A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection
Abstract Co-infection with malaria and human immunodeficiency virus (HIV) increases the severity and mortality rates of both diseases. A better understanding of the effects of co-infections could help in the diagnosis, prompt treatment, prevention, and control of malarial parasites among HIV-infecte...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2021-08-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-95591-6 |
| _version_ | 1818856635489058816 |
|---|---|
| author | Aongart Mahittikorn Kwuntida Uthaisar Kotepui Giovanni De Jesus Milanez Frederick Ramirez Masangkay Manas Kotepui |
| author_facet | Aongart Mahittikorn Kwuntida Uthaisar Kotepui Giovanni De Jesus Milanez Frederick Ramirez Masangkay Manas Kotepui |
| author_sort | Aongart Mahittikorn |
| collection | DOAJ |
| description | Abstract Co-infection with malaria and human immunodeficiency virus (HIV) increases the severity and mortality rates of both diseases. A better understanding of the effects of co-infections could help in the diagnosis, prompt treatment, prevention, and control of malarial parasites among HIV-infected patients. In this systematic review and meta-analysis, we estimated the prevalence and characteristics of severe malaria (SM) caused by co-infection with HIV. We included relevant studies that were conducted between the years 1991 and 2018 and reporting on SM. We pooled the prevalence of SM in patients with co-infection, pooled odds ratios of SM in patients with co-infection and Plasmodium mono-infection, and differences in laboratory parameters such as parasite density and leucocyte counts, between co-infected and Plasmodium mono-infected patients. The meta-analysis included 29 studies (1126 SM cases). The pooled prevalence of SM in co-infected patients using the data of 23 studies (SM = 795 cases, all co-infection cases = 2534 cases) was 43.0% (95% confidence interval [CI] 31.0–56.0%; I2, 98.0%). Overall, the odds of SM from 18 studies were pooled. The odds of SM were significantly higher in co-infected patients than in Plasmodium mono-infected patients (OR 2.41; 95% CI 1.43–4.08; I2 = 85%; P = 0.001) and also significantly higher in children (OR 9.69; 95% CI 5.14–18.3; I2, 0%; P < 0.0001; two studies) than in adults (OR 2.68; 95% CI 1.52–4.73; I2, 79.0%; P = 0.0007; 12 studies). Co-infected patients with SM had a higher parasite density than those with Plasmodium mono-infection when the data of seven studies were analysed (SMD, 1.25; 95% CI 0.14–2.36; I2, 98.0%; P = 0.03) and higher leukocyte counts when the data of four studies were analysed (MD, 1570 cells/µL; 95% CI 850–2300 cells/µL; I2, 21.0%; P < 0.0001). Thus, the prevalence of SM among patients co-infected with Plasmodium spp. and HIV is high. Because co-infections could lead to SM, patients with Plasmodium spp. and HIV co-infection should be identified and treated to reduce the prevalence of SM and the number of deaths. |
| first_indexed | 2024-12-19T08:27:38Z |
| format | Article |
| id | doaj.art-0a5707172ec841f19decfb25ce02e551 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T08:27:38Z |
| publishDate | 2021-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-0a5707172ec841f19decfb25ce02e5512022-12-21T20:29:15ZengNature PortfolioScientific Reports2045-23222021-08-0111111910.1038/s41598-021-95591-6A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infectionAongart Mahittikorn0Kwuntida Uthaisar Kotepui1Giovanni De Jesus Milanez2Frederick Ramirez Masangkay3Manas Kotepui4Department of Protozoology, Faculty of Tropical Medicine, Mahidol UniversityMedical Technology, School of Allied Health Sciences, Walailak University, Tha SalaDepartment of Medical Technology, Faculty of Pharmacy, University of Santo TomasDepartment of Medical Technology, Institute of Arts and Sciences, Far Eastern University-ManilaMedical Technology, School of Allied Health Sciences, Walailak University, Tha SalaAbstract Co-infection with malaria and human immunodeficiency virus (HIV) increases the severity and mortality rates of both diseases. A better understanding of the effects of co-infections could help in the diagnosis, prompt treatment, prevention, and control of malarial parasites among HIV-infected patients. In this systematic review and meta-analysis, we estimated the prevalence and characteristics of severe malaria (SM) caused by co-infection with HIV. We included relevant studies that were conducted between the years 1991 and 2018 and reporting on SM. We pooled the prevalence of SM in patients with co-infection, pooled odds ratios of SM in patients with co-infection and Plasmodium mono-infection, and differences in laboratory parameters such as parasite density and leucocyte counts, between co-infected and Plasmodium mono-infected patients. The meta-analysis included 29 studies (1126 SM cases). The pooled prevalence of SM in co-infected patients using the data of 23 studies (SM = 795 cases, all co-infection cases = 2534 cases) was 43.0% (95% confidence interval [CI] 31.0–56.0%; I2, 98.0%). Overall, the odds of SM from 18 studies were pooled. The odds of SM were significantly higher in co-infected patients than in Plasmodium mono-infected patients (OR 2.41; 95% CI 1.43–4.08; I2 = 85%; P = 0.001) and also significantly higher in children (OR 9.69; 95% CI 5.14–18.3; I2, 0%; P < 0.0001; two studies) than in adults (OR 2.68; 95% CI 1.52–4.73; I2, 79.0%; P = 0.0007; 12 studies). Co-infected patients with SM had a higher parasite density than those with Plasmodium mono-infection when the data of seven studies were analysed (SMD, 1.25; 95% CI 0.14–2.36; I2, 98.0%; P = 0.03) and higher leukocyte counts when the data of four studies were analysed (MD, 1570 cells/µL; 95% CI 850–2300 cells/µL; I2, 21.0%; P < 0.0001). Thus, the prevalence of SM among patients co-infected with Plasmodium spp. and HIV is high. Because co-infections could lead to SM, patients with Plasmodium spp. and HIV co-infection should be identified and treated to reduce the prevalence of SM and the number of deaths.https://doi.org/10.1038/s41598-021-95591-6 |
| spellingShingle | Aongart Mahittikorn Kwuntida Uthaisar Kotepui Giovanni De Jesus Milanez Frederick Ramirez Masangkay Manas Kotepui A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection Scientific Reports |
| title | A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection |
| title_full | A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection |
| title_fullStr | A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection |
| title_full_unstemmed | A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection |
| title_short | A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection |
| title_sort | meta analysis on the prevalence and characteristics of severe malaria in patients with plasmodium spp and hiv co infection |
| url | https://doi.org/10.1038/s41598-021-95591-6 |
| work_keys_str_mv | AT aongartmahittikorn ametaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT kwuntidauthaisarkotepui ametaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT giovannidejesusmilanez ametaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT frederickramirezmasangkay ametaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT manaskotepui ametaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT aongartmahittikorn metaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT kwuntidauthaisarkotepui metaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT giovannidejesusmilanez metaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT frederickramirezmasangkay metaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection AT manaskotepui metaanalysisontheprevalenceandcharacteristicsofseveremalariainpatientswithplasmodiumsppandhivcoinfection |