Sero-prevalence of human immunodeficiency virus–hepatitis B virus (HIV–HBV) co-infection among pregnant women attending antenatal care (ANC) in sub-Saharan Africa (SSA) and the associated risk factors: a systematic review and meta-analysis

Abstract

Background There is plenitude of information on HIV infection among pregnant mothers attending antenatal care (ANC) in sub-Saharan Africa. However, the epidemiology of HBV–HIV co-infections in the same cohort is not clear despite the common route of transmission of both viruses. The aim of our study was to synthesize data on the prevalence of HBV–HIV co-infection among pregnant women attending ANC in Sub-Saharan Africa to assist in the design of public health interventions to mitigate the challenge. Methods The study was done in tandem with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards and the Cochran’s Q test, I2 statistics for heterogeneity and the prevalence were calculated using commercially available software called MedCalcs (https://www.medcalc.org). A random effect model was used to pool the prevalence since all the heterogeneities were high (≥ 78%) and Phet < 0.05 indicated significant heterogeneities. The risk factors and risk differences for HBV–HIV co-infection were analyzed. Any likely sources of heterogeneity were analyzed through sensitivity analysis, meta-regression and sub-group analysis. All analyses were done at 95% level of significance and a P < 0.05 was considered significant. Results The overall pooled prevalence of HBV–HIV co-infection among pregnant mothers in sub-Saharan Africa was low 3.302% (95%CI = 2.285 to 4.4498%) with heterogeneities (I2) of 97.59% (P > 0.0001). Within regional sub group meta-analyses, West Africa had significantly higher prevalence of 5.155% (95% = 2.671 to 8.392%) with heterogeneity (I2) of 92.25% (P < 0.0001) than any other region (P < 0.001). Articles published from 2004–2010 had significantly higher prevalence of 6.356% (95% = 3.611 to 9.811%) with heterogeneity (I2) 91.15% (P < 0.0001) compared to those published from 2011 to 2019 (P < 0.001). The HIV positive cohort had significantly higher prevalence of HBV–HIV co-infection of 8.312% (95% CI = 5.806 to 11.22%) with heterogeneity (I2)94.90% (P < 0.0001) than the mothers sampled from the general population with a prevalence of 2.152% (95% CI = 1.358 to 3.125%) (P < 0.001). The overall and sub group analyses had high heterogeneities (I2 > 89%, P < 0.0001) but was reduced for South Africa (I2) = 78.4% (P = 0.0314). Age, marital status and employment were independent factors significantly associated with risk of HBV–HIV co-infection (P < 0.001) but not extent of gravidity and education level (P > 0.05). After meta-regression for year of publication and sample size for HBsAg positivity, the results were not significantly associated with HBV pooled prevalence for sample size (P = 0.146) and year of publication (P = 0.560). Following sensitivity analysis, the HBsAg pooled prevalence slightly increased to 3.429% (95% CI = 2.459 to 4.554%) with heterogeneity I2 = 96.59% (95% CI = 95.93 to 97.14%), P < 0.0001 Conclusion There is an urgent need for routine HBV screening among HIV positive pregnant mothers attending antenatal care in sub-Saharan Africa to establish the extent of HBV–HIV co-infection in this cohort. Future studies need to investigate the putative risk factors for HBV–HIV co-infection and prioritize plausible control strategies.

Antibiotic-resistance in medically important bacteria isolated from commercial herbal medicines in Africa from 2000 to 2021: a systematic review and meta-analysis

“…A standard search strategy, i.e., the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), was used to screen for eligibility of the published articles concerning drug-resistant bacterial contamination of herbal medicines in Africa between 2000 and 2021 [ 33 ]. Eighteen research articles with a total sample size of 1111 met our inclusion criteria (Fig.…”

Global evidence on the potential of some Ugandan herbal medicines to mitigate antibiotic resistance: a systematic review and meta-analysis from 1996 to 2021

“…Screening for eligible studies A standard search strategy, i.e., the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), was used to screen for eligibility of the research articles published worldwide, on the antibacterial effects of the six plants, from 1996 to 2021 (57). Sixty-one research articles met our inclusion criteria.…”

“…Overall, 61 studies were eligible and thus included in this meta-analysis. Most of them(35,57.4%), were published from the year 2007 to 2017, and the minority in 1996 to 2006 (5, 8.2%). The studies were found in 23 countries across all continents except North America; mostly in Africa and Asia(27,44.3% each) (Fig.2).…”

Mapping Hepatitis B Virus Genotypes, Recombinant Genotypes and Sub- genotypes on the African continent from 1997 to 2021: A Systematic Review with Meta-Analysis

“…Genotype E has been associated with mother to child transmission(103) (104). Thus, its high prevalence presupposes an un met need towards screening for HBV during antenatal care increasing the risk of mother-to-child transmission of HBV (105). Finally.…”