Influenza A and D Viruses in Non-Human Mammalian Hosts in Africa: A Systematic Review and Meta-Analysis

We conducted a systematic review and meta-analysis to investigate the prevalence and current knowledge of influenza A virus (IAV) and influenza D virus (IDV) in non-human mammalian hosts in Africa. PubMed, Google Scholar, Wiley Online Library and World Organisation for Animal Health (OIE-WAHIS) were searched for studies on IAV and IDV from 2000 to 2020. Pooled prevalence and seroprevalences were estimated using the quality effects meta-analysis model. The estimated pooled prevalence and seroprevalence of IAV in pigs in Africa was 1.6% (95% CI: 0–5%) and 14.9% (95% CI: 5–28%), respectively. The seroprevalence of IDV was 87.2% (95% CI: 24–100%) in camels, 9.3% (95% CI: 0–24%) in cattle, 2.2% (95% CI: 0–4%) in small ruminants and 0.0% (95% CI: 0–2%) in pigs. In pigs, H1N1 and H1N1pdm09 IAVs were commonly detected. Notably, the highly pathogenic H5N1 virus was also detected in pigs. Other subtypes detected serologically and/or virologically included H3N8 and H7N7 in equids, H1N1, and H3N8 and H5N1 in dogs and cats. Furthermore, various wildlife animals were exposed to different IAV subtypes. For prudent mitigation of influenza epizootics and possible human infections, influenza surveillance efforts in Africa should not neglect non-human mammalian hosts. The impact of IAV and IDV in non-human mammalian hosts in Africa deserves further investigation.

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Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-81057-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sanju Gautam ◽

Nipun Shrestha ◽

Sweta Mahato ◽

Tuan P. A. Nguyen ◽

Shiva Raj Mishra ◽

...

Keyword(s):

Systematic Review ◽

Sri Lanka ◽

Treatment Failure ◽

South Asia ◽

Treatment Outcomes ◽

Meta Analysis ◽

Tb Treatment ◽

Effect Model ◽

Pooled Prevalence ◽

The Impact

AbstractThe escalating burden of diabetes is increasing the risk of contracting tuberculosis (TB) and has a pervasive impact on TB treatment outcomes. Therefore, we conducted this systematic review and meta-analysis to examine the burden of diabetes among TB patients and assess its impact on TB treatment in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). PubMed, Excerpta Medica Database (EMBASE), and CINAHL databases were systematically searched for observational (cross-sectional, case–control and cohort) studies that reported prevalence of diabetes in TB patients and published between 1 January 1980 and 30 July 2020. A random-effect model for computing the pooled prevalence of diabetes and a fixed-effect model for assessing its impact on TB treatment were used. The review was registered with PROSPERO number CRD42020167896. Of the 3463 identified studies, a total of 74 studies (47 studies from India, 10 from Pakistan, four from Nepal and two from both Bangladesh and Sri-Lanka) were included in this systematic review: 65 studies for the prevalence of diabetes among TB patients and nine studies for the impact of diabetes on TB treatment outcomes. The pooled prevalence of diabetes in TB patients was 21% (95% CI 18.0, 23.0; I2 98.3%), varying from 11% in Bangladesh to 24% in Sri-Lanka. The prevalence was higher in studies having a sample size less than 300 (23%, 95% CI 18.0, 27.0), studies conducted in adults (21%, 95% CI 18.0, 23.0) and countries with high TB burden (21%, 95% CI 19.0, 24.0). Publication bias was detected based on the graphic asymmetry of the funnel plot and Egger’s test (p < 0.001). Compared with non-diabetic TB patients, patients with TB and diabetes were associated with higher odds of mortality (Odds Ratio (OR) 1.7; 95% CI 1.2, 2.51; I2 19.4%) and treatment failure (OR 1.7; 95% CI 1.1, 2.4; I2 49.6%), but not associated with Multi-drug resistant TB (OR 1.0; 95% CI 0.6, 1.7; I2 40.7%). This study found a high burden of diabetes among TB patients in South Asia. Patients with TB-diabetes were at higher risk of treatment failure and mortality compared to TB alone. Screening for diabetes among TB patients along with planning and implementation of preventive and curative strategies for both TB and diabetes are urgently needed.

