Prevalence and Characteristics of Malaria and Influenza Co-Infection in Febrile Patients: A Systematic Review and Meta-Analysis

Abstract

Malaria and influenza are co-endemic in several geographical areas, and differentiation of their clinical features is difficult. The present study aimed to qualitatively and quantitatively analyze the prevalence and characteristics of malaria and influenza co-infection in febrile patients. The systematic review was registered at PROSPERO (CRD42021264525). Relevant literature that reported malaria and influenza co-infection in febrile patients were searched in PubMed, Web of Science, and Scopus from 20 June to 27 June 2021 and the risk of bias for each study was assessed. Quantitative analysis included pooled prevalence, and the odds of malaria and influenza virus co-infection among febrile patients were estimated using a random-effects model. Subgroup analyses were performed to summarize the effect estimate for each group. Funnel plot, Egger’s test, and contour-enhanced funnel plot were used to demonstrate any publication bias among outcomes of included studies. Among 4253 studies retrieved, 10 studies that enrolled 22,066 febrile patients with 650 co-infected patients were included for qualitative and quantitative syntheses. The pooled prevalence of malaria and influenza virus co-infection among febrile patients was 31.0% in Nigeria, 1.0% in Tanzania, 1.0% in Uganda, 1.0% in Malawi, 1.0% in Ghana, 0% in Cambodia, 7.0% in the Central African Republic, and 7.0% in Kenya. Meta-analysis also showed co-infection occurrence by chance (p = 0.097, odds ratio 0.54, 95% CI 0.26–1.12, I2 94.9%). The prevalence of malaria and influenza virus co-infection among febrile patients was heterogeneous by country, characteristics of febrile participants, and diagnostic tests for influenza virus. Further studies should investigate severe clinical manifestations or differentiate clinical outcomes between mono-infected or co-infected individuals, whether the co-infection leads to severe disease outcome.

Emerging Diseases/Viruses Prevention, Control, Surveillance, and One Health

“…Another study aims to analyze the prevalence and characteristics of malaria and influenza co-infection in febrile patients. The prevalence of this co-infection among these patients is revealed to be heterogeneous by country, the characteristics of the febrile participants, and the diagnostic tests for influenza virus [ 21 ].…”

Special Issue “Emerging Diseases/Viruses: Prevention, Control, Surveillance, and One Health”

“…In this Special Issue, we invite colleagues to submit original research articles and scientific reviews to assemble a collection of papers highlighting the progress in our understanding of all aspects related to surveillance and control of zoonotic diseases, including (1) the development of new diagnostic tools, (2) outbreak investigation and surveillance programs of emerging pathogens (including One Health approaches), and (3) understanding the mechanisms of pathogen emergence. The first 10 papers published in this Special Issue address topics related to viruses (SARS-CoV-2, influenza, DENV, WNV, ZIKV), bacteria ( Escherichia coli ), and parasites (Leishmania, Plasmodium) [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”