1984 - 2020年非洲孕妇人群中人类免疫缺陷病毒血清学标志物血清流行率的系统评价与荟萃分析
Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020.
作者信息
Ebogo-Belobo Jean Thierry, Kenmoe Sebastien, Mbongue Mikangue Chris Andre, Tchatchouang Serges, Robertine Lontuo-Fogang, Takuissu Guy Roussel, Ndzie Ondigui Juliette Laure, Bowo-Ngandji Arnol, Kenfack-Momo Raoul, Kengne-Ndé Cyprien, Mbaga Donatien Serge, Menkem Elisabeth Zeuko'o, Kame-Ngasse Ginette Irma, Magoudjou-Pekam Jeannette Nina, Kenfack-Zanguim Josiane, Esemu Seraphine Nkie, Tagnouokam-Ngoupo Paul Alain, Ndip Lucy, Njouom Richard
机构信息
Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon.
Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon.
出版信息
World J Crit Care Med. 2023 Dec 9;12(5):264-285. doi: 10.5492/wjccm.v12.i5.264.
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 I 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 ( < 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.
背景
人类免疫缺陷病毒（HIV）是一个主要的公共卫生问题，尤其是在非洲，那里的HIV感染率仍然很高。孕妇感染HIV的风险增加，这对母婴健康都有重大影响。
目的
回顾总结非洲孕妇中的HIV血清阳性率。同时确定导致特定研究估计值差异的区域和临床特征。
方法
该研究纳入了来自任何非洲国家或地区的孕妇，无论其症状如何，以及在任何环境下进行的任何研究设计。通过电子文献检索，对截至2023年2月发表的文章进行了回顾。评估了纳入研究的质量。应用DerSimonian和Laird随机效应模型来确定非洲孕妇中HIV合并血清阳性率。进行亚组分析和敏感性分析以识别异质性的潜在来源。用Cochran's Q检验和I统计量评估异质性，用Egger检验评估发表偏倚。
结果
定量综合分析（荟萃分析）纳入了1984年至2020年期间进行的总共248项研究。在所有研究中，146项（58.9%）偏倚风险较低，102项（41.1%）偏倚风险中等。纳入研究中没有HIV阳性孕妇死亡。估计孕妇中的总体HIV血清阳性率为9.3%[95%置信区间（CI）：8.3 - 10.3]。亚组分析显示各亚组间存在统计学上的显著异质性（<0.001），其中南非的血清阳性率最高（29.4%，95%CI：26.5 - 32.4），北非的血清阳性率最低（0.7%，95%CI：0.3 - 1.3）。
结论
该综述发现非洲国家孕妇中的HIV血清阳性率仍然很高，特别是在南部非洲国家。本综述可为制定有针对性的公共卫生干预措施提供参考，以解决非洲国家孕妇中高HIV血清阳性率的问题。
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