Prevalence of maternal Group B Streptococcus rectovaginal colonization among pregnant women in Ethiopia: protocol for a systematic review and meta-analysis

Abstract Background: Rectovaginal colonization with Group B streptococcus (GBS) during pregnancy is an important risk factor for serious infections including neonatal sepsis, pneumonia, and meningitis. It is also associated with stillbirth and preterm birth. Since globally rates of GBS colonization, as well as rates of vertical transmission to the newborn, differ broadly, having national data is important for implementing strategies to reduce neonatal morbidity and mortality as a result of GBS infection. We propose this systematic review and meta-analysis to describe the prevalence of rectovaginal GBS colonization, rate of vertical transmission, and the antibiotic resistance pattern among third trimester pregnant women in Ethiopia.Methods: A systematic search will be done of PubMed (MEDLINE), EMBASE, CINHAL, and Cochrane Library. In addition, google scholar will be searched, and a reference list of the already identified articles will be checked to find additional eligible articles that were missed during the initial search. Two reviewers will screen all retrieved articles and assess the methodological quality of included studies using the Newcastle-Ottawa Scale (NOS) checklist. Any disagreement between two reviewers will be resolved by a third reviewer. We will extract data using the JBI data extraction tool for the systematic review of prevalence studies. The data analysis will be conducted using Stata Statistical Software: Release 15. We will present pooled estimates of the prevalence of GBS colonization and rates of vertical transmission with a 95% confidence interval.Discussion: This will be the first synthesis of data on GBS during pregnancy at a national level. It will inform decision-makers in determining whether a universal or a risk-based screening strategy is most appropriate, as well as guiding them in adopting an intrapartum antibiotic protocol.Registration: Submitted to PROSPERO on 18/03/2021