Prevalence of Five Clinically Relevant Genital Microorganisms Among Women in South America, 2014-2024: A Systematic Review and Meta-Analysis.

Background: Genital tract infections and dysbiosis-related conditions contribute substantially to women's sexual and reproductive morbidity. In South America, evidence on clinically relevant genital microorganisms remains fragmented across countries, populations, and diagnostic approaches. This systematic review and meta-analysis synthesized the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Gardnerella vaginalis, and Candida spp. among women in South America. Methods: We searched PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO for studies published from 1 January 2014 to 29 February 2024. Eligible studies reported prevalence data for at least one target microorganism in female populations from South American countries. Two reviewers independently screened studies, extracted data, and assessed methodological quality using Joanna Briggs Institute criteria for prevalence studies. Crude prevalence and random-effects pooled prevalence estimates with 95% confidence intervals were calculated. The review protocol was registered in PROSPERO (CRD420261324060). Results: Of 629 records identified, 51 studies from eight South American countries and French Guiana met the eligibility criteria for the systematic review, and 46 contributed to the main pooled prevalence meta-analysis. Substantial between-study heterogeneity was observed across all pathogen-specific analyses. Pooled prevalence was highest for G. vaginalis (28%), followed by Candida spp. (12%), C. trachomatis (7%), T. vaginalis (6%), and N. gonorrhoeae (3.2%). Conclusions: This review highlights the heterogeneous burden of clinically relevant genital microorganisms among women in South America and supports standardized diagnostic approaches, clearer phenotypic definitions, and stronger surveillance across underrepresented regional settings.