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

doi:10.5492/wjccm.v12.i5.264

Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020

World J Crit Care Med. 2023 Dec 9;12(5):264-285. doi: 10.5492/wjccm.v12.i5.264.

Authors

Jean Thierry Ebogo-Belobo¹, Sebastien Kenmoe², Chris Andre Mbongue Mikangue³, Serges Tchatchouang⁴, Lontuo-Fogang Robertine⁵, Guy Roussel Takuissu⁶, Juliette Laure Ndzie Ondigui³, Arnol Bowo-Ngandji³, Raoul Kenfack-Momo⁷, Cyprien Kengne-Ndé⁸, Donatien Serge Mbaga³, Elisabeth Zeuko'o Menkem⁹, Ginette Irma Kame-Ngasse¹, Jeannette Nina Magoudjou-Pekam⁷, Josiane Kenfack-Zanguim⁷, Seraphine Nkie Esemu¹⁰, Paul Alain Tagnouokam-Ngoupo¹¹, Lucy Ndip¹⁰, Richard Njouom¹¹

Affiliations

¹ Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon.
² Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon. sebastien.kenmoe@ubuea.cm.
³ Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon.
⁴ Scientific Direction, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon.
⁵ Department of Animal Biology, University of Dschang, Dschang 00237, Cameroon.
⁶ Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon.
⁷ Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon.
⁸ Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala 00237, Cameroon.
⁹ Department of Biomedical Sciences, University of Buea, Buea 00237, Cameroon.
¹⁰ Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon.
¹¹ Department of Virology, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon.

Abstract

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.

Keywords: Africa; Human immunodeficiency virus; Meta-analysis; Pregnant women; Prevalence; Review.