Table 1.
Characteristics of the included studies.
| No. | Author, year | Study area (years of the survey) | Study design | Age range | Gender | Participants | HIV status | Plasmodium mono–infections | Detection method for Plasmodium sp. | Severe malaria (mono-infections) | HIV mono-infections | Detection method for HIV | Co-infections |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | Addissie et al. (2007)21 | Ethiopia (2003–2004) | Cross-sectional study | 15–34 | Male (203), Female (104) |
337 P. falciparum Severe 62 Prostration 18 Hyperparasitemia 17 Cerebral manifestations 16 Other 18 |
Recently diagnosed | 323 (P. falciparum) | Microscopy |
Severe malaria 52 Cerebral malaria 16, prostration 18, hyperparasitemia, and other complications (estimated 18) |
NA | ELISA |
14 (P. falciparum) Severe malaria 3 (P. falciparum) |
| 2. | Amodu-Sanni et al. (2020)22 | Nigeria (2016) | Cross-sectional study | 3 months to 15 years | Male (143), Female (137) | 140 HIV positive, 140 HIV negative | Undertreated | 132 (P. falciparum) | Microscopy | Severe malaria 84 | 40 | ELISA, PCR |
100 (P. falciparum) Severe malaria 46 (P. falciparum) |
| 3. | Berg et al. (2014)2 | Mozambique (2011–2012) | Cross-sectional study | 18–84 | Male (142), Female (126) | 212 adults with fever and/or suspected malaria, 56 healthy controls | Recently diagnosed | 61 (P. falciparum) | Microscopy, RDT, PCR |
Severe malaria 24/52 Hypotension (1/52), Respiratory distress (3/52), Hyperpyrexia (6/50), GCS < 11 and/or convulsions (5/61), Bleeding disturbances and/or hemolysis (1/61), Jaundice (3/61) Severe anemia (3/55), Hypoglycaemia (0/47), Renal failure (3/46), Hyperparasitaemia (16/53) |
NA | RDT, PCR |
70 (P. falciparum) Severe malaria 55/66 (P. falciparum) Hypotension (0/63), Respiratory distress (15/61), Hyperpyrexia (3/54), GCS < 11 and/or convulsions (6/70), Bleeding disturbances and/or hemolysis (9/70), Jaundice and/or se-bilirubin (13/70), Severe anemia (10/67), Hypoglecemia (5/62), Renal failure (15/63), Hyperparasitemia (33/64) |
| 4. | Berg et al. (2008)23 | Mozambique (2006) | Cross-sectional study | 16–92 | Male (167), Female (166) | 333 adult patients | Immunosuppressed | 8 (P. falciparum) | Microscopy |
Severe malaria 4 Jaundice 1, Renal failure 2, fatal 1 |
NA | RDT |
12 (P. falciparum) Severe malaria 9 (P. falciparum) Jaundice 2, Renal failure 6, Fatal 1 |
| 5. | Berg et al. (2020)24 | Mozambique (2011–2012) | Cross-sectional study | ≥ 18 years | Male (71), Female (60) | 131 P. falciparum | Undertreated | 61 (P. falciparum) | Microscopy, RDT |
Severe malaria 28 Bleeding disturbances and/or haemolysis 1, Fatal 1 |
NA | PCR |
70 (P. falciparum) Severe malaria 57 (P. falciparum) Bleeding disturbances and/or hemolysis 9, Fetal 9 |
| 6. | Berkley et al. (2009)25 | Kenya (1998–2002) | Cross-sectional study | Children aged ≥ 60 days | NA | 3,068 severe P. falciparum, 592 healthy control | Recently diagnosed | P. falciparum | Microscopy | Severe malaria 938/1071 |
119/684 10/592 |
ELISA | Severe malaria 133/1071 (P. falciparum) |
