Burdens of Rubella and Cytomegalovirus infections among pregnant women in Africa: A systematic review and meta-analysis

Human Cytomegalovirus (CMV) and rubella virus have been linked to adverse pregnancy outcomes and birth defects such as hearing loss, developmental delay, and intellectual disability. Despite the burden of Cytomegalovirus and rubella infections remaining a major problem in Africa, there is no strong and extensive data on the burdens of all types of Cytomegaloviruses and rubella infections in Africa. Thus, this study aimed to assess the pooled prevalence of Cytomegalovirus and rubella infections and associated factors among pregnant women in Africa. Articles were retrieved through a comprehensive search strategy using PubMed, EMBASE, CINHAL (EBSCO), Google Scholar, DOAJ, Web of sciences, MEDLINE, Cochrane Library, and Google search. Data were extracted using a checklist. Data synthesis and statistical analysis were conducted using STATA version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effect model. A total of 322 articles were identified, of which 64 (a total of 23,467 pregnant women) were included in the review. The overall pooled prevalence of Cytomegalovirus G and Rubella G infections were 79% (95% CI: 74 to 85) and 78% (95% CI: 71 to 84) respectively. Northern Africa and Southern Africa had the highest prevalence of Cytomegalovirus G (100%) and Rubella G (86%), respectively. Cytomegalovirus infection was statistically associated with educational status, parity, residence, and age, whereas rubella infection was statistically associated with educational status and age. Cytomegalovirus and rubella infection burden was found to be high in Africa. To reduce the burdens of these infections, condition-based approaches and country context-specific appropriate preventive measures need to be implemented.