Umbrella review and meta-analysis on malaria infection and associated factors among pregnant women in Africa, 2026

Malaria remains a formidable public health challenge in Africa, disproportionately affecting vulnerable populations. Pregnant women are specifically at risk due to physiological and immunological changes that increase susceptibility to infection, leading to severe maternal and neonatal outcomes such as anaemia and low birth weight. Even though there were many systematic reviews and meta-analysis in Africa, existing systematic reviews and meta-analysis were fragmented, regionally focused, and overlapping of primary study metrics was not determined before. This umbrella review aimed to synthesize evidence from existing systematic reviews and meta-analyses to estimate the pooled prevalence of malaria infection among pregnant women in Africa and identify key associated risk factors to inform evidence-based control strategies. Following PRIOR and Joanna Briggs Institute guidelines, a systematic search was conducted across six international databases for studies published between February1/2016 up to February1/2026. Ten high-quality systematic reviews (AMSTAR-2) involving a total of 139,256 participants were included. Data synthesis was performed using a random-effects model to account for anticipated variability. The overall pooled prevalence of malaria infection among pregnant women was 20.74% (95% CI 14.07, 27.41). However, extreme heterogeneity was observed (I 2 =99.85%), with regional estimates ranging from 6.49 to 34.3%. Significant risk factors identified included the non-use of insecticide-treated nets (AOR: 4.31; 95% CI 1.37–7.24) and proximity to stagnant water bodies (AOR: 4.21; 95% CI 2.13–6.30). Malaria infection remains a critical threat to maternal health in Africa, characterized by significant regional variation. Providing insecticide-treated nets and avoiding stagnant water were the major prevention methods of malaria infection.