Dominance of antimicrobial resistance bacteria and risk factors of bacteriuria infection among pregnant women in East Africa: implications for public health
Bibliographic record
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".