Journal Article

Malaria prevalence in HIV-positive children, pregnant women, and adults: a systematic review and meta-analysis

Mirzohreh, Seyedeh-Tarlan, Barac, Aleksandra, Bangoura, Berit, Safarpour, Hanieh, Ahmadpour, Ehsan, Pagheh, Abdol Sattar

2022

Overview

Background Malaria in human immunodeficiency virus (HIV)-positive patients is an ever-increasing global burden for human health. The present meta-analysis summarizes published literature on the prevalence of malaria infection in HIV-positive children, pregnant women and adults. Methods This study followed the PRISMA guideline. The PubMed, Science Direct, Google Scholar, Scopus and Cochrane databases were searched for relevant entries published between 1 January 1983 and 1 March 2020. All peer-reviewed original papers evaluating the prevalence of malaria among HIV-positive patients were included. Incoherence and heterogeneity between studies were quantified by the I 2 index and Cochran’s Q test. Publication and population biases were assessed with funnel plots, and Egger’s regression asymmetry test. Results A total of 106 studies were included in this systematic review. The average prevalence of malaria among HIV-positive children, HIV-positive pregnant women and HIV-positive adults was 39.4% (95% confidence interval [CI]: 26.6–52.9), 32.3% (95% CI = 26.3–38.6) and 27.3% (95% CI = 20.1–35.1), respectively. In adult patients with HIV, CD4 + (cluster of differentiation 4) < 200 cells/µl and age < 40 years were associated with a significant increase in the odds of malaria infection (odds ratio [OR] = 1.5, 95% CI = 1.2–1.7 and OR = 1.1, 95% CI = 1–1.3, respectively). Antiretroviral therapy (ART) and being male were associated with a significant decrease in the chance of malaria infection in HIV-positive adults (OR = 0.8, 95% CI = 0.7–0.9 and OR = 0.2, 95% CI = 0.2–0.3, respectively). In pregnant women with HIV, CD4 + count < 200 cells/µl was related to a higher risk for malaria infection (OR = 1.5, 95% CI = 1.1–1.9). Conclusions This systematic review demonstrates that malaria infection is concerningly common among HIV-positive children, pregnant women and adults. Among HIV-positive adults, ART medication and being male were associated with a substantial decrease in infection with malaria. For pregnant women, CD4 + count of < 200 cells/µl was a considerable risk factor for malaria infection. Graphical Abstract

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Adult / Adults / AIDS / Anopheles / Antiretroviral agents / Antiretroviral drugs / Antiretroviral therapy / asymmetry / Biomedical and Life Sciences / Biomedicine / Blood transfusions / CD4 antigen / Cell differentiation / Cells / Child / Children / confidence interval / Confidence intervals / Demographic aspects / Disease transmission / drug therapy / Entomology / Female / guidelines / Health / Health aspects / Health risks / Heterogeneity / HIV / HIV Infections - complications / HIV Infections - drug therapy / HIV Infections - epidemiology / HIV patients / Human diseases / human health / Human immunodeficiency virus / Humans / Immune system / Incoherence / Infections / Infectious Diseases / Malaria / Malaria - complications / Malaria - epidemiology / Male / Males / Meta-analysis / Mortality / odds ratio / Parasitology / People living with HIV / Plasmodium / Pregnancy / Pregnant People / Pregnant women / Prevalence / Protozoan parasite / Review / Risk analysis / Risk Factors / Search engines / Statistical analysis / Statistics / Systematic review / Tropical Medicine / Vector-borne diseases / Veterinary Medicine/Veterinary Science / Virology / Women / Womens health