible studies. The overall prevalence estimate of asymptomatic Plasmodium infection prevalence was 26.1%% (95%CI: 21–31.2%, I2 = 99.0%). According to species-specific pooled prevalence estimate, Plasmodium falciparum was dominant species (22.1%, 95%CI: 17.1–27.2%, I2 = 98.6%), followed by Plasmodium vivax, Plasmodium malariae and Plasmodium ovale, respectively, found to be 3% (95%CI: 0–5%, I2 = 88.3%), 0.8% (95%CI: 0.3–0.13%, I2 = 60.5%), and 0.2% (95%CI: -0.01–0.5%, I2 = 31.5%). Asymptomatic malaria-infected pregnant women were 2.28 times more likely anemic (OR = 2.28, 95%CI: 1.66–3.13, I2 = 56.3%) than in non-infected pregnant women. Asymptomatic malaria infection was 1.54 times higher (OR = 1.54, 95%CI: 1.28–1.85, I2 = 11.5%) in primigravida women compared to multigravida women. Conclusion In SSA, asymptomatic malaria infection in pregnant women is prevalent, and it is associated with an increased likelihood of anemia compared to non-infected pregnant women. Thus, screening of asymptomatic pregnant women for malaria and anemia should be included as part of antenatal care.

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Siraj Hussen ◽  
Birkneh Tilahun Tadesse

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.


Author(s):  
Alemu Earsido Addila ◽  
Telake Azale Bisetegn ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal Mengistu ◽  
Getnet Mihretie Beyene

Abstract Background Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries. Methods The results of the review were reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline and, it was registered in the Prospero database, number CRD42019127103. The available primary studies were collated from different databases: PubMed, CINAHL, Cochrane Library, PsycINFO, Google Scholar, African Journals Online and Centre for Addiction and Mental Health Library. The main search terms were [((alcohol consumption) OR (alcohol drinking) OR (alcohol use) OR (ethanol use) OR (alcohol exposure)) AND ((pregnant women) OR (pregnant mother) OR (during pregnancy)) AND (Sub-Saharan Africa)]. We used the Joanna Briggs Institute (JBI) for critical appraisal of studies. The random-effects model was computed to estimate the pooled prevalence. Heterogeneity between studies was checked using the I2 statistic and the Cochrane Q test. Results The review resulted in 963 original studies after searching various databases, and finally 37 studies in qualitative synthesis and 30 articles in the systematic review and meta-analysis were included. The overall summary estimate of the prevalence of alcohol consumption during pregnancy was found to be 20.83% (95% CI: 18.21, 23.46). The pooled estimate of meta-analysis showed that depression (OR: 1.572; 95% CI: 1.34, 1.845), partners’ alcohol use (OR: 1.32, 95% CI: 1.11, 1.57), knowledge on harmful effect of alcohol consumption (OR: 0.36, 95% CI: 0.29, 0.45) and, unplanned pregnancy (OR: 2.33, 95% CI: 1.17, 4.63) were statistically significant factors with alcohol consumption during pregnancy. Conclusions The result showed that there was high alcohol consumption during pregnancy in Sub- Saharan Africa. Alcohol consumption during pregnancy was associated with depression, partners’ alcohol use, unplanned pregnancy and knowledge of the harmful effects of alcohol consumption. Therefore, this will be a basis for public policy and resource allocation for prevention initiatives.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  

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.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249789
Author(s):  
Meseret Belete Fite ◽  
Kedir Teji Roba ◽  
Lemessa Oljira ◽  
Abera Kenay Tura ◽  
Tesfaye Assebe Yadeta

Background Anemia is one of the world’s leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was conducted very carefully in order to give up the pooled compliance of Iron and Folic-Acid Supplementation in Sub-Saharan Africa. Methods To conduct this brief systematic review and meta-analysis, a related literature search was done from different sources, PubMed Medline and Google Scholar Journals. Then IFA Supplementation related searching engine was used to make the work more meaningful and intensive. Moreover, we used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to assess the quality of the study in terms of their inclusion. Then, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to carry out the work in a carful manner. Finally, the pooled effect size was computed using the review manager and Compressive Meta-analysis software. Results Twenty-three studies, which encompassed 24272 pregnant women, were chosen for the analysis. From those an overall prevalence of compliance with Iron and Folic Acid Supplementation (IFAS) in pregnancy in SSA was 39.2%. However, the result from meta-analysis showed that women who were counseled on IFAS in their courses of pregnancy were 1.96 times more likely to adhere to IFAS compared to those who were not counseled [OR:1.96, 95% CI (1.76-,5.93)]. Moreover, it showed that women who had knowledge of IFAS were 2.71 times more likely to have compliance with IFAS as compared to those who had no knowledge of IFAS [OR:2.71, 95% CI (1.33,5.54)]. Also it revealed that those women who had knowledge of anemia were 5.42 times more likely to have compliance with IFAS as compared with those who had no knowledge of anemia [OR5.42, 95% CI (1.52, 19.43)]. Furthermore, women who had received fourth visit for ANC were 1.54 times more likely to have compliance with IFAS as compared to those who had not received for ANC [OR 1.54, 95% CI (0.66, 3.58.43)]. Conclusions Our finding from this systematic review and meta-analysis shows the low case in prevalence of compliance to IFAS among pregnant women in SSA. Predictors for this includes: knowledge about anemia, knowledge about IFAS, counseling on IFAS and receiving fourth antenatal care visit were statistically correlated positively with compliance to IFAS. This demands careful appraisal of effect of prevention work for functioning policy, programs and plan nutrition intrusions for refining maternal dietary intake in gestation. Also dietary education intrusion requires to be planned to satisfy the needs of pregnant women. So we hope that the result of this study might be essential as a bridging stone for policy makers of Africa; exclusively for maternal and child health care. Finally, we recommended further studies to be conducted in the area of the study for more intensive and detailed suggestions.


