Setegn Abebaw, Amare Gashaw Azanaw, Abebe Wagaw, Damtie Wassie Alemayehu, Geremew Gebremariam Wulie, Bekalu Abaynesh Fentahun, Alemayehu Tekletsadik Tekleslassie, Megabiaw Fentahun, Wondmagegn Yenesew Mihret, Abriham Zufan Yiheyis, Wassie Yilkal Abebaw, Kibralew Getasew, Girmay Getu, Assefa Muluneh, Mengistie Berihun Agegn
Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Laboratory Sciences, Debre Markos University, Debre Markos, Ethiopia.
Malar J. 2024 Dec 18;23(1):382. doi: 10.1186/s12936-024-05192-7.
Due to the overlapping endemic regions and the high burden of both infections, coinfection with Plasmodium falciparum and Schistosoma mansoni poses distinct public health concerns that require coordinated, multifaceted interventions. There are epidemiological studies on the coinfection of these two parasites in Ethiopia, and the results differ and are inconsistent from one region to another. Thus, the goal of this systematic review and meta-analysis was to ascertain Ethiopia's pooled prevalence of P. falciparum and S. mansoni coinfection.
The preferred reporting item review and meta-analysis guidelines were followed in this study. PubMed, Google Scholar, Research4Life, Scopus, African-Wider, and EMBASE were the primary search databases. The final analysis included six studies in total. Stata software version 11 was used for analysis after Microsoft Excel was used to extract the data. The critical appraisal tool developed by the Joanna Briggs Institute was used to evaluate the methodological quality of the studies. Publication bias was checked via a funnel plot, Begg's test, and Egger's test. The pooled prevalence of P. falciparum and S. mansoni coinfection was estimated via a random effect model via the Der Simonian-Laird method. The heterogeneity of the studies was evaluated via I statistical tests.
The pooled prevalence of P. falciparum and S. mansoni coinfections in Ethiopia was 10.496% (95% CI 6.134, 14.859). Subgroup analysis of geopolitical regions revealed that the highest and lowest pooled prevalence rates of coinfection were 11.808% (95% CI 0.304, 23.312) and 8.600% (95% CI 5.755, 11.445), respectively, in the Amhara and Benishangul Gumuz regions.
This study highlights the substantial prevalence of P. falciparum and S. mansoni coinfection in Ethiopia's general population, with considerable geographical variation. Targeted and intensive public health interventions are necessary because it has the highest incidence in the Amhara region, and ongoing efforts are needed to address the relatively lower but still considerable prevalence in the Benishangul Gumuz region. These results direct future research, integrated control strategy design, and resource allocation to successfully manage Ethiopia's combined burden of malaria and schistosomiasis.
由于疟原虫和曼氏血吸虫的流行区域重叠,且这两种感染的负担都很重,恶性疟原虫和曼氏血吸虫合并感染引发了独特的公共卫生问题,需要采取协调一致的多方面干预措施。埃塞俄比亚有关于这两种寄生虫合并感染的流行病学研究,但其结果在不同地区存在差异且不一致。因此,本系统评价和荟萃分析的目的是确定埃塞俄比亚恶性疟原虫和曼氏血吸虫合并感染的总体患病率。
本研究遵循首选报告项目的系统评价和荟萃分析指南。PubMed、谷歌学术、Research4Life、Scopus、African-Wider和EMBASE是主要的检索数据库。最终分析共纳入六项研究。在使用Microsoft Excel提取数据后,使用Stata软件11版进行分析。采用乔安娜·布里格斯研究所开发的关键评价工具来评估研究的方法学质量。通过漏斗图、Begg检验和Egger检验来检查发表偏倚。采用Der Simonian-Laird方法通过随机效应模型估计恶性疟原虫和曼氏血吸虫合并感染的总体患病率。通过I统计检验评估研究的异质性。
埃塞俄比亚恶性疟原虫和曼氏血吸虫合并感染的总体患病率为10.496%(95%可信区间6.134,14.859)。按地缘政治区域进行的亚组分析显示,阿姆哈拉地区和本尚古勒-古穆兹地区合并感染的总体患病率最高和最低,分别为11.808%(95%可信区间0.304,23.312)和8.600%(95%可信区间5.755,11.445)。
本研究突出了埃塞俄比亚普通人群中恶性疟原虫和曼氏血吸虫合并感染的高患病率,且存在显著的地理差异。由于阿姆哈拉地区发病率最高,有针对性的强化公共卫生干预措施是必要的,同时需要持续努力解决本尚古勒-古穆兹地区相对较低但仍然可观的患病率问题。这些结果为未来的研究、综合控制策略设计和资源分配指明了方向,以成功应对埃塞俄比亚疟疾和血吸虫病的综合负担。