Better knowledge of the face of the current dengue virus (DENV) epidemiology in Africa can help to implement efficient strategies to curb the burden of dengue fever. We conducted this systematic review and meta-analysis to determine the prevalence of DENV infection in Africa. We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to June 10th, 2019 without any language restriction. We used a random-effects model to pool studies. A total of 76 studies (80,977 participants; 24 countries) were included. No study had high risk of bias. Twenty-two (29%) had moderate and 54 (71%) had low risk of bias. In apparently healthy individuals, the pooled prevalence of DENV was 15.6% (95% confidence interval 9.9–22.2), 3.5% (0.8–7.8), and 0.0% (0.0–0.5) respectively for immunoglobulins (Ig) G, IgM, and for ribonucleic acid (RNA) in apparently healthy populations. In populations presenting with fever, the prevalence was 24.8% (13.8–37.8), 10.8% (3.8–20.6k) and 8.4% (3.7–14.4) for IgG, IgM, and for RNA respectively. There was heterogeneity in the distribution between different regions of Africa. The prevalence of DENV infection is high in the African continent. Dengue fever therefore deserves more attention from healthcare workers, researchers, and health policy makers.
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. Electronic supplementary material The online version of this article (10.1186/s40249-019-0526-8) contains supplementary material, which is available to authorized users.
IntroductionThe burden of lower respiratory tract infections (LRTIs) is a substantial public health concern. However, the epidemiology of LRTI and its bacterial aetiologies are poorly characterised, particularly in the African continent. Providing accurate data can help design cost-effective interventions to curb the burden of respiratory infections in Africa. Therefore, the aim of this systematic review and meta-analysis will be to determine the prevalence of respiratory Bacterial Aetiologies in people with low Respiratory tract Infections in Africa (BARIAFRICA) and associated factors.Methods and analysisWe will search PubMed, EMBASE, Web of Science, African Journals Online, Cumulative Index to Nursing and Allied Health Literature, and Global Index Medicus to identify studies that reported the prevalence (of enough data to compute this estimate) of respiratory bacterial infections in people with LRTIs in Africa from 1 January 2000 to 31 March 2018, without any linguistic restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently by two investigators. Heterogeneity will be evaluated using the χ² test on Cochran’s Q statistic and quantified with H and I² statistics. Prevalence will be pooled using a random-effect meta-analysis model. Subgroup and meta-regression analyses will be used to identify sources of heterogeneity of prevalence estimates. This study will be reported according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationSince this study will be based on published data, it does not require ethical approval. This systematic review and meta-analysis is intended to serve as a basis for determining the burden of LRTIs, for identifying data gaps and for guiding future investigations in Africa. The final report will be published in peer-reviewed journals, presented in conferences and submitted to relevant health policy makers.PROSPERO registration numberCRD42018092359.
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