Prevalence, probability, and characteristics of malaria and filariasis co-infections: A systematic review and meta-analysis

Background: Malaria and filariasis are significant vector-borne diseases that are co-endemic in the same human populations. This study aims to collate the evidence, probability, and characteristics of malaria and filariasis co-infections in participants among studies reporting the co-occurrence of both diseases. Methods: We searched for potentially relevant articles reporting the co-occurrence of malaria and filariasis in five electronic databases (Embase, PubMed, Scopus, Medline, and CENTRAL) from inception to May 22, 2022. We estimated the pooled prevalence and probability of malaria and filariasis co-infections among study participants using random-effects meta-analyses and synthesized the characteristics of patients with co-infections narratively. Results: We identified 951 articles, 24 of which (96,838 participants) met eligibility criteria and were included in the systematic review. Results of the meta-analysis showed a pooled prevalence of malaria and filariasis co-infections among participants of 11%. The prevalence of co-infections was 2.3% in Africa, 0.2% in Asia, and 1.6% in South America. The pooled prevalences of malaria and Wuchereria bancrofti, malaria and Loa loa, malaria and Mansonella perstans co-infections were 0.7%, 1.2%, and 1.0%, respectively. The meta-analysis results showed that the co-infections between two parasites occurred by probability (P = 0.001). Patients with co-infections were at increased risk of having an enlarged spleen, a lower rate of severe anemia, lower parasite density, and more asymptomatic clinical status. Patients with co-infections had decreased levels of C-X-C motif chemokine 5, tumor necrosis factor–α, interleukin-4, c4 complement, and interleukin-10. In addition, patients with co-infections had a lower interleukin-10/tumor necrosis factor–α ratio and higher interleukin-10/interleukin-6 ratio. Conclusion: The present study showed that the prevalence of malaria and filariasis co-infections was low and varied between geographical areas in the selected articles. Co-infections tended to occur with a low probability. Further studies investigating the outcomes and characteristics of co-infections are needed. Author summary: Malaria is caused by the bite of Anopheles mosquitoes infected with the protozoan genus Plasmodium species. Filariasis is caused by the infections of filarial nematode diseases, including lymphatic filariasis, mansonellosis, and loiasis through the bite of Anopheles and other vectors. We searched and synthesized the literatures reporting the co-occurrence of malaria and filariasis. We found that the overall prevalence of malaria and filariasis co-infections among participants of 11%. The prevalence of co-infections was 2.3% in Africa, 0.2% in Asia, and 1.6% in South America. The overall prevalences of malaria and lymphatic filariasis, malaria and loiasis, malaria and mansonellosis co-infections were 0.7%, 1.2%, and 1.0%, respectively. The co-infections between two parasites occurred by probability. Patients with co-infections of both diseases were at increased risk of having an enlarged spleen, a lower rate of severe anemia, lower parasite density, and more asymptomatic clinical status. In addition, patients with co-infections showed alterations of cytokine and chemokine levels such as C-X-C motif chemokine 5, tumor necrosis factor–α, interleukin-4, c4 complement, interleukin-6, and interleukin-10.

Polrat Wilairatana & Kwuntida Uthaisar Kotepui & Wanida Mala & Kinley Wangdi & Manas Kotepui, 2022. "Prevalence, probability, and characteristics of malaria and filariasis co-infections: A systematic review and meta-analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 16(10), pages 1-22, October.

Handle: RePEc:plo:pntd00:0010857
DOI: 10.1371/journal.pntd.0010857

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