Sexually transmitted infections in the middle east and North Africa: comprehensive systematic review and meta-analysis

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 1229 - 23
• Main Authors: Obeid, Dalia, Alsuwairi, Feda, Alnemari, Rawan, Al-Qahtani, Ahmed, Kurdi, Wesam, Alfareh, Manal, Alsanea, Madain, Alabdulkareem, Maha, Alharbi, Layla, Alhamlan, Fatimah S.
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.11.2024; BioMed Central; BMC
• Subjects: Africa, Northern - epidemiology; Analysis; Annual reports; Cancer; Candida; Chlamydia; Cytomegalovirus; Drug resistance; Epidemiology; Female; Gender; Gonorrhea; HBV; HCV; Hepatitis B; Hepatitis C; HIV; HPV; Human immunodeficiency virus; Human papillomavirus; Humans; Infections; Infertility; Male; Medical screening; Medical Subject Headings-MeSH; MENA; Meta-analysis; Middle East - epidemiology; Mycoplasma; Non-specific urethritis; Papillomavirus Infections - epidemiology; Papillomavirus Infections - virology; Pathogens; Prevalence; Prevention; Public health; Regional analysis; Risk factors; Serology; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; STD; Stigma (Social psychology); STIs; Surveillance systems; Syphilis; Systematic review; Ureaplasma; Urethritis; Vaccination; Vaginosis; Viral infections; Viruses; Womens health; Middle East; Africa, Northern; Northern Africa; Egypt; Sudan; North Africa; Libya; Bahrain; Oman; Syria; Saudi Arabia; Lebanon; Turkey; Iran; Morocco; Qatar; Algeria; Iraq; Kuwait; Tunisia; Yemen; Bacterial vaginosis (BV); Candidiasis; HIV; Ureaplasma; Nongonococcal urethritis (NGU); HCV; HBV; STIs; HPV; MENA
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-10153-1

Globally, sexually transmitted infections (STIs) collectively cause 2.3 million deaths and 1.2 million cases of cancer annually. However, the epidemiology of STIs in the Middle East and North Africa (MENA) is not well assessed because of various social and cultural factors. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and covering 23 MENA countries, 19 STIs, and data from 20,435,971 participants. PubMed, Embase, regional and international databases, and country-level reports were searched up to May 2024. The analysis revealed significant regional variations in the prevalence of STIs within the MENA region. In North Africa, the most common STIs were bacterial vaginosis (31%), human papillomavirus (HPV, 23%), and Candida spp. (15%). In the Gulf Cooperation Council region and Yemen, Ureaplasma (25%), nongonococcal urethritis (NGU, 16%), and Mycoplasma spp. (12%) were the predominant infections. In the Levant region, the top STIs were HPV (20%), hepatitis B virus (HBV, 9%), and Candida spp. (9%). In Iran, Ureaplasma spp. (18%), HPV (17%), and cytomegalovirus (8%) were the most prevalent infections, whereas Ureaplasma spp. (20%), Candida spp. (18%), and HPV (16%) were most frequently detected in Türkiye. Gender-based disparities were observed, with a higher prevalence of Ureaplasma spp., Neisseria gonorrhoeae, and herpes in men and higher rates of Mycoplasma spp., HPV, HBV, and Candida spp. in women. Overall, high rates of nongonococcal urethritis (16.3%), Ureaplasma spp. (13.7%), HPV (12.7%), and Candida spp. (9.4%) were recorded in the MENA region. Most MENA countries lack national STI screening programs, and the reported data are primarily from symptomatic individuals. Establishing robust surveillance systems, addressing stigma and barriers to healthcare access, and expanding STIs screening and vaccination programs are crucial for accurately capturing the true burden of STIs in MENA countries.