Malaria and helminth co-infections in children living in endemic countries: A systematic review with meta-analysis

Background Current knowledge on the burden of, and interactions between malaria helminth co-infections, as well impact of dual infections anaemia, remains inconclusive. We have conducted a systematic review with meta-analysis to update current first step towards developing deploying coordinated approaches control and, ultimately, elimination malaria-helminth co-infections among children living in endemic countries. Methodology/Principal findings searched Medline, Embase, Global Health Web Science from each database inception until 16 March 2020, for peer-reviewed articles reporting No language restriction was applied. Following removal duplicates, two reviewers independently screened studies eligibility. used summary odds ratio (OR) 95% confidence intervals (CI) measure association (random-effects model). also performed Chi-square heterogeneity test based Cochrane’s Q evaluated severity using I 2 statistics. The included were examined publication bias funnel plot statistical significance assessed Egger’s (bias if p<0.1). Fifty-five 3,507 citations eligible, 28 which had sufficient data meta-analysis. enrolled 22, 114 13 countries across sub-Saharan Africa, Southeast Asia South America. Overall, pooled estimates showed prevalence Plasmodium -helminth 17.7% (95% CI 12.7–23.2%). Summary 14 lower P . falciparum infection co-infected Schistosoma spp (OR: 0.65; 95%CI: 0.37–1.16). Similar observed 24 soil transmitted helminths (STH) 0.42; 0.28–0.64). When adjusted age, gender, socio-economic status, nutritional status geographic location children, risk STH higher compared who did not (OR = 1.3; 1.03–1.65). A subset that anaemia than alone 1.20; CI: 0.59–2.45), almost equal Plasmodium-Schistosoma or 0.97, 0.30–3.14). Conclusions/Significance suggests co-infection is high nature remain inconclusive may be modulated by immune responses affected children.