Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis

Abstract Background Severe complications among patients with Plasmodium malariae infection are rare. This is the first systematic review and meta-analysis demonstrating the global prevalence and mortality of severe P. malariae infection in humans. Methods The systematic review and meta-analysis foll...

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Main Authors: Manas Kotepui, Kwuntida Uthaisar Kotepui, Giovanni D. Milanez, Frederick R. Masangkay
Format: Article
Language:English
Published: BMC 2020-07-01
Series:Malaria Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12936-020-03344-z
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author Manas Kotepui
Kwuntida Uthaisar Kotepui
Giovanni D. Milanez
Frederick R. Masangkay
author_facet Manas Kotepui
Kwuntida Uthaisar Kotepui
Giovanni D. Milanez
Frederick R. Masangkay
author_sort Manas Kotepui
collection DOAJ
description Abstract Background Severe complications among patients with Plasmodium malariae infection are rare. This is the first systematic review and meta-analysis demonstrating the global prevalence and mortality of severe P. malariae infection in humans. Methods The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All research articles published on the severity and mortality of P. malariae infection cases in humans were retrieved from three public databases: PubMed, Scopus, and ISI Web of Science. The pooled prevalence estimate and 95% confidence interval (CI) of complications in patients with P. malariae malaria was analysed using the random-effects model provided in Stata software. The pooled odds ratio (OR) and 95% CI of severe malaria for P. malariae infection and Plasmodium falciparum infection were analysed using Review Manager software. Results Six studies were used to estimate the pooled prevalence of severe P. malariae malaria. Out of 10,520 patients infected with P. malariae, the pooled prevalence estimate of severe P. malariae infection was 3% (95% CI 2–5%), with high heterogeneity (I2: 90.7%). Severe anaemia (3.32%), pulmonary complications (0.46%), and renal impairments (0.24%) were the most common severe complications found in patients with P. malariae infection. The pooled proportion of severe anaemia for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.74, 95% CI 0.22–2.45, I2 = 98%). The pooled proportion of pulmonary complications was comparable between patients with P. malariae infection and those with P. falciparum infection among the four included studies (OR: 1.44; 95% CI 0.17–12.31, I2: 92%). For renal complications, the funnel plot showed that the pooled proportion of renal complications for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.94, 95% CI 0.18–4.93, I2: 91%). The mortality rate of patients with P. malariae infection was 0.17% (18/10,502 cases). Conclusions This systematic review demonstrated that approximately two percent of patients with P. malariae infection developed severe complications, with a low mortality rate. Severe anaemia, pulmonary involvement, and renal impairment were the most common complications found in patients with P. malariae infection. Although a low prevalence and low mortality of P. malariae infection have been reported, patients with P. malariae infection need to be investigated for severe anaemia and, if present, treated aggressively to prevent anaemia-related death.
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spelling doaj.art-8c98961ee5694da78db6f47c1e80a60a2022-12-21T22:45:54ZengBMCMalaria Journal1475-28752020-07-0119111310.1186/s12936-020-03344-zGlobal prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysisManas Kotepui0Kwuntida Uthaisar Kotepui1Giovanni D. Milanez2Frederick R. Masangkay3Medical Technology, School of Allied Health Sciences, Walailak UniversityMedical Technology, School of Allied Health Sciences, Walailak UniversityDepartment of Medical Technology, Far Eastern UniversityDepartment of Medical Technology, Far Eastern UniversityAbstract Background Severe complications among patients with Plasmodium malariae infection are rare. This is the first systematic review and meta-analysis demonstrating the global prevalence and mortality of severe P. malariae infection in humans. Methods The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All research articles published on the severity and mortality of P. malariae infection cases in humans were retrieved from three public databases: PubMed, Scopus, and ISI Web of Science. The pooled prevalence estimate and 95% confidence interval (CI) of complications in patients with P. malariae malaria was analysed using the random-effects model provided in Stata software. The pooled odds ratio (OR) and 95% CI of severe malaria for P. malariae infection and Plasmodium falciparum infection were analysed using Review Manager software. Results Six studies were used to estimate the pooled prevalence of severe P. malariae malaria. Out of 10,520 patients infected with P. malariae, the pooled prevalence estimate of severe P. malariae infection was 3% (95% CI 2–5%), with high heterogeneity (I2: 90.7%). Severe anaemia (3.32%), pulmonary complications (0.46%), and renal impairments (0.24%) were the most common severe complications found in patients with P. malariae infection. The pooled proportion of severe anaemia for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.74, 95% CI 0.22–2.45, I2 = 98%). The pooled proportion of pulmonary complications was comparable between patients with P. malariae infection and those with P. falciparum infection among the four included studies (OR: 1.44; 95% CI 0.17–12.31, I2: 92%). For renal complications, the funnel plot showed that the pooled proportion of renal complications for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.94, 95% CI 0.18–4.93, I2: 91%). The mortality rate of patients with P. malariae infection was 0.17% (18/10,502 cases). Conclusions This systematic review demonstrated that approximately two percent of patients with P. malariae infection developed severe complications, with a low mortality rate. Severe anaemia, pulmonary involvement, and renal impairment were the most common complications found in patients with P. malariae infection. Although a low prevalence and low mortality of P. malariae infection have been reported, patients with P. malariae infection need to be investigated for severe anaemia and, if present, treated aggressively to prevent anaemia-related death.http://link.springer.com/article/10.1186/s12936-020-03344-zSevereComplicationsP. malariaeQuartan malaria
spellingShingle Manas Kotepui
Kwuntida Uthaisar Kotepui
Giovanni D. Milanez
Frederick R. Masangkay
Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
Malaria Journal
Severe
Complications
P. malariae
Quartan malaria
title Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
title_full Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
title_fullStr Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
title_full_unstemmed Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
title_short Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
title_sort global prevalence and mortality of severe plasmodium malariae infection a systematic review and meta analysis
topic Severe
Complications
P. malariae
Quartan malaria
url http://link.springer.com/article/10.1186/s12936-020-03344-z
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AT giovannidmilanez globalprevalenceandmortalityofsevereplasmodiummalariaeinfectionasystematicreviewandmetaanalysis
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