SYSTEMATIC REVIEW article

Front. Public Health

Sec. Infectious Diseases: Epidemiology and Prevention

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1543119

This article is part of the Research TopicReproductive Infectious Diseases: Matters Across the Spectrum of Reproductive HealthView all 5 articles

Prevalence and associated factors of syphilis among female sex workers in East Africa: A systematic review and meta-analysis

Provisionally accepted
  • 1Woldia University, Woldiya, Ethiopia
  • 2University of South Africa, Pretoria, South Africa

The final, formatted version of the article will be published soon.

Background: Syphilis is the most common sexually transmitted infection caused by Treponema pallidum, a pathogen that is exclusive to humans. Syphilis is a highly treatable infection, but if left untreated, it can result in serious health complications, including adverse reproductive outcomes, diminished quality of life, and an increased risk of Human Immunodeficiency Virus (HIV) transmission. Female sex workers (FSWs) are considered a high-risk group for the transmission of syphilis. Therefore, this review aimed to estimate the pooled prevalence of syphilis and identify the associated factors among female sex workers in the East African region.Methods: This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Databases such as PubMed/MEDLINE, Scopus, ScienceDirect, and Google Scholar search engines were explored to access eligible articles. STATA 11 statistical software was used to carry out the meta-analysis. A random-effects model was employed to estimate the pooled prevalence of syphilis and its predictors among female sex workers in the East African region. Higgen's I 2 test statistics was done to assess the heterogeneity of the included articles. Publication bias was evaluated visually using funnel plots and statistically through Egger's weighted regression test.Results: A total of 16,456 articles were retrieved, among which 24 studies involving 25,979 female sex workers were included in the final meta-analysis. The pooled estimates of syphilis among female sex workers were 14.7% (95%CI: 11.06-18.35) and I 2 of 99.1%, p=0.000. Sub-group analyses were conducted based on country and publication year to address heterogeneity. The results revealed that the highest prevalence was 18.48% (95% CI:11.064-25.899) in Ethiopia and 2.79% (95% CI: 1.49-4.09) in Kenya. Regarding publication year, the prevalence was 16.3% (95% CI: 12.01-20.61) in studies conducted before 2014 and 12.5% (95% CI: 5. 85-19.16) in studies conducted after 2014. Among the factors old age was a significant predictor of syphilis among female sex workers.Conclusions: This review revealed a relatively higher prevalence of syphilis compared to the global estimate. To effectively curb syphilis among female sex workers in East Africa, intervention strategies should address the high prevalence and key associated factors through comprehensive approaches.

Keywords: Syphilis, Treponema pallidum, Female sex workers, predictors, East Africa, Meta-analysis

Received: 10 Dec 2024; Accepted: 04 Jun 2025.

Copyright: © 2025 Gedfie, Kassahun, Jemal, Gashaw, Bazezew, Debash, Kumie, Misganaw, Tefera, Alemu, Mezgebu, Kassanew, Tamrat, Abebe, Ashagre, Sisay, Gashaw and Reta. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Solomon Gedfie, Woldia University, Woldiya, Ethiopia

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