2020 ◽  
Vol 16 (10) ◽  
pp. 2472-2478
Author(s):  
Zemenu Yohannes Kassa ◽  
Siraj Hussen ◽  
Solomon Asnake

Author(s):  
Muluken Dessalegn Muluneh ◽  
Virginia Stulz ◽  
Lyn Francis ◽  
Kingsley Agho

This study aimed to systematically review studies that examined the prevalence of gender based violence (GBV) that included intimate partner violence (IPV) and non-IPV among women in sub-Saharan Africa (SSA). This evidence is an important aspect to work towards achieving the Sustainable Development Goals (SDG’s) target of eliminating all forms of violence in SSA. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. Studies on GBV in SSA countries that were published in English from 2008 to 2019 were included. A random effect meta-analysis was used. Fifty-eight studies met the inclusion criteria. The pooled prevalence of IPV among women was 44%, the past year-pooled prevalence of IPV was 35.5% and non-IPV pooled prevalence was 14%. The highest prevalence rates of IPV that were reported included emotional (29.40%), physical (25.87%) and sexual (18.75%) violence. The sub-regional analysis found that women residing in Western (30%) and Eastern (25%) African regions experienced higher levels of emotional violence. Integrated mitigation measures to reduce GBV in SSA should focus mainly on IPV in order to achieve the SDG’s that will lead to sustainable changes in women’s health.


2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Moges Mareg ◽  
Esmelealem Mihretu

Abstract Background In the developing world, such as the sub-Saharan African region, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to under-nutrition. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in sub-Saharan Africa. Methods The primary studies for this review were retrieved from PubMed/ MEDLINE online, Science Direct, Hinari, web of science, CINHAL, EMBASE, WHO databases, Google, and Google Scholar databases. The articles selected for this meta-analysis were published between 2010 and 2020. The last search date was 18 October 2021. The data was extracted in Microsoft Excel format and exported to STATA Version 14.0. A random effect meta-analysis model was used. Heterogeneity was evaluated by the I2 test. The Egger weighted regression test was used to assess publication bias. Results We retrieved 847 records from these databases. Of which records, 813 were excluded due to different reasons and 34 studies were included in the final analysis. The pooled prevalence of stunting, underweight and wasting in HIV infected children was 46.7% (95% CI; 40.36–53.07, I2 = 98.7%, p < 0.01), 35.9% (95% CI; 30.79–41.02, I2 = 97.4% p < 0.01), and 23.0% (95% CI; 18.67–27.42, I2 = 96.9%, p < 0.01) respectively. The advanced WHO HIV/AIDS clinical staging (III&IV) [OR = 6.74 (95%: 1.747, 26.021), I2 = 94.7%] and household food insecurity were associated with stunting [OR = 5.92 (95% CI 3.9, 8.87), I2 = 55.7%]. Low family economic status [OR = 4.737 (95% CI: 2.605, 8.614), I2 = 31.2%] and increased feeding frequency [OR = 0.323 (95% CI: 0.172, 0.605), I2 = 69.8%] were significantly associated with under-weight. Anemia [OR = 2.860 (95% CI: 1.636, 5.000), I2 = 74.8%] and diarrhea in the previous month [OR = 4.117 (95% CI: 2.876, 5.894), I2 = 0.0%] were also associated with wasting among HIV infected children in sub-Saharan Africa. Conclusions The pooled prevalence of under-nutrition among HIV infected children was high. Nutritional assessment and interventions need great attention as a part of HIV care for HIV positive children. The implementation of policies and strategies established by national and international stakeholders in ART care centres should take a maximum emphasis on reducing under-nutrition among HIV infected children.


Viruses ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 62 ◽  
Author(s):  
Debasu Damtie ◽  
Mulugeta Melku ◽  
Belay Tessema ◽  
Anastasia N. Vlasova

Rotavirus infection is the major cause of acute gastroenteritis among children globally. Sub-Saharan Africa including Ethiopia is disproportionally affected by the disease. The aims of this review were to determine the pooled prevalence of rotavirus infection among children under-five and to identify the dominant rotavirus genotypes in Ethiopia. Twelve studies were included to estimate the pooled prevalence of rotavirus acute gastroenteritis and five studies were used to determine predominantly circulating genotypes of rotavirus. The pooled prevalence of rotavirus infection was 23% (95% CI = 22%–24%). G3 (27.1%) and P[8] (49%) were the dominant G and P types, respectively. The G8 G-type uncommon in humans but highly prevalent in cattle was also reported accounting for 1% of all cases. The major G/P combinations were G12P[8] (15.4%), G3P[6] (14.2%), G1P[8] (13.6%) and G3P[8] (12.9%) collectively accounting for 56.1% of rotavirus strains. Similar to other parts of the world, the dominance of G1, G3, P[6] and P[8] genotypes was noted in Ethiopia. The increased prevalence of G12P[8] strains observed in Ethiopia was similar to observations in other geographic regions in the post-vaccine introduction period. Thus, further studies are required on the vaccine effectiveness, genotype distribution and inter-species transmission potential of rotaviruses in Ethiopia.


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