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Molecular Investigation of miRNA Biomarkers as Chemoresistance Regulators in Melanoma: A Protocol for Systematic Review and Meta-Analysis

Genes ◽

10.3390/genes13010115 ◽

2022 ◽

Vol 13 (1) ◽

pp. 115

Author(s):

Peter Shaw ◽

Greg Raymond ◽

Katherine S. Tzou ◽

Siddhartha Baxi ◽

Ravishankar Ram Mani ◽

...

Keyword(s):

Systematic Review ◽

Fixed Effects ◽

Meta Analysis ◽

Cochrane Review ◽

Bibliographic Databases ◽

Analysis Model ◽

Pairwise Correlation ◽

Meta Regression Analysis ◽

Trim And Fill ◽

The Impact

Introduction: Melanoma is a global disease that is predominant in Western countries. However, reliable data resources and comprehensive studies on the theragnostic efficiency of miRNAs in melanoma are scarce. Hence, a decisive study or comprehensive review is required to collate the evidence for profiling miRNAs as a theragnostic marker. This protocol details a comprehensive systematic review and meta-analysis on the impact of miRNAs on chemoresistance and their association with theragnosis in melanoma. Methods and analysis: The articles will be retrieved from online bibliographic databases, including Cochrane Review, EMBASE, MEDLINE, PubMed, Scopus, Science Direct, and Web of Science, with different permutations of ‘keywords’. To obtain full-text papers of relevant research, a stated search method will be used, along with selection criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Protocols 2015 (PRISMA-P) standards were used to create this study protocol. The hazard ratio (HR) with a 95% confidence interval will be analyzed using Comprehensive Meta-Analysis (CMA) software 3.0. (CI). The pooled effect size will be calculated using a random or fixed-effects meta-analysis model. Cochran’s Q test and the I2 statistic will be used to determine heterogeneity. Egger’s bias indicator test, Orwin’s and the classic fail-safe N tests, the Begg and Mazumdar rank collection test, and Duval and Tweedie’s trim and fill calculation will all be used to determine publication bias. The overall standard deviation will be evaluated using Z-statistics. Subgroup analyses will be performed according to the melanoma participants’ clinicopathological and biological characteristics and methodological factors if sufficient studies and retrieved data are identified and available. The source of heterogeneity will be assessed using a meta-regression analysis. A pairwise matrix could be developed using either a pairwise correlation or expression associations of miRNA with patients’ survival for the same studies.

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HIV-Tuberculous Meningitis Co-infection: A Systematic Review and Meta-analysis

Current Pharmaceutical Biotechnology ◽

10.2174/1389201021666200730143906 ◽

2020 ◽

Vol 21 ◽

Author(s):

Ali Purmohamad ◽

Taher Azimi ◽

Mohammad Javad Nasiri ◽

Mehdi Goudarzi ◽

Moein Zangiabadian ◽

...

Keyword(s):

Systematic Review ◽

Human Immunodeficiency Virus ◽

Tuberculous Meningitis ◽

Preventive Measures ◽

Meta Analysis ◽

Cochrane Library ◽

Analysis Model ◽

Pooled Prevalence ◽

Immunodeficiency Virus ◽

High Prevalence

: Human immunodeficiency virus (HIV)-infected persons are at a higher risk of developing Tuberculous meningitis (TBM). We aimed to estimate the prevalence of TBM-HIV co-infection. We systematically searched Pubmed/Medline, Embase and Cochrane library databases from January 1, 2000, to January 31, 2017, to find relevant studies. We employed the random-effects meta-analysis model to estimate the pooled prevalence of TBM-HIV co-infection. Twenty-six eligible studies showed the prevalence of HIV in TBM patients. In the pooled analyses, the prevalence of HIV was 30% (95% CI: 12-47) in patients with confirmed TBM, and 12.1% (95% CI: 7.3-19.2) in patients with suspected TBM. This study shows a high prevalence of TBM-HIV co-infection. Establishing proper diagnostic criteria and preventive measures for TBM infections could assist in the prevention and management of TBM infection, particularly TBM-HIV co-infection.

