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ADDITIONAL FILE 1

PRISMA 2009 Flow Diagram

Figure S.1. PRISMA based Flow diagram displaying the study selection [29].

E lig ib ili ty In cl u d e d Id e n ti f ca ti o n S cr e e n in g

Additional records identified by snowballing sampling

(references) (n=135) Records identified through a

search conducted per each individual African country

(n = 228) Records identified through

PubMed (n = 97), Embase (OVID) (n = 150)

Records excluded based on title and abstract (n = 567)

- Study not about VMB

- Cohort not from sub-Saharan Africa region - Participants not pregnant

Records screened (n = 610)

Full-text articles excluded, with reasons (n = 24) - Specific chosen group of microorganisms not

VMB (n =8)

- Vaginal swab was collected post-delivery (n =4) - Article with no separate data for pregnant group

(n =2)

- Molecular markers/metabolomics (n = 3) - Other study-design (review/abstract) (n= 2) - Data included in other article selected (n= 2) - Not currently pregnancy (n=2)

- Protocol for VMB paper (n=2) - Cultured based methodology (n= 2)

Full-text articles assessed for eligibility

(n = 43)

Selected articles that are duplicates (n =6)

Studies included in qualitative synthesis

(n = 10)

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