Burden of cervical lesion in Ethiopia: Systematic review and meta-analysis

Abstract Though cervical cancer is largely preventable, it is still the second most common female cancer globally and the leading cause of cancer deaths among females in African. Though many efforts has been done to study the burden of the disease in Ethiopia, there are still fragmented primary studies reported cervical lesion. Hence, this systematic review and meta-analysis aimed in estimating the pooled prevalence of cervical cancer and its trend in Ethiopia. Methods: This systematic review and meta-analysis was conducted using available data. PubMed, Web of Science, SCOPUS, Science Direct, Google Scholar, African Index Medicus (AIM), African Journals Online databases and Ethiopian University research repositories were searched following the Preferred Items for Systematic review and Meta-analysis (PRISMA) guideline. STATA 15 statistical software was used to analyse the data. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality appraisal tool for meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. A random effect model was computed to estimate the pooled prevalence of cervical lesion in Ethiopia. In addition, the trend of cervical lesion in the country was depicted. Result: Fifteen studies with a total of 25,348 participants were included in the analysis. The overall pooled prevalence of cervical lesion was 16.36 (95 CI: 10.97-21.75). The subgroup analysis by region showed the highest prevalence of cervical lesion at the Southern Nations and Nationalities Peoples Region (19.65%; 95% CI: 15.51 – 23.80). The trend of cervical lesion showed an increased pattern overtime from 1992 to 2018 in the meta-regression analysis. Conclusion: One among six of the study participants had cervical lesion. The trend also showed that there is still an increased cervical lesion in the country. Best practices in achieving high vaccination coverage shall be adapted from other successful countries. Key words: Cervical cancer, cervical lesion, systematic review, Ethiopia