Prevalence and risk of Plasmodium vivax infection among Duffