Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis

Abstract Background Although Africa is a region of hyper endemicity to viral hepatitis B (HBV) and C (HCV) infections, there is limited data on their related burden among pregnant women. The present systematic review and meta-analysis aimed to determine the magnitude of these infections among pregna...

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Main Authors: Jean Joel Bigna, Angeladine M. Kenne, Aghiles Hamroun, Marie S. Ndangang, Audrey Joyce Foka, Dahlia Noelle Tounouga, Rémi Lenain, Marie A. Amougou, Jobert Richie Nansseu
Format: Article
Language:English
Published: BMC 2019-03-01
Series:Infectious Diseases of Poverty
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40249-019-0526-8
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spelling doaj-1582cdc24a014836adde3c49cf127cbb2020-11-25T02:10:15ZengBMCInfectious Diseases of Poverty2049-99572019-03-018111210.1186/s40249-019-0526-8Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysisJean Joel Bigna0Angeladine M. Kenne1Aghiles Hamroun2Marie S. Ndangang3Audrey Joyce Foka4Dahlia Noelle Tounouga5Rémi Lenain6Marie A. Amougou7Jobert Richie Nansseu8Department of Epidemiology and Public Health, Centre Pasteur of CameroonDepartment of Epidemiology and Public Health, Centre Pasteur of CameroonFaculty of Medicine, University of Paris SudDepartment of Medical Information and Informatics, Rouen University HospitalFaculty of Medicine and Biomedical Sciences, University of Yaoundé IFaculty of Medicine and Biomedical Sciences, University of Yaoundé IDepartment of Nephrology, Huriez Hospital, Lille University HospitalDepartment of Virology, Centre Pasteur of CameroonDepartment for the Control of Disease, Epidemics and Pandemics, Ministry of Public HealthAbstract Background Although Africa is a region of hyper endemicity to viral hepatitis B (HBV) and C (HCV) infections, there is limited data on their related burden among pregnant women. The present systematic review and meta-analysis aimed to determine the magnitude of these infections among pregnant women living in Africa and investigate its association with gender-related human development indicators. Main text We searched PubMed, Embase, Web of Science, Africa Journal Online, and Global Index Medicus, with no language restriction, to identify observational studies on HBV and HCV infections in pregnant women residing in Africa published from January 1, 2000 until December 31, 2017. Eligible studies reported the prevalence of HBV and/or HCV infection(s) (HBs antigen and HCV antibodies) and/or infectivity (HBe antigen or detectable HCV viral load). Each study was independently reviewed for methodological quality. We used a random-effects model meta-analysis to pool studies. In total, 145 studies (258 251 participants, 30 countries) were included, of which 120 (82.8%) had a low, 24 (16.5%) a moderate, and one (0.7%) had a high risk of bias. The prevalence of HBV and HCV infections was 6.8% (95% confidence interval [CI]: 6.1–7.6, 113 studies) and 3.4% (95% CI: 2.6–4.2, 58 studies), respectively. The prevalence of HBe antigen and HCV detectable viral load was 18.9% (95% CI: 14.4–23.9) and 62.3% (95% CI: 51.6–72.5) in HBV positive and HCV positive pregnant women, respectively. The multivariable meta-regression analysis showed that the prevalence of HBV infection increased with decreasing gender development index, males’ level of education and females’ expected years of schooling. Furthermore, this prevalence was higher in rural areas and in western and central Africa. The prevalence of HCV infection increased with decreasing proportion of seats held by women in parliament. Conclusions To address the burden of HBV and HCV infections, beyond well-known risk factors at the individual-level, macro-level factors including gender-related human development indicators and dwelling in rural areas should be considered. In Africa, HBV or HCV infected mothers seems to have high potential of transmission to their children.http://link.springer.com/article/10.1186/s40249-019-0526-8Hepatitis BHepatitis CDevelopmentAfricaGenderPregnant
collection DOAJ
language English
format Article
sources DOAJ
author Jean Joel Bigna
Angeladine M. Kenne
Aghiles Hamroun
Marie S. Ndangang
Audrey Joyce Foka
Dahlia Noelle Tounouga
Rémi Lenain
Marie A. Amougou
Jobert Richie Nansseu
spellingShingle Jean Joel Bigna
Angeladine M. Kenne
Aghiles Hamroun
Marie S. Ndangang
Audrey Joyce Foka
Dahlia Noelle Tounouga
Rémi Lenain
Marie A. Amougou
Jobert Richie Nansseu
Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis
Infectious Diseases of Poverty
Hepatitis B
Hepatitis C
Development
Africa
Gender
Pregnant
author_facet Jean Joel Bigna
Angeladine M. Kenne
Aghiles Hamroun
Marie S. Ndangang
Audrey Joyce Foka
Dahlia Noelle Tounouga
Rémi Lenain
Marie A. Amougou
Jobert Richie Nansseu
author_sort Jean Joel Bigna
title Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis
title_short Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis
title_full Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis
title_fullStr Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis
title_full_unstemmed Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis
title_sort gender development and hepatitis b and c infections among pregnant women in africa: a systematic review and meta-analysis
publisher BMC
series Infectious Diseases of Poverty
issn 2049-9957
publishDate 2019-03-01
description Abstract Background Although Africa is a region of hyper endemicity to viral hepatitis B (HBV) and C (HCV) infections, there is limited data on their related burden among pregnant women. The present systematic review and meta-analysis aimed to determine the magnitude of these infections among pregnant women living in Africa and investigate its association with gender-related human development indicators. Main text We searched PubMed, Embase, Web of Science, Africa Journal Online, and Global Index Medicus, with no language restriction, to identify observational studies on HBV and HCV infections in pregnant women residing in Africa published from January 1, 2000 until December 31, 2017. Eligible studies reported the prevalence of HBV and/or HCV infection(s) (HBs antigen and HCV antibodies) and/or infectivity (HBe antigen or detectable HCV viral load). Each study was independently reviewed for methodological quality. We used a random-effects model meta-analysis to pool studies. In total, 145 studies (258 251 participants, 30 countries) were included, of which 120 (82.8%) had a low, 24 (16.5%) a moderate, and one (0.7%) had a high risk of bias. The prevalence of HBV and HCV infections was 6.8% (95% confidence interval [CI]: 6.1–7.6, 113 studies) and 3.4% (95% CI: 2.6–4.2, 58 studies), respectively. The prevalence of HBe antigen and HCV detectable viral load was 18.9% (95% CI: 14.4–23.9) and 62.3% (95% CI: 51.6–72.5) in HBV positive and HCV positive pregnant women, respectively. The multivariable meta-regression analysis showed that the prevalence of HBV infection increased with decreasing gender development index, males’ level of education and females’ expected years of schooling. Furthermore, this prevalence was higher in rural areas and in western and central Africa. The prevalence of HCV infection increased with decreasing proportion of seats held by women in parliament. Conclusions To address the burden of HBV and HCV infections, beyond well-known risk factors at the individual-level, macro-level factors including gender-related human development indicators and dwelling in rural areas should be considered. In Africa, HBV or HCV infected mothers seems to have high potential of transmission to their children.
topic Hepatitis B
Hepatitis C
Development
Africa
Gender
Pregnant
url http://link.springer.com/article/10.1186/s40249-019-0526-8
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