Malaria and helminth co-infections in children living in endemic countries: A systematic review with meta-analysis.
Malaria and helminth co-infections in children living in endemic countries: A systematic review with meta-analysis.
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DOI：
10.1371/journal.pntd.0009138
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发表时间：
2021-03
影响因子：
3.8
通讯作者：
Greenwood B
中科院分区：
文献类型：
--
作者：
Afolabi MO;Ale BM;Dabira ED;Agbla SC;Bustinduy AL;Ndiaye JLA;Greenwood B
目前关于疟疾和寄生虫共同感染的负担和相互作用以及双重感染对贫血的影响的知识仍然没有定论。我们进行了一项采用荟萃分析的系统回顾，以更新现有知识，作为制定和部署协调方法以控制并最终消除疟疾流行国家儿童中疟疾-寄生虫合并感染的第一步。截至2020年3月16日，我们检索了Medline、Embase、Global Health和Web of Science的每个数据库，检索了报告疟疾流行国家儿童疟疾-寄生虫合并感染的同行评审文章。没有使用语言限制。在删除重复项后，两位审稿人独立筛选研究的合格性。我们使用总结优势比（OR）和95%置信区间（CI）作为关联的度量（随机效应模型）。我们还基于Cochrane’s Q进行卡方异质性检验，并使用I2统计量评估异质性的严重程度。采用漏斗图检查纳入研究的发表偏倚，采用Egger检验评估统计学显著性（p<0.1）。3507篇被筛选的引文中有55篇符合条件，其中28篇有足够的数据进行meta分析。28项研究在撒哈拉以南非洲、东南亚和南美洲的13个国家招募了22,114名儿童。总体而言，汇总估计显示，疟原虫-蠕虫合并感染的患病率为17.7% （95% CI 12.7-23.2%）。14项研究的汇总估计显示，合并血吸虫感染的儿童感染恶性疟原虫的几率较低（OR: 0.65; 95%CI: 0.37-1.16）。从24项研究的汇总估计中观察到，与土壤传播蠕虫（STH）共感染的儿童中，恶性疟原虫感染的几率也同样较低（OR: 0.42; 95%CI: 0.28-0.64）。经年龄、性别、社会经济状况、营养状况和儿童地理位置等因素调整后，合并STH感染的儿童发生恶性疟原虫感染的风险高于未感染STH的儿童（OR = 1.3; 95% CI 1.03-1.65）。一组16项研究的子集显示，合并疟原虫和STH的儿童患贫血的几率高于单独感染疟原虫的儿童（OR = 1.20; 95% CI: 0.59-2.45），而合并血吸虫和单独感染疟原虫的儿童患贫血的几率几乎相等（OR = 0.97, 95% CI: 0.30-3.14）。目前的综述表明，在疟疾流行国家的儿童中，疟疾-寄生虫合并感染的流行率很高。疟疾和蠕虫感染之间相互作用的性质以及共同感染对贫血的影响仍然没有定论，可能受到受影响儿童免疫反应的调节。需要最新的证据来指导规划和实施适当的干预措施，以控制影响流行国家儿童的疟疾和蠕虫混合感染。我们进行了一项系统回顾和荟萃分析，以更新目前关于发展中国家儿童疟疾和蠕虫双重感染负担程度的知识。我们检索了Medline、Embase、Global Health和Web of Science从数据库建立到2020年3月16日的所有已发表文章，没有任何语言限制。我们发现了55项符合条件的研究，其中28项纳入了meta分析。证据综合摘要表明，儿童中涉及疟疾和寄生虫的双重感染负担很高，并且在流行国家之间差异很大。感染土壤传播性蠕虫（STH）、血孢杆菌和曼氏杆菌的儿童感染恶性疟原虫的风险较低。相反，与单独感染疟原虫的儿童相比，同时感染疟原虫和血吸虫的儿童患贫血的几率更高，而同时感染疟原虫和血吸虫的儿童患贫血的几率与单独感染疟原虫的儿童几乎相等。这些发现强调有必要进一步了解疟疾-寄生虫合并感染的流行病学，以便支持实施适当的干预措施，控制并最终消除流行国家，特别是低收入和中等收入国家（LMIC）儿童的双重感染。
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. 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 endemic countries. 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). 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. Updated evidence is needed to guide the planning and implementation of appropriate interventions for control of mixed infections involving malaria and worms affecting children living in endemic countries. We performed a systematic review and meta-analysis to update current knowledge on the magnitude of the burden of dual infections with malaria and worms in children in the developing world. We searched all published articles available in Medline, Embase, Global Health and Web of Science from the database inception until 16 March 2020, without any language restriction. We found 55 eligible studies, and 28 of these studies were included in the meta-analysis. A summary of the evidence synthesis showed that the burden of dual infections involving malaria and worm parasites is high in children and varies significantly across endemic countries. There was a lower risk of P. falciparum infection in children infected with soil transmitted helminths (STH) or S. haematobium or S.mansoni. Conversely, the odds of anaemia were higher in children who had dual infections with Plasmodium and STH parasites than in children with a Plasmodium infection alone while the odds of anaemia were almost equal in children who were co-infected with Plasmodium-Schistosoma compared to those with a Plasmodium infection alone. These findings underscore the need to further understand the epidemiology of malaria-helminth co-infections in order to support implementation of appropriate interventions for control and, ultimately, elimination of the dual infections in children living in endemic countries, especially low and middle-income countries (LMIC).
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DOI：
10.1186/s13223-018-0235-z
发表时间：
2018
期刊：
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
影响因子：
--
作者：
Bwanika R;Kato CD;Welishe J;Mwandah DC
通讯作者：
Mwandah DC
影响因子：
3.8
作者：
Dejon-Agobe, Jean Claude;Zinsou, Jeannot Frejus;Adegnika, Ayola Akim
通讯作者：
Adegnika, Ayola Akim
DOI：
10.4269/ajtmh.2005.72.702
发表时间：
2005-06-01
影响因子：
3.3
作者：
Briand, V;Watier, L;Cot, M
通讯作者：
Cot, M
影响因子：
3
作者：
Abanyie FA;McCracken C;Kirwan P;Molloy SF;Asaolu SO;Holland CV;Gutman J;Lamb TJ
通讯作者：
Lamb TJ
影响因子：
3.7
作者：
Degarege, Abraham;Legesse, Mengistu;Erko, Berhanu
通讯作者：
Erko, Berhanu