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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020
Jean Thierry Ebogo-Belobo, Sebastien Kenmoe, Chris Andre Mbongue Mikangue, Serges Tchatchouang, Lontuo-Fogang Robertine, Guy Roussel Takuissu, Juliette Laure Ndzie Ondigui, Arnol Bowo-Ngandji, Raoul Kenfack-Momo, Cyprien Kengne-Ndé, Donatien Serge Mbaga, Elisabeth Zeuko'o Menkem, Ginette Irma Kame-Ngasse, Jeannette Nina Magoudjou-Pekam, Josiane Kenfack-Zanguim, Seraphine Nkie Esemu, Paul Alain Tagnouokam-Ngoupo, Lucy Ndip, Richard Njouom
Jean Thierry Ebogo-Belobo, Ginette Irma Kame-Ngasse, Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
Sebastien Kenmoe, Seraphine Nkie Esemu, Lucy Ndip, Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
Chris Andre Mbongue Mikangue, Juliette Laure Ndzie Ondigui, Arnol Bowo-Ngandji, Donatien Serge Mbaga, Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
Serges Tchatchouang, Scientific Direction, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon
Lontuo-Fogang Robertine, Department of Animal Biology, University of Dschang, Dschang 00237, Cameroon
Guy Roussel Takuissu, Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
Raoul Kenfack-Momo, Jeannette Nina Magoudjou-Pekam, Josiane Kenfack-Zanguim, Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
Cyprien Kengne-Ndé, Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala 00237, Cameroon
Elisabeth Zeuko'o Menkem, Department of Biomedical Sciences, University of Buea, Buea 00237, Cameroon
Paul Alain Tagnouokam-Ngoupo, Richard Njouom, Department of Virology, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon
Author contributions: Ebogo-Belobo JT, Kenmoe S, and Njouom R were responsible for conception and design of the study as well as project administration; Ebogo-Belobo JT, Kenmoe S, Mbongue Mikangue CA, Tchatchouang S, Robertine LF, Takuissu GR, Ndzie Ondigui JL, Bowo-Ngandji A, Kenfack-Momo R, Kengne-Ndé C, Mbaga DS, Menkem EZ, Kame-Ngasse GI, Magoudjou-Pekam JN, Kenfack-Zanguim J, Esemu SN, Tagnouokam-Ngoupo PA, Ndip L, and Njouom R were responsible for the data curation and interpretation of results; Kengne-Nde C and Kenmoe S were responsible for statistical analysis; Kenmoe S and Njouom R were responsible for the project supervision; Ebogo-Belobo JT and Kenmoe S wrote the original draft; All authors critically reviewed the first draft and approved the final version of the paper for submission, and have read and approve the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Sebastien Kenmoe, PhD, Assistant Lecturer, Department of Microbiology and Parasitology, University of Buea, Molyko to Buea town Rd, Buea 00237, Cameroon.
sebastien.kenmoe@ubuea.cm
Received: July 29, 2023
Peer-review started: July 29, 2023
First decision: September 14, 2023
Revised: September 19, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: December 9, 2023
Processing time: 130 Days and 19.2 Hours
BACKGROUND
Human immunodeficiency virus (HIV) is a major public health concern, particularly in Africa where HIV rates remain substantial. Pregnant women are at an increased risk of acquiring HIV, which has a significant impact on both maternal and child health.
AIM
To review summarizes HIV seroprevalence among pregnant women in Africa. It also identifies regional and clinical characteristics that contribute to study-specific estimates variation.
METHODS
The study included pregnant women from any African country or region, irrespective of their symptoms, and any study design conducted in any setting. Using electronic literature searches, articles published until February 2023 were reviewed. The quality of the included studies was evaluated. The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa. Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity. Heterogeneity was assessed with Cochran's Q test and I2 statistics, and publication bias was assessed with Egger's test.
RESULTS
A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis (meta-analysis). Out of the total studies, 146 (58.9%) had a low risk of bias and 102 (41.1%) had a moderate risk of bias. No HIV-positive pregnant women died in the included studies. The overall HIV seroprevalence in pregnant women was estimated to be 9.3% [95% confidence interval (CI): 8.3-10.3]. The subgroup analysis showed statistically significant heterogeneity across subgroups (P < 0.001), with the highest seroprevalence observed in Southern Africa (29.4%, 95%CI: 26.5-32.4) and the lowest seroprevalence observed in Northern Africa (0.7%, 95%CI: 0.3-1.3).
CONCLUSION
The review found that HIV seroprevalence among pregnant women in African countries remains significant, particularly in Southern African countries. This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
Core Tip: A meta-analysis reveals a 9.3% Human immunodeficiency virus (HIV) seroprevalence among pregnant women in Africa, with regional variations. Southern Africa reports the highest rates at 29.4%, whereas Northern Africa shows the lowest at 0.7%. These findings underscore the need for targeted public health interventions to tackle high HIV seroprevalence in pregnant women, especially in Southern African countries.