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Bovine Ehrlichiosis Prevalence: A Systematic Review and Meta-Analysis of Molecular Studies

World s Veterinary Journal ◽

10.54203/scil.2021.wvj1 ◽

2021 ◽

Vol 11 (1) ◽

pp. 1-15

Author(s):

D. Katterine Bonilla-Aldana ◽

Keidenis Quintero-Rada ◽

Juan Pablo Montoya-Posada ◽

Diego Soler-Tovar ◽

Paola Barato ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Animal Health ◽

Notifiable Disease ◽

Individual Level ◽

Lack Of Information ◽

Pooled Prevalence ◽

The Individual ◽

World Organization ◽

Meta Analyses

While some Ehrlichia species, such as E. ruminantium and E. minasensis, are not popular even among veterinarians, they can infect cattle. The current study aimed to review studies on Ehrlichia spp. to evaluate its worldwide molecular prevalence, given the lack of information about bovine ehrlichiosis and the lack of previous systematic reviews and meta-analyses on this subject. In order to determine the molecular prevalence of Ehrlichia spp. in cattle, a systematic review of the literature was conducted in three databases. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence with 95% confidence intervals (95% CI) and measures of heterogeneity were reported. Subgroup analyses were performed in terms of Ehrlichia species, country, and regions. The literature search yielded 1051 papers until August 1, 2019, with 71 studies entirely eligible for review. The pooled molecular prevalence for Ehrlichia at the individual level (N = 6232) was 2.3% (95% CI: 1.7-2.9%) with the highest value of 82.4%. Studies identified the highest pooled molecular prevalence of 6.6% (95% CI: 0.6-12.7%) for E. canis, followed by E. ruminantium (n = 4695, 75.33%) 52 studies, with 1.7% (95% CI: 1.1-2.3%) and E. chaffeensis with 1.5% (95% CI: 0.0-0.3%). Moreover, the obtained result was indicative of only one study addressing E. minasensis. As the findings suggested, heartwater (E. ruminantium infection) is a notifiable disease of domestic and wild ruminants, recorded by the World Organization for Animal Health. There is a possible risk of endemic heartwater in the Americas due to the climatic features. Furthermore, E. minasensis, E. chaffeensis, and E. canis were observed in cattle although the two last species could be a molecular misidentification with regard to their phylogenetic relationships with E. minasensis.

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Prevalence and impact of comorbidities in axial spondyloarthritis: systematic review and meta-analysis

Rheumatology ◽

10.1093/rheumatology/keaa246 ◽

2020 ◽

Vol 59 (Supplement_4) ◽

pp. iv47-iv57 ◽

Cited By ~ 2

Author(s):

Sizheng Steven Zhao ◽

Selina Robertson ◽

Tzvi Reich ◽

Nicolas L Harrison ◽

Robert J Moots ◽

...

Keyword(s):

Systematic Review ◽

Axial Spondyloarthritis ◽

Meta Analysis ◽

Work Productivity ◽

Comorbid Condition ◽

Random Effects Models ◽

Pooled Prevalence ◽

Comorbidity Burden ◽

Meta Analyses ◽

The Impact

Abstract Objectives Comorbidities are common in people with axial spondyloarthritis (axSpA). In this systematic review and meta-analysis, we aimed to: (i) describe the prevalence of commonly reported comorbidities, (ii) compare comorbidities between axSpA and control populations, and (iii) examine the impact of comorbidity burden on axSpA outcomes. Methods We systematically searched Medline, PubMed, Scopus and Web of Science using a predefined protocol in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We excluded studies of only one comorbid condition or a few closely related diseases within one organ system. Where possible, meta-analysis was performed using random-effects models. Results A total of 40 studies were included for analysis. 36 studies reported prevalence of comorbidities, amounting to a combined sample size of 119 427 patients. The number of comorbidities studied ranged from 3 to 43. The most prevalent individual comorbidities were hypertension (pooled prevalence 23%), hyperlipidaemia (17%) and obesity (14%). Eleven studies consistently showed higher prevalence of comorbidities in axSpA than controls, particularly large differences were seen for depression [pooled odds ratio (OR) 1.80] and heart failure (OR 1.84). Comorbidities (total number of and individual conditions) were also associated with axSpA disease activity, functional impairment, quality of life, work productivity and mortality. Conclusions Comorbidities are common in axSpA, particularly cardiovascular diseases and risk factors. Most comorbidities were more prevalent in axSpA patients than in control populations. Overall comorbidity burden, and many individual conditions, were associated with axSpA outcomes including worse disease severity, work productivity and mortality.