| 7. | Beyene et al. (2017)26 | Ethiopia (2012–2013) | Cross-sectional study | < 27 years (139), 27.00–31.99 years (141), 32.0–39.74 years (113), ≥ 39.75 (131) | Male (250), Female (284) | 528 people living with HIV/AIDS | Recently diagnosed | NA | Microscopy, RDT | NA |
436 Severe anemia 12 |
NA |
92 (52 P. falciparum, 37 P. vivax, and 3 mixed infections) Severe anemia 25 (Plasmodium spp.) |
| 8. | Bronzan et al. (2007)27 | Malawi (1996–2005) | Cross-sectional study | ≥ 6 months old | Male (250), Female (541) | 1388 severe malaria | Recently diagnosed | 941 severe malaria (P. falciparum) | NA |
941 severe malaria Cerebral malaria 541/627 Cerebral malaria and severe anemia 291/355, severe anemia 109/137 |
RDT |
Severe malaria 178 (P. falciparum) Cerebral malaria 86/627 Cerebral malaria and severe anemia 64/355, severe anemia 28/137 |
|
| 9. | Chalwe et al. (2009)28 | Zambia (2004–2005) | Case–control study |
15–49 years 15–19, 20–29, 30–39, 40–49 |
Male (42), Female (45) | 29 severe malaria, 29 uncomplicated malaria, 29 asymptomatic community controls | Immunosuppressed | 32 (P. falciparum) | Microscopy, RDT |
Severe 2 Jaundice 1 |
NA | RDT, ELISA, Western blot |
55 (P. falciparum) Severe malaria 27 (P. falciparum) Impaired consciousness 15, Severe anemia 5, Convulsions 6, Jaundice 3, Hypoglycemia 11, Hyperparasitemia 6 |
| 10. | Cohen et al. (2005)15 | South Africa (2001–2002) | A prospective cohort study |
15–49 years: Malaria-mono-infection: 29 (17–49) Co-infection: 30 (17–49) |
Malaria-mono-infection: Male (178), Female (48) Co-infection: Male (85), Female (25) |
502 P. falciparum patients | Immunosuppressed | 226 (P. falciparum) | Microscopy, RDT |
Severe malaria 14: Cerebral malaria 4, Severe anemia 0 Renal impairment 9, Shock 2, Acidosis 3, Hypoglycemia 0, Hepatic dysfunction 8 |
NA | RDT, ELISA |
110 (P. falciparum) Severe malaria 18 (P. falciparum): Cerebral malaria 3 Severe anemia 3, Renal impairment 14, Shock 2, Acidosis 11, Hypoglycemia 1, Hepatic dysfunction 6 |
| 11. | Davenport et al. (2010)29 | Kenya (2004–2006) | Cross-sectional study | 3–36 months |
Malaria-mono-infection: Male (219), Female (187) Co-infection: Male (14), Female (10) |
542 with P. falciparum | Undertreated | 406 (P. falciparum) | Microscopy | Severe anemia 44 | NA | RDT, PCR |
24 (P. falciparum) Severe anemia 14 (P. falciparum) |
| 12. | Grimwade et al. (2004)42 | South Africa (2000) | Cross-sectional study |
Adults (> 14 y): Malaria-mono-infection: 28 (18–43) Co-infection: 30 (22–42) |
Malaria-mono-infection: Male (211), Female (222) Co-infection: Male (70), Female (110) |
1,109 febrile adults | Recently diagnosed | 433 (P. falciparum) | Microscopy, RDT |
Severe malaria 62: Severe malaria 18: Impaired renal function 32, Coma 16, Severe anemia 22, Pulmonary edema 2, Bleeding 0, Acidosis 13, Confusion 18, Jaundice 3 |
152 | ELISA |
180 (P. falciparum) Severe malaria 18 (P. falciparum): Renal failure 28, Coma 16, Severe anemia 14, Pulmonary edema 4, Bleeding 2, Acidosis 15, Confusion 7, Jaundice 9 |
| 13. | Hendriksen et al. (2012)30 | Mozambique (2005–2010) | Cross-sectional study |
Malaria-mono-infection: 2.5–23 Co-infection: 3–38 Age group < 15 and > 15 years |
