Prevalence and Molecular Epidemiology of Human T-Lymphotropic Virus Type 1 among Women Attending Antenatal Clinics in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
Human T-cell lymphotropic virus type 1 (HTLV-1) imposes a substantial disease burden in sub-Saharan Africa (SSA), which is arguably the world's largest endemic area for HTLV-1. Evidence that mother-to-child transmission persists as a major mode of transmission in SSA prompted us to estimate the...
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Published in | The American journal of tropical medicine and hygiene Vol. 101; no. 4; pp. 908 - 915 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Institute of Tropical Medicine
01.01.2019
The American Society of Tropical Medicine and Hygiene |
Subjects | |
Online Access | Get full text |
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Summary: | Human T-cell lymphotropic virus type 1 (HTLV-1) imposes a substantial disease burden in sub-Saharan Africa (SSA), which is arguably the world's largest endemic area for HTLV-1. Evidence that mother-to-child transmission persists as a major mode of transmission in SSA prompted us to estimate the pooled prevalence of HTLV-1 among pregnant women throughout the region. We systematically reviewed databases including EMBASE, MEDLINE, Web of Science, and the Cochrane Database of Systemic Reviews from their inception to November 2018. We selected studies with data on HTLV-1 prevalence among pregnant women in SSA. A random effect meta-analysis was conducted on all eligible data and heterogeneity was assessed through subgroup analyses. A total of 18 studies, covering 14,079 pregnant women, were selected. The evidence base was high to moderate in quality. The pooled prevalence, per 100 women, of the 18 studies that screened HTLV-1 was 1.67 (95% CI: 1.00-2.50), a figure that masks regional variations. In Western, Central, Southern, and Eastern Africa, the numbers were 2.34 (1.68-3.09), 2.00 (0.75-3.79), 0.30 (0.10-0.57), and 0.00 (0.00-0.21), respectively. The prevalence of HTLV-1 infection among pregnant women in SSA, especially in Western and Central Africa, strengthens the case for action to implement routine screening of pregnant women for HTLV-1. Rigorous studies using confirmatory testing and molecular analysis would characterize more accurately the prevalence of this infection, consolidate the evidence base, and further guide beneficial interventions. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 Authors’ addresses: Alain M. Ngoma, Douglas Hospital Research Centre, McGill University, Montreal, Canada, E-mail: alain.ngoma@mail.mcgill.ca. Paulin M. Beya, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, E-mail: paulin.mutombo@unikin.ac.cd. Magot D. Omokoko, Hôpital de la Cité-de-la Santé, Affiliated to the University of Montreal, Laval, Canada, E-mail: magot.diata.omokoko@umontreal.ca. Eddy S. Mvika, Centre National de Transfusion Sanguine, Kinshasa, Democratic Republic of the Congo, E-mail: eddymvika@yahoo.fr. Kenneth E. Nollet, Department of Blood Transfusion and Transplantation Immunology and Radiation Medical Science Center, Fukushima Medical University, Fukushima, Japan, E-mail: nollet@fmu.ac.jp. Hitoshi Ohto, Radiation Medical Science Center, Fukushima Medical University, Fukushima, Japan, E-mail: hit-ohto@fmu.ac.jp. |
ISSN: | 0002-9637 1476-1645 |
DOI: | 10.4269/ajtmh.19-0182 |