ABSTRACTBackground: Tuberculosis (TB) and Human immunodeficiency Virus (HIV) co-infection is a global public health concern. Sub-Sahara Africa (SSA) has a double burden of TB and HIV. Although pregnant women are vulnerable population to both TB and HIV, little is known about the burden of their co-infection. Therefore, this study systematically …
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ABSTRACTBackground: Tuberculosis (TB) and Human immunodeficiency Virus (HIV) co-infection is a global public health concern. Sub-Sahara Africa (SSA) has a double burden of TB and HIV. Although pregnant women are vulnerable population to both TB and HIV, little is known about the burden of their co-infection. Therefore, this study systematically mapped evidence on the burden of TB-HIV co-infection among pregnant women in SSA with a focus on incidence, prevalence, and mortality.Methods: We used the scoping review guidelines provided by Arksey & O’Malley, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. We searched PubMed, Google Scholar, and ScienceDirect electronic databases for relevant studies. The reference list of included studies was also searched for relevant studies. To reduce selection bias, two reviewers independently screened the articles at the abstract and full text screening phases using the eligibility criteria as a guide. Data extraction was performed using a pilot form by one reviewer and cross-checked by a second reviewer to ensure accuracy and reliability of this study findings. Thematic analysis was conducted, and the outcomes organised into themes and sub-themes, and a summary of the findings reported. The results of this study were presented using the Preferred Reporting Items for Systematic Reviews and Meta-analysis: Extension for Scoping Review as a guide. Results: Of the total 99 articles screened, 8 of them met the eligibility criteria and were included for data extraction. All the studies were conducted in health facility-based from 3 different countries in SSA. Five studies, representing 62.5% presented evidence from South Africa, 2 (25%) studies reported from Kenya, and the last 1 (12.5%) reported evidence from Ethiopia. The finding from the included studies revealed that the prevalence and mortality attributable to TB-HIV co-infection among pregnant women was increasing. No study was found reporting evidence on the incidence of TB-HIV coinfection among pregnant women. We found no evidence from over 40 SSA countries on the burden of TB-HIV coinfection among pregnant women.Conclusion: This study’s findings suggest there is an increasing prevalence of TB-HIV co-infection among pregnant women in SSA although we found limited studies. We recommend TB screening and testing should be integrated with prevention of mother-to-child transmission services to facilitate early diagnosis of new TB-HIV coifection cases for treatment. This study also revealed a worrying research gap with regards to studies investigating the burden of TB-HIV coinfection in SSA. Therefore, more epidemiological studies investigating the burden of TB-HIV co-infection among pregnant women to inform policy in SSA, particularly in high TB-HIV prevalence countries are urgently needed.Keywords: Prevalence, Incidence, Mortality, Tuberculosis, Human Immuno-deficienncy Virus, Co-infection, Pregnant women, Sub-Saharan Africa.
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