Malaria-mono-infection: Male (6314), Female (286) Co-infection: Male (68), Female (55) |
896 with suspected severe malaria | Recently diagnosed | 600 (P. falciparum) | Microscopy, RDT |
Severe malaria 549 Coma 454, Convulsions 516, Prostration 137, Shock 21, Severe respiratory distress 38, Severe acidosis 109, Hypoglycemia 33, Severe anemia with respiratory distress 67, Black water fever 28, Severe jaundice 17, Hyperparasitemia 109 |
NA | RDT, PCR |
123 (P. falciparum) Severe malaria 107 (P. falciparum) Coma 89, Convulsions 74, Prostration 31, Shock 6, Severe respiratory distress 20, Severe acidosis 38, Hypoglycemia 10, Severe anemia with respiratory distress 18, Black water fever 15, Severe jaundice 9, Hyperparasitemia 33 |
| 14. | Hochman et al. (2015)31 | Malawi (1996–2010) | Case–control study | 6 months to 12 years |
Malaria-mono-infection: Male (39), Female (18) Co-infection: Male (7), Female (8) |
103 autopsy tissues | Recently diagnosed | 57 (P. falciparum) | ELISA | Cerebral malaria 57 | NA | IHC | Cerebral malaria 15 (P. falciparum) |
| 15. | Huson et al. (2015)32 | Gabon (2012–2013) | Prospective observational study | age ≥ 18 years |
Malaria-mono-infection: Male (44), Female (69) Co-infection: Male (0), Female (14) |
103 patients with sepsis 127 patients with malaria, 60 HIV infected control | Undertreated | 133 (P. falciparum) | Microscopy |
0 Fetal 0 |
RDT, PCR |
14 (P. falciparum) Fetal 1 (P. falciparum) |
|
| 16. | Imani et al. (2011)43 | Uganda (2006–2007) | Case–control study | < 12 years | Cerebral malaria: Male (70), Female (30), uncomplicated malaria: Male (92), Female (40), non-malaria: Male (84), Female (36) |
352 children: 100 cerebral malaria, 132 uncomplicated malaria, 120 non-malaria |
Recently diagnosed | 220 (P. falciparum) | Microscopy |
220 Cerebral malaria 91/220 |
NA | RDT |
12 (P. falciparum) Cerebral malaria 9/12 (P. falciparum) |
| 17. | Jacques et al. (2019)33 | Congo (2017–2018) | Cross-sectional study |
12–60 years Co-infection 12–60 years |
Male (111), Female (114) | 225 undernourished children (200 malaria) | Recently diagnosed | NA | Microscopy | NA | NA | RDT, ELISA, PCR |
168 (Plasmodium spp.) Severe anemia 86 (Plasmodium spp.) |
| 18. | Joice et al. (2016)34 | Malawi (1996–2011) | Case–control study |
Malaria-mono-infection: 3.1–8.8 Co-infection: 1.7–3.6 |
Malaria-mono-infection: Male (38), Female Co-infection: Male (9), Female (11) |
103 autopsy cases | NA | 75 (P. falciparum) | IHC | Cerebral malaria 75 | NA | PCR | Cerebral malaria 20/95 (P. falciparum) |
| 19. | Kyeyune et al. (2014)44 | Malawi (2002–2004) | Prospective observational study | aged < 2 years | NA | 391 children with severe anemia | Recently diagnosed | 183/312 (P. falciparum) | Microscopy | severe anemia 183 | 19 | RDT, PCR |
26/45 (P. falciparum) Severe anemia 26 (P. falciparum) |
| 20. | Mandala et al. (2018)35 | Malawi (2005–2006) | Cross-sectional study | 1.2–4.6 years | Male (5), Female (33) | 38 Cerebral malaria, 35 severe malarial anemia, control 42, HIV positive 4 | Recently diagnosed | Severe malaria 59 (P. falciparum) | Microscopy |
59 Cerebral malaria 29, Severe anemia 30 |
4 | RDT, PCR |
14 (P. falciparum) Cerebral malaria 9, Severe anemia 5 |
| 21. | Mouala et al. (2008)36 | France (1996–2003) | Retrospective study | < 30, 30–39, 40–49, > 50 years | Male (99), Female (91) |
190 imported malaria P. falciparum 178, other species 12 |
Undertreated | 150 (P. falciparum) | Microscopy | Severe malaria 54 | NA | PCR |
28 (P. falciparum) Severe malaria 11 (P. falciparum) |
| 22. | Munyenyembe et al. (2018)37 | Malawi (2016–2017) | Cross-sectional study |
Malaria-mono-infection: 20–67 Co-infection: 18–66 |
Male (50), Female (57) | 107 participants with malaria | Undertreated | 76 (P. falciparum) | Microscopy, RDT | Severe malaria 18 | NA | RDT |
30 (P. falciparum) Severe malaria 12 (P. falciparum) |
| 23. | Niyongabo et al. (1994)45 | Burundi (1991–1992) | Cross-sectional study | Adults | Male (22), Female (9) | 31 cerebral malaria (P. falciparum) | Recently diagnosed | 29 (P. falciparum) | Microscopy | Severe malaria 17 | NA | ELISA, Western blot | Severe malaria 12 (P. falciparum) |
| 24. | Nkuo-Akenji et al. (2008)38 | Cameroon (2006) | Cross-sectional study | 15–49 years: 15–25, 26–35 and 36–49 years | Male (183), Female (501) | 684 outpatients | Undertreated | 324 (P. falciparum) | Microscopy | Hyperparasitemia 84 | 57 | RDT |
201 (P. falciparum) Hyperparasitemia 102 (P. falciparum) |
| 25. | Otieno et al. (2006)46 | Kenya | A prospective cohort study |
Children < 2 years: Malaria-mono-infection: 11.66 (0.45) Co-infection: 12.04 (1.34) |
Malaria-mono-infection: Male (109), Female (85) Co-infection: Male (12), Female (12) |
317 Children | Recently diagnosed | 194 (P. falciparum) | Microscopy | Severe anemia 37 | NA | RDT, PCR |
23 (P. falciparum) Severe anemia 15 (P. falciparum) |
| 26. | Sandie et al. (2019)39 | Cameroon (2014) | Cross-sectional study | 1–72 years | Male (112), Female (299) | HIV positive patients | Recently diagnosed and undertreated | 34 (Plasmodium spp.) | Microscopy | Severe anemia 1/3 | 285 | RDT |
24 (Plasmodium spp.) Severe anemia 1/9 (Plasmodium spp.) |
| 27. | Saracino et al. (2012)40 | Mozambique (2010) | Cross-sectional study | > 15 years | Male (262), Female (168) | 330 adult patients | Undertreated | 39 (P. falciparum) | Microscopy, RDT | Severe malaria 17 | NA | RDT |
51 (P. falciparum) Severe malaria 29 (P. falciparum) |
| 28. | Tagoe DNA and Boachie (2012)41 | Ghana | Cross-sectional study | 18–65 years | Male (59), Female (161) | 220 adults with HIV | Undertreated | NA | Microscopy, RDT | NA | 186 | NA |
34 (P. falciparum) Severe anemia 6 (P. falciparum) |
| 29. | Tay et al. (2015)17 | Ghana (2011–2012) | Cross-sectional study | 1–73 years: 1–4 (12), 5–9 (2), 10–14 (9), 15–24 (37), 25–34 (147), 35–44 (138), 45–60 (69), > 60 (5) | Male (108), Female (292) | 400 HIV sero-positive participants | Undertreated and immunosuppressed | NA | Microscopy | NA | 326 | RDT |
47 (Plasmodium spp.) Severe anemia 11 (Plasmodium spp.) |
ELISA enzyme-linked immunosorbent assay, GCS Glasgow Coma Scale, IHC immunohistochemistry, NA not applicable, P. Plasmodium, PCR polymerase chain reaction, RDT rapid diagnostic testing.