Bacterial Profile and asymptomatic bacteriuria among pregnant women in Africa: A systematic review and meta analysis

Abstract

Background: 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. Methods: Systematic search of published studies done on PubMed, EMBASE, Web of Science, SCOPUS, Psy-chInfo, 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 TM 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. Findings: 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 Escherichia coli with pooled prevalence 33.4% (95% CI: 27.3 -39.4) Interpretation: 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.

Prevalence of Asymptomatic Bacteriuria (ASB) in Pregnant Women in India: A Systematic Review and Meta-Analysis

“…revealed variation in the prevalence with highest prevalence 22% in West Africa with heterogeneity index (I 2 ) of 98.34% ( P < 0.001) and the lowest prevalence 11% in North Africa. [ 69 ] The variation in our study was less as compared to the one conducted in Africa.…”

“…Meta-analysis that involved 15,108 pregnant Iranian women from mainly cross-sectional studies showed overall prevalence of ASB as 13% in Iran and Africa reported the prevalence of 11.1% (95% CI: 7.8, 14.4), which was comparable to the present study. [ 68 , 69 ]…”

Gambaran Pola Kuman dan Sensitivitas Antibiotik pada Ibu Hamil dengan Bakteriuria Asimtomatik yang Berobat ke RSUD dr. Zainoel Abidin

“…Bakteriuria asimtomatik adalah kolonisasi bakteri yang persisten pada traktus urinarius tanpa gejala simtomatik atau klinis dengan ditemukannya bakteri >10 5 cfu/ml yang diambil dari sampel urin midstream (Awoke dkk., 2021). Pada ibu hamil terjadi perubahan anatomi, fisiologi serta penurunan sistem imun, sehingga sangat rentan untuk terjadinya bakteriuria asimtomatik, dan bisa berlanjut menjadi infeksi saluran kemih yang mempunyai gejala klinis (Azami dkk., 2019).…”

Prevalence, antimicrobial susceptibility profile, and associated risk factors of uropathogenic Escherichia coli among pregnant women attending Dr. Sumait Hospital Mogadishu, Somalia

“…Escherichia coli is the most prevalent pathogen, causing between 75% and 90% of bacteriuria in pregnant women (7)(8)(9). Additionally, pregnant women are considered vulnerable hosts for UTIs due to the physiological changes associated with pregnancy, leading to compromised immunity (4).…”