Magnitude and predictors of gestational trophoblastic disease in East Africa: a systematic review and meta-analysis

Gestational Trophoblastic Disease (GTD) encompasses a spectrum of placenta-related disorders with significant health risks. Despite the varying reported prevalence rates in East Africa, no comprehensive meta-analysis has been conducted to synthesize the overall burden and predictors of GTD in this region.

Following the PRISMA guidelines, we conducted a systematic review and meta-analysis of studies from PubMed, Cochrane Library, and Google Scholar (search period: 2000-2024). We assessed heterogeneity (I² and Q tests), pooled estimates using a random-effects model, and evaluated publication bias using funnel plots and Egger's test. A sensitivity analysis was performed to test the robustness of the findings.

Eleven studies were included, revealing a pooled GTD magnitude of 10.5% (95% CI: 8.8-12.3; I² = 100%, p < 0.001). Significant predictors included prior GTD history (AOR = 3.2, 95% CI: 0.6-5.7; I² = 75.2%, p = 0.018) and grand multiparity (AOR = 8.9, 95% CI: 2.8-15.1; I² = 76%, p = 0.041). Subgroup analysis showed that complete molar pregnancies (37.8%, 95% CI: 5.9-69.8) were more prevalent than partial molar pregnancies (11.8%, 95% CI: 9.7-13.9), both with high heterogeneity (I² = 100%, p < 0.001).

Gestational trophoblastic disease remains a significant public health burden in East Africa, where delayed healthcare access contributes to worsened outcomes. Women with a history of gestational trophoblastic disease or high parity constitute high-risk populations that require targeted screening programs and early intervention strategies to improve their detection and management.