Awoke Nefsu, Tekalign Tiwabwork, Teshome Mistre, Lolaso Tsegaye, Dendir Getahun, Obsa Mohammed Suleiman
School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
EClinicalMedicine. 2021 Jun 9;37:100952. doi: 10.1016/j.eclinm.2021.100952. eCollection 2021 Jul.
Different physiologic changes that occur during pregnancy, such as Hydroureter, dilatation of the renal pelvis, glycosuria and aminoaciduria, and low urine production predispose pregnant women for ascending urinary tract infection. Globally, 2% to 15% of the pregnant women have urinary tract infection without specific symptoms. Therefore, this study aimed to estimate the prevalence of asymptomatic bacteriuria (ABU) in pregnant women in Africa.
Systematic search of published studies done on PubMed, EMBASE, Web of Science, SCOPUS, PsychInfo, CINAHL, and google scholar for gray literature. All published observational studies until October 30, 2020 were included. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality of studies was assessed by modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using a random-effects method with the double arcsine transformation approach using the STATA™ Version 14 software. Trim and fill analysis was done to correct presence of significant publication bias. The study protocol is prospectively registered on PROSPERO, registration number CRD42020212601.
From 3393 obtained studies, 48 studies from 12 African countries involving 15, 664 pregnant women included in this Meta-analysis. The overall pooled prevalence of asymptomatic bacteriuria among pregnant women in Africa after correction for publication bias by trim and fill analysis was found to be 11.1% (95% CI: 7.8, 14.4). The most common bacterial isolates involved in the etiology of ABU was with pooled prevalence 33.4% (95% CI: 27.3 - 39.4).
Asymptomatic bacteriuria is substantial among pregnant women in Africa. Therefore, all pregnant women should be tested for the presence of asymptomatic bacteriuria. A screening program must be based not only on the incidence but also on a cost-efficacy evaluation and a microbiological evaluation.
There was no funding source for this study.
孕期会发生不同的生理变化，如输尿管积水、肾盂扩张、糖尿和氨基酸尿，以及尿量减少，这些因素使孕妇易发生上行性尿路感染。在全球范围内，2%至15%的孕妇患有尿路感染但无特定症状。因此，本研究旨在评估非洲孕妇无症状菌尿（ABU）的患病率。
在PubMed、EMBASE、科学网、SCOPUS、PsychInfo、CINAHL和谷歌学术上系统检索已发表的研究及灰色文献。纳入截至2020年10月30日所有已发表的观察性研究。本荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。采用改良的纽卡斯尔-渥太华量表（NOS）评估研究质量。使用随机效应方法和双反正弦变换法，借助STATA™ 14版软件进行荟萃分析。采用修剪和填充分析来纠正显著发表偏倚的存在。该研究方案已在PROSPERO上进行前瞻性注册，注册号为CRD42020212601。
从3393项获得的研究中，本荟萃分析纳入了来自12个非洲国家的48项研究，涉及15664名孕妇。经修剪和填充分析校正发表偏倚后，非洲孕妇无症状菌尿的总体合并患病率为11.1%（95%CI：7.8，14.4）。ABU病因中最常见的分离菌是 ，合并患病率为33.4%（95%CI：27.3 - 39.4）。
非洲孕妇中无症状菌尿的情况较为严重。因此，所有孕妇都应接受无症状菌尿检测。筛查方案不仅应基于发病率，还应基于成本效益评估和微生物学评估。
本研究无资金来源。
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