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Prevalence of Goiter Among School-Aged Children in Ethiopia: Update of Systematic Review and Meta-analysis

Global Advances in Health and Medicine ◽

10.1177/2164956120988660 ◽

2021 ◽

Vol 10 ◽

pp. 216495612098866

Author(s):

Yohannes Tekalegn ◽

Kebebe Bekele ◽

Biniyam Sahiledengle ◽

Demelash Woldeyohannes

Keyword(s):

Systematic Review ◽

Iodine Deficiency ◽

Meta Analysis ◽

Random Effect ◽

Health Concern ◽

School Age Children ◽

Forest Plot ◽

School Age ◽

Analysis Model ◽

Pooled Prevalence

Background Iodine deficiency is a major public health concern throughout the world. Goiter is the most visible sign of iodine deficiency. In Ethiopia, a study finding regarding the prevalence of goiter among school-age children is inconsistent and highly variable. Objectives To estimate the pooled prevalence of goiter among school-age children in Ethiopia. Methods Three international databases (MEDLINE/Pub-Med, Google Scholar and Science Direct) were systematically searched. Besides, the reference sections of identified articles were searched to increase the chance of detecting missed articles in gray literature. STATA Version 14 statistical software was used to conduct a meta-analysis. The pooled prevalence with a 95% confidence interval was displayed using the forest plot. A random-effect meta-analysis model was used to compute the pooled prevalence, and The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Results A total of 14 studies fulfilled the inclusion criteria and included in this systematic review and Meta-analysis, with a total sample size of 26,282. The finding of this systematic review revealed that the pooled prevalence of goiter among school-age children was 42.9% (95% CI: 38.8–46.9). The highest prevalence of goiter (46.7%) was observed in Oromia region and the lowest (26.3%) was observed in Benishangul-Gumuz region. Conclusions This review finding revealed that more than two in five of the school children in Ethiopia suffer from iodine deficiency disorder as manifested by the goiter rate.

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Colostrum avoidance and associated factors in Ethiopia: A systematic review and meta-analysis

10.21203/rs.3.rs-83791/v1 ◽

2020 ◽

Author(s):

Jemberu Nigussie ◽

Bekahegn Girma ◽

Alemayehu Molla ◽

Moges Mareg

Keyword(s):

Systematic Review ◽

Associated Factors ◽

Meta Analysis ◽

Random Effect ◽

Health Benefit ◽

Plain Water ◽

Analysis Model ◽

Prelacteal Feeding ◽

Timely Initiation ◽

Pooled Prevalence

Abstract Background: Colostrum is the first milk produced by the mammary glands during the second half of pregnancy for a few days (3-4) after birth. However, colostrum is a normative standard for infants’ complete form of nutrition, most mothers' giving prelacteal food such as honey, butter, sugar water, and plain water instead of colostrum to their newborn. In Ethiopia, colostrum was seen as abnormal milk causing abdominal problems, and to mitigate this problem most mothers were discarding the portion of the colostrum. Although studies have been conducted on colostrum avoidance and associated factors in Ethiopia, their report was inconsistent regarding the prevalence and associated factors. The main aim of this systematic review and meta-analysis was to estimate the pooled prevalence of colostrum avoidance and associated factors in Ethiopia.Methods: In this systematic review and meta-analysis databases such as Google, Google Scholar, PubMed/Medline, Science Direct, and Hinari were searched. We found a total of 327 records, of which 292 records were excluded due to duplication and unrelated to our objective. Finally, 35 studies were included in this systematic review and meta-analysis. The data were extracted in Microsoft Excel format and exported to STATA Version 14.0 statistical software for analysis. Heterogeneity was checked by the I2 test. A random-effect meta-analysis model was used to estimate the pooled prevalence of colostrum avoidance and associated factors. Egger’s weighted regression and Begg’s rank correlation test were used to assess publication bias. Result: This review revealed that the pooled prevalence of colostrum avoidance in Ethiopia was 20.5% (95% CI; 16.46, 24.45). Ante-natal care (ANC) visits [OR= 0.274 (95% CI; 0.175, 0.428)], place of delivery [OR= 3.8 (95% CI; 2.9, 4.9)], breastfed counselling [OR= 0.261(95% CI; 0.147 - 0.462), timely initiation of breast feeding [OR = 3.8 (95% CI; 1.9, 7.4)] and prelacteal feeding [OR= 5.77 (95% CI; 4.03- 8.22)] were significant factors for colostrum avoidance. Conclusion: This meta-analysis showed that one of five mothers discarded colostrum in Ethiopia. Colostrum avoidance was higher in rural mothers than in urban mothers. Strengthening ANC visits, institutional delivery, breastfed counseling, early initiation of breastfeeding, and avoidance of prelacteal feeding are recommended interventions to reduce colostrum avoidance in Ethiopia. Furthermore, promoting the health benefit of colostrum and its nutritional value also emphasizes to improving colostrum feeding in the community.

