Abstract
BackgroundSyphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors.MethodsA comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively.ResultWe identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68–2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92–3.14%) and 1.90% (95% CI, 0.40–3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86–5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57–2.75) in Amhara and 1.46% (95% CI, 0.69–2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12–0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15–7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35–17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60–1.01%).ConclusionThis study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations.Systematic review registrationPROSPERO CRD42020211650
Highlights
Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries
Pooled prevalence of syphilis‐Human immunodeficiency virus (HIV) co‐infection among pregnant women The overall pooled prevalence of syphilis-HIV co-infection among pregnant women in this meta-analysis was 0.80% (Fig. 4)
Pregnant women who had previous history of sexually transmitted infection (STI) were more than four times more likely to develop syphilis than women who had no such history, odds ratio (OR) 4.88, whereas married women had 63% lower risk of having syphilis compared to those who are not cohabiting, OR 0.37 (Table 4)
Summary
Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Syphilis is a sexually transmitted infection (STI) caused by the spirochete Treponema pallidum, and it continues to be a main public health problem worldwide [1]. It spreads primarily through sexual contact and vertical transmission and can rarely be spread through blood. Pregnant women are sexually active and are at risk of STI, including syphilis [4]. More than half of infected women transmit the infection to their babies resulting in adverse pregnancy outcomes including early fetal death, stillbirth, preterm birth, low birth weight, neonatal death, and congenital infection in infants [5]
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