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Abstract：
BACKGROUND: The peripartum period is both a highly vulnerable stage and a significant indicator of a population\'s health status. Interest is increasing in human T-cell lymphotropic virus type-1 (HTLV-1) transmission due to its adverse health impacts. However, nationally representative data on HTLV-1 that are important for health planning are unavailable for this subpopulation.
OBJECTIVE: This study aimed to conduct a pooled estimate of HTLV-1 prevalence among pregnant women in Nigeria to quantify its clinical burden and public health implications.
METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 statement.
RESULTS: After a systematic review of the Nigerian literature, 12 studies (2,821 pregnant or postnatal women) were included in the final evidence synthesis. The estimated HTLV-1 prevalence in Nigerian peripartum women following a positive screening test by enzyme-linked immunosorbent assay was 5.44% (95% confidence interval [CI], 3.16%-9.20%). A subgroup analysis of the 2 major regions showed a slightly higher prevalence in the Western versus Southern region (5.55% [95% CI, 2.49%-11.87%]; and 4.91% [95% CI, 2.11%-11.02%]; P=0.84). However, a subgroup analysis by geopolitical zone revealed that Southwestern and Northwestern Nigeria had the highest prevalence (9.23% [95% CI, 4.35%-18.55%; I2=93%] and 7.15% [95% CI, 1.54%-27.54%]; I2=92%). Our decade-old subgroup analysis found inconsistencies in the HTLV-1 prevalence. Furthermore, our literature review revealed a prevalence of HTLV infection among patients with various clinical types of lymphomas/leukemias and myelopathy of 2%-22%.
CONCLUSIONS: These findings have important implications in defining the epidemiological patterns of HTLV-1 infection in Nigeria. They also suggest the presence of HTLV-endemic clusters near low-endemic areas, even within the same geopolitical zones.
OBJECTIVE: This study aimed to conduct a pooled estimate of HTLV-1 prevalence among pregnant women in Nigeria to quantify its clinical burden and public health implications.
METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 statement.
RESULTS: After a systematic review of the Nigerian literature, 12 studies (2,821 pregnant or postnatal women) were included in the final evidence synthesis. The estimated HTLV-1 prevalence in Nigerian peripartum women following a positive screening test by enzyme-linked immunosorbent assay was 5.44% (95% confidence interval [CI], 3.16%-9.20%). A subgroup analysis of the 2 major regions showed a slightly higher prevalence in the Western versus Southern region (5.55% [95% CI, 2.49%-11.87%]; and 4.91% [95% CI, 2.11%-11.02%]; P=0.84). However, a subgroup analysis by geopolitical zone revealed that Southwestern and Northwestern Nigeria had the highest prevalence (9.23% [95% CI, 4.35%-18.55%; I2=93%] and 7.15% [95% CI, 1.54%-27.54%]; I2=92%). Our decade-old subgroup analysis found inconsistencies in the HTLV-1 prevalence. Furthermore, our literature review revealed a prevalence of HTLV infection among patients with various clinical types of lymphomas/leukemias and myelopathy of 2%-22%.
CONCLUSIONS: These findings have important implications in defining the epidemiological patterns of HTLV-1 infection in Nigeria. They also suggest the presence of HTLV-endemic clusters near low-endemic areas, even within the same geopolitical zones.
摘要：
围产期既是一个高度脆弱的阶段，也是一个人口健康状况的重要指标。由于人类T细胞白血病病毒1型（HTLV-1）的不良健康影响，其传播的兴趣正在增加。然而,对健康规划重要的HTLV-1的全国代表性数据无法用于该亚人群.这项研究旨在对尼日利亚孕妇的HTLV-1患病率进行汇总估计，以量化其临床负担和公共卫生影响。本系统评价是根据2020年系统评价和荟萃分析的首选报告项目进行的。在对尼日利亚文献进行系统回顾之后，12项研究（2821名孕妇或产后妇女）被纳入最终证据综合。通过酶联免疫吸附试验进行阳性筛查后，尼日利亚围产期妇女的估计HTLV-1患病率为5.44％（95％置信区间[CI]，3.16-9.20%）。对两个主要地区的亚组分析显示，西部地区与南部地区的患病率略高（5.55％[95％CI，2.49-11.87％]；4.91％[95％CI，2.11-11.02]；P=0.84）。然而,按地缘政治地区进行的亚组分析显示,尼日利亚西南部和西北部的患病率最高(9.23%[95%CI,4.35-18.55;I2,93%]和7.15%[95%CI,1.54-27.54];I2,92%).我们十年前的亚组分析发现HTLV-1患病率不一致。此外，我们的文献综述显示,在各种临床类型的淋巴瘤/白血病和脊髓病患者中,HTLV感染率为2-22%.这些发现对确定尼日利亚HTLV-1感染的流行病学模式具有重要意义。他们还表明，在低流行区附近存在HTLV流行簇，即使在相同的地缘政治区内。
