Abstract
Background Bacterial infections in pregnancy pose significant health risks in East Africa. This study estimates pooled prevalence and identifies key risk factors, addressing limited data to improve maternal health outcomes in the region.
Methods This study employed a systematic review and meta-analysis, analyzing data from eight East African studies (2016–2021). Searches spanned PubMed, Embase, Scopus, and more, with manual reference checks. Data quality was assessed via the Newcastle-Ottawa Scale. RevMan software with a random-effects model estimated pooled prevalence and hazard ratios for risk factors.
Results A pooled analysis of antimicrobial resistance (AMR) bacterial isolates from pregnant women in East Africa highlights concerning prevalence rates of various pathogens. Escherichia coli emerged as the most common pathogen, present in 43% (95% CI: 37–48%) of cases, followed by Staphylococcus aureus at 20% (95% CI: 0.12, 0.29) and Corynebacterium, Enterococcus, and Nocardia species (CONs) in 16% (95% CI: 10–23%) and 16% (95% CI: 12–21%) (Prevalence of K. pneumoniae). A very small proportion 6% (95% CI: 2 − 11%) was found to be infected with Pseudomonas aeruginosa. The forest plot highlights risk factors for infections in pregnant women in East Africa: antibiotic use (HR: 2.0, 95% CI: 1.5–2.6), smoking (HR: 1.3, 95% CI: 1.0–1.6), poor sanitation (HR: 1.8, 95% CI: 1.2–2.4), diabetes (HR: 2.1, 95% CI: 1.5–2.8), and age > 30 years (HR: 1.5, 95% CI: 1.1–2.0).
Conclusions This analysis reveals a significant prevalence of bacterial infections, particularly Escherichia coli, among pregnant women in East Africa, with antimicrobial resistance (AMR) complicating treatment. The study identified several key risk factors, including antibiotic use, smoking, poor sanitation, diabetes, and age over 30, which are associated with higher rates of infection. While these findings emphasize the need for further research, the results suggest that routine bacterial screening, AMR surveillance, improved sanitation, and antibiotic stewardship are important steps in mitigating the impact of these infections. Public health strategies should prioritize high-risk groups, encourage hygiene practices, and continue to guide policy and interventions through ongoing studies.
© The Author(s) 2025.
Methods This study employed a systematic review and meta-analysis, analyzing data from eight East African studies (2016–2021). Searches spanned PubMed, Embase, Scopus, and more, with manual reference checks. Data quality was assessed via the Newcastle-Ottawa Scale. RevMan software with a random-effects model estimated pooled prevalence and hazard ratios for risk factors.
Results A pooled analysis of antimicrobial resistance (AMR) bacterial isolates from pregnant women in East Africa highlights concerning prevalence rates of various pathogens. Escherichia coli emerged as the most common pathogen, present in 43% (95% CI: 37–48%) of cases, followed by Staphylococcus aureus at 20% (95% CI: 0.12, 0.29) and Corynebacterium, Enterococcus, and Nocardia species (CONs) in 16% (95% CI: 10–23%) and 16% (95% CI: 12–21%) (Prevalence of K. pneumoniae). A very small proportion 6% (95% CI: 2 − 11%) was found to be infected with Pseudomonas aeruginosa. The forest plot highlights risk factors for infections in pregnant women in East Africa: antibiotic use (HR: 2.0, 95% CI: 1.5–2.6), smoking (HR: 1.3, 95% CI: 1.0–1.6), poor sanitation (HR: 1.8, 95% CI: 1.2–2.4), diabetes (HR: 2.1, 95% CI: 1.5–2.8), and age > 30 years (HR: 1.5, 95% CI: 1.1–2.0).
Conclusions This analysis reveals a significant prevalence of bacterial infections, particularly Escherichia coli, among pregnant women in East Africa, with antimicrobial resistance (AMR) complicating treatment. The study identified several key risk factors, including antibiotic use, smoking, poor sanitation, diabetes, and age over 30, which are associated with higher rates of infection. While these findings emphasize the need for further research, the results suggest that routine bacterial screening, AMR surveillance, improved sanitation, and antibiotic stewardship are important steps in mitigating the impact of these infections. Public health strategies should prioritize high-risk groups, encourage hygiene practices, and continue to guide policy and interventions through ongoing studies.
© The Author(s) 2025.
| Original language | English |
|---|---|
| Article number | 98 |
| Journal | Journal of Health, Population and Nutrition |
| Volume | 44 |
| Issue number | 1 |
| Online published | 2 Apr 2025 |
| DOIs | |
| Publication status | Published - Dec 2025 |
| Externally published | Yes |
Funding
There is no fund received from any organization to conduct this study. However, expense for data collection was covered by principal investigator.
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
-
SDG 3 Good Health and Well-being -
SDG 6 Clean Water and Sanitation
Research Keywords
- Antimicrobial Resistance (AMR)
- Bacterial infections
- Escherichia coli
- Pregnant women
- Public Health interventions
Publisher's Copyright Statement
- This full text is made available under CC-BY-NC-ND 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/
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