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Prevalence and characteristics of malaria co-infection among individuals with visceral leishmaniasis in Africa and Asia: a systematic review and meta-analysis.
Parasit Vectors. 2021 Oct 23; 14(1):545.PV

Abstract

BACKGROUND

Malaria and visceral leishmaniasis (VL) co-infection can occur due to the overlapping geographical distributions of these diseases; however, only limited data of this co-infection have been reported and reviewed. This study aimed to explore the pooled prevalence and characteristics of this co-infection using a systematic review approach.

METHODS

The PubMed, Web of Science and Scopus databases were searched for relevant studies. The quality of these studies was assessed in accordance with strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. The numbers of individuals co-infected with Plasmodium and VL and the total numbers of individuals with VL were used to estimate the pooled prevalence using random-effects models. Differences in age, sex and the presence of anemia and malnutrition on admission were compared between co-infected individuals and individuals with VL using a random-effects model; the results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity among the included studies was assessed and quantified using Cochrane Q and I2 statistics.

RESULTS

Of the 3075 studies identified, 12 met the eligibility criteria and were included in this systematic review. The pooled prevalence of Plasmodium infection among the 6453 individuals with VL was 13%, with substantial heterogeneity of the data (95% CI 7-18%, I2 97.9%). Subgroup analysis demonstrated that the highest prevalence of co-infection occurred in African countries, whereas the lowest prevalence occurred in Asian countries. Patients aged < 5 years had higher odds of having co-infection than having VL (co-infection, n = 202; VL, n = 410) (OR 1.66, 95% CI 1.37-2.01, I2 0%; P < 0.0001), whereas patients aged 20-29 years had lower odds of having co-infection than having VL (co-infection, n = 170; VL, n = 699) (OR 0.75, 95% CI 0.60-0.93, I2 18%; P = 0.01). Male patients had equivalent odds of having co-infection and having VL (co-infection, n = 525; VL, n = 2232) (OR 0.92, 95% CI 0.078-1.08, I2 0%; P = 0.29). Patients with co-infection had lower odds of having anemia at admission than those with VL (co-infection, n = 902; VL, n = 2939) (OR 0.64, 95% CI 0.44-0.93, I2 0%; P = 0.02). No difference in malnutrition at admission was found in the meta-analysis.

CONCLUSIONS

The prevalence of malaria co-infection among individuals with VL was heterogeneous and ranged from 7 to 18%, depending on geographical area. Age and anemia at admission were associated with co-infection status. Further longitudinal studies are needed to determine if co-infection with malaria has an impact on the severity of VL.

Authors+Show Affiliations

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, 80160, Thailand.Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, 10100, Manila, Philippines.Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, 10100, Manila, Philippines.Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, 80160, Thailand.Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, 80160, Thailand. manas.ko@wu.ac.th.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

34688312

Citation

Wilairatana, Polrat, et al. "Prevalence and Characteristics of Malaria Co-infection Among Individuals With Visceral Leishmaniasis in Africa and Asia: a Systematic Review and Meta-analysis." Parasites & Vectors, vol. 14, no. 1, 2021, p. 545.
Wilairatana P, Chanmol W, Rattaprasert P, et al. Prevalence and characteristics of malaria co-infection among individuals with visceral leishmaniasis in Africa and Asia: a systematic review and meta-analysis. Parasit Vectors. 2021;14(1):545.
Wilairatana, P., Chanmol, W., Rattaprasert, P., Masangkay, F. R., Milanez, G. J., Kotepui, K. U., & Kotepui, M. (2021). Prevalence and characteristics of malaria co-infection among individuals with visceral leishmaniasis in Africa and Asia: a systematic review and meta-analysis. Parasites & Vectors, 14(1), 545. https://doi.org/10.1186/s13071-021-05045-1
Wilairatana P, et al. Prevalence and Characteristics of Malaria Co-infection Among Individuals With Visceral Leishmaniasis in Africa and Asia: a Systematic Review and Meta-analysis. Parasit Vectors. 2021 Oct 23;14(1):545. PubMed PMID: 34688312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and characteristics of malaria co-infection among individuals with visceral leishmaniasis in Africa and Asia: a systematic review and meta-analysis. AU - Wilairatana,Polrat, AU - Chanmol,Wetpisit, AU - Rattaprasert,Pongruj, AU - Masangkay,Frederick Ramirez, AU - Milanez,Giovanni De Jesus, AU - Kotepui,Kwuntida Uthaisar, AU - Kotepui,Manas, Y1 - 2021/10/23/ PY - 2021/08/31/received PY - 2021/09/29/accepted PY - 2021/10/24/entrez PY - 2021/10/25/pubmed PY - 2022/1/1/medline KW - Co-infection KW - Leishmania KW - Leishmaniasis KW - Malaria KW - Plasmodium KW - Visceral leishmaniasis SP - 545 EP - 545 JF - Parasites & vectors JO - Parasit Vectors VL - 14 IS - 1 N2 - BACKGROUND: Malaria and visceral leishmaniasis (VL) co-infection can occur due to the overlapping geographical distributions of these diseases; however, only limited data of this co-infection have been reported and reviewed. This study aimed to explore the pooled prevalence and characteristics of this co-infection using a systematic review approach. METHODS: The PubMed, Web of Science and Scopus databases were searched for relevant studies. The quality of these studies was assessed in accordance with strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. The numbers of individuals co-infected with Plasmodium and VL and the total numbers of individuals with VL were used to estimate the pooled prevalence using random-effects models. Differences in age, sex and the presence of anemia and malnutrition on admission were compared between co-infected individuals and individuals with VL using a random-effects model; the results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity among the included studies was assessed and quantified using Cochrane Q and I2 statistics. RESULTS: Of the 3075 studies identified, 12 met the eligibility criteria and were included in this systematic review. The pooled prevalence of Plasmodium infection among the 6453 individuals with VL was 13%, with substantial heterogeneity of the data (95% CI 7-18%, I2 97.9%). Subgroup analysis demonstrated that the highest prevalence of co-infection occurred in African countries, whereas the lowest prevalence occurred in Asian countries. Patients aged < 5 years had higher odds of having co-infection than having VL (co-infection, n = 202; VL, n = 410) (OR 1.66, 95% CI 1.37-2.01, I2 0%; P < 0.0001), whereas patients aged 20-29 years had lower odds of having co-infection than having VL (co-infection, n = 170; VL, n = 699) (OR 0.75, 95% CI 0.60-0.93, I2 18%; P = 0.01). Male patients had equivalent odds of having co-infection and having VL (co-infection, n = 525; VL, n = 2232) (OR 0.92, 95% CI 0.078-1.08, I2 0%; P = 0.29). Patients with co-infection had lower odds of having anemia at admission than those with VL (co-infection, n = 902; VL, n = 2939) (OR 0.64, 95% CI 0.44-0.93, I2 0%; P = 0.02). No difference in malnutrition at admission was found in the meta-analysis. CONCLUSIONS: The prevalence of malaria co-infection among individuals with VL was heterogeneous and ranged from 7 to 18%, depending on geographical area. Age and anemia at admission were associated with co-infection status. Further longitudinal studies are needed to determine if co-infection with malaria has an impact on the severity of VL. SN - 1756-3305 UR - https://www.unboundmedicine.com/medline/citation/34688312/Prevalence_and_characteristics_of_malaria_co_infection_among_individuals_with_visceral_leishmaniasis_in_Africa_and_Asia:_a_systematic_review_and_meta_analysis_ DB - PRIME DP - Unbound Medicine ER -