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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
ARTICLE HIGHLIGHTS
Research background
An extensive literature review was carried out in various databases up until February 2023, using key terms such as Human immunodeficiency virus (HIV), pregnancy, and Africa. Through this literature search, we noted a significant body of evidence detailing HIV infection prevalence among pregnant women in Africa.
Research motivation
Given the continued high incidence and impact of HIV among pregnant women in Africa, there is a critical need to enhance our understanding of the specific factors that contribute to this high prevalence and the variations in these proportions. There is also an urgent need to examine strategies that could effectively mitigate both horizontal (person-to-person) and vertical (mother-to-child) HIV transmission during pregnancy and breastfeeding.
Research objectives
This research aims to provide a comprehensive understanding of HIV prevalence among pregnant women in Africa by identifying and analyzing the regional and clinical characteristics that contribute to variations in study-specific estimates.
Research methods
This systematic review and meta-analysis, compliant with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and registered in PROSPERO, assessed the seroprevalence of HIV serological markers among pregnant women in Africa up to 2023. All types of study designs from any African region were eligible if the sample size was greater than 10 and published in English or French. A literature search was conducted in databases such as Pubmed, Web of Science, African Index Medicus, and African Journal online, with relevant search terms. The quality of the included studies was assessed using the appropriate tool. The DerSimonian and Laird random-effects model was used to determine pooled HIV seroprevalence.
Research results
This systematic review analyzed data from 248 studies investigating HIV seroprevalence in pregnant women across various African countries from 1984 to 2020. The overall HIV seroprevalence was estimated at 9.3% [95% confidence interval (CI): 8.3-10.3]. The highest seroprevalence was found in Southern Africa (29.4%, 95%CI: 26.5-32.4), while Northern Africa had the lowest (0.7%, 95%CI: 0.3-1.3). Among the different types of HIV, HIV-1 seroprevalence was significantly higher than HIV-2 (P < 0.001).
Research conclusions
This comprehensive analysis identified a high HIV seroprevalence among pregnant women in Africa at an estimated 9.3%, highlighting the significant burden of HIV in the region.
Research perspectives
Considering the substantial HIV seroprevalence among pregnant women in Africa, this analysis underlines the need for sustained efforts to prevent HIV transmission and provide effective care and treatment for HIV-positive pregnant women, especially in regions with high seroprevalence. Future research should aim to elucidate the factors contributing to high seroprevalence, especially in Southern Africa, and devise effective preventive and therapeutic strategies tailored to the region's needs.