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The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9072150 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2150 ◽

Cited By ~ 3

Author(s):

Bendix Labeit ◽

Marc Pawlitzki ◽

Tobias Ruck ◽

Paul Muhle ◽

Inga Claus ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Inflammatory Myopathy ◽

Random Effect Model ◽

Idiopathic Inflammatory Myopathy ◽

Prevalence Estimate ◽

Laryngeal Elevation ◽

Pooled Prevalence ◽

The Impact

(1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic criteria for idiopathic inflammatory myopathy (IIM). However, the data on dysphagia in IIM are heterogenous and partly conflicting. The aim of this study was to conduct a systematic review on epidemiology, pathophysiology, outcome and therapy and a meta-analysis on the prevalence of dysphagia in IIM. (2) Methods: Medline was systematically searched for all relevant articles. A random effect model was chosen to estimate the pooled prevalence of dysphagia in the overall cohort of patients with IIM and in different subgroups. (3) Results: 234 studies were included in the review and 116 (10,382 subjects) in the meta-analysis. Dysphagia can occur as initial or sole symptom. The overall pooled prevalence estimate in IIM was 36% and with 56% particularly high in inclusion body myositis. The prevalence estimate was significantly higher in patients with cancer-associated myositis and with NXP2 autoantibodies. Dysphagia is caused by inflammatory involvement of the swallowing muscles, which can lead to reduced pharyngeal contractility, cricopharyngeal dysfunction, reduced laryngeal elevation and hypomotility of the esophagus. Swallowing disorders not only impair the quality of life but can lead to serious complications such as aspiration pneumonia, thus increasing mortality. Beneficial treatment approaches reported include immunomodulatory therapy, the treatment of associated malignant diseases or interventional procedures targeting the cricopharyngeal muscle such as myotomy, dilatation or botulinum toxin injections. (4) Conclusion: Dysphagia should be included as a therapeutic target, especially in the outlined high-risk groups.

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Prevalence and outcomes of malaria as co-infection among patients with human African trypanosomiasis: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-03295-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kwuntida Uthaisar Kotepui ◽

Frederick Ramirez Masangkay ◽

Giovanni De Jesus Milanez ◽

Manas Kotepui

Keyword(s):

Systematic Review ◽

Human African Trypanosomiasis ◽

Meta Analysis ◽

Case Fatality ◽

Current Evidence ◽

African Trypanosomiasis ◽

Antimalarial Treatment ◽

Qualitative Synthesis ◽

Pooled Prevalence ◽

The Impact

AbstractHuman African trypanosomiasis (HAT) is endemic in Africa; hence, the possibility of co-infection with malaria among patients with HAT exists. The present study investigated co-infection with malaria among patients with HAT to provide current evidence and characteristics to support further studies. Potentially relevant studies that reported Plasmodium spp. infection in patients with HAT was searched in PubMed, Web of Science, and Scopus. The risk of bias among the included studies was assessed using the checklist for analytical cross-sectional studies developed by the Joanna Briggs Institute. The pooled prevalence of Plasmodium spp. infection in patients with HAT was quantitatively synthesized using a random-effects model. Subgroup analyses of study sites and stages of HAT were performed to identify heterogeneity regarding prevalence among the included studies. The heterogeneity of the outcome among the included studies was assessed using Cochran’s Q and I2 statistics for consistency. Publication bias was assessed if the number of included studies was 10 or more. For qualitative synthesis, a narrative synthesis of the impact of Plasmodium spp. infection on the clinical and outcome characteristics of HAT was performed when the included studies provided qualitative data. Among 327 studies identified from three databases, nine studies were included in the systematic review and meta-analysis. The prevalence of Plasmodium spp. co-infection (692 cases) among patients with HAT (1523 cases) was 50% (95% confidence interval [CI] = 28–72%, I2 = 98.1%, seven studies). Subgroup analysis by type of HAT (gambiense or rhodesiense HAT) revealed that among patients with gambiense HAT, the pooled prevalence of Plasmodium spp. infection was 46% (95% CI = 14–78%, I2 = 96.62%, four studies), whereas that among patients with rhodesiense HAT was 44% (95% CI = 40–49%, I2 = 98.3%, three studies). Qualitative syntheses demonstrated that Plasmodium spp. infection in individuals with HAT might influence the risk of encephalopathy syndrome, drug toxicity, and significantly longer corrected QT time. Moreover, longer hospital stays and higher treatment costs were recorded among co-infected individuals. Because of the high prevalence of malaria among patients with HAT, some patients were positive for malaria parasites despite being asymptomatic. Therefore, it is suggested to test every patient with HAT for malaria before HAT treatment. If malaria is present, then antimalarial treatment is recommended before HAT treatment. Antimalarial treatment in patients with HAT might decrease the probability of poor clinical outcomes and case fatality in HAT.

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

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009138 ◽

2021 ◽

Vol 15 (2) ◽

pp. e0009138

Author(s):

Muhammed O. Afolabi ◽

Boni M. Ale ◽

Edgard D. Dabira ◽

Schadrac C. Agbla ◽

Amaya L. Bustinduy ◽

...

Keyword(s):

Systematic Review ◽

Current Knowledge ◽

Economic Status ◽

Meta Analysis ◽

Statistical Significance ◽

Geographic Location ◽

Sub Saharan Africa ◽

Chi Square ◽

Lower Odds ◽

The Impact

Background Current knowledge on the burden of, and interactions between malaria and helminth co-infections, as well as the impact of the dual infections on anaemia, remains inconclusive. We have conducted a systematic review with meta-analysis to update current knowledge as a first step towards developing and deploying coordinated approaches to the control and, ultimately, elimination of malaria-helminth co-infections among children living in endemic countries. Methodology/Principal findings We searched Medline, Embase, Global Health and Web of Science from each database inception until 16 March 2020, for peer-reviewed articles reporting malaria-helminth co-infections in children living in a LMIC. No language restriction was applied. Following removal of duplicates, two reviewers independently screened the studies for eligibility. We used the summary odds ratio (OR) and 95% confidence intervals (CI) as a measure of association (random-effects model). We also performed Chi-square heterogeneity test based on Cochrane’s Q and evaluated the severity of heterogeneity using I2 statistics. The included studies were examined for publication bias using a funnel plot and statistical significance was assessed using Egger’s test (bias if p<0.1). Fifty-five of the 3,507 citations screened were eligible, 28 of which had sufficient data for meta-analysis. The 28 studies enrolled 22, 114 children in 13 countries across sub-Saharan Africa, Southeast Asia and South America. Overall, the pooled estimates showed a prevalence of Plasmodium-helminth co-infections of 17.7% (95% CI 12.7–23.2%). Summary estimates from 14 studies showed a lower odds of P. falciparum infection in children co-infected with Schistosoma spp (OR: 0.65; 95%CI: 0.37–1.16). Similar lower odds of P. falciparum infection were observed from the summary estimates of 24 studies in children co-infected with soil transmitted helminths (STH) (OR: 0.42; 95%CI: 0.28–0.64). When adjusted for age, gender, socio-economic status, nutritional status and geographic location of the children, the risk of P. falciparum infection in children co-infected with STH was higher compared with children who did not have STH infection (OR = 1.3; 95% CI 1.03–1.65). A subset of 16 studies showed that the odds of anaemia were higher in children co-infected with Plasmodium and STH than in children with Plasmodium infection alone (OR = 1.20; 95% CI: 0.59–2.45), and were almost equal in children co-infected with Plasmodium-Schistosoma spp or Plasmodium infection alone (OR = 0.97, 95% CI: 0.30–3.14). Conclusions/Significance The current review suggests that prevalence of malaria-helminth co-infection is high in children living in endemic countries. The nature of the interactions between malaria and helminth infection and the impact of the co-infection on anaemia remain inconclusive and may be modulated by the immune responses of the affected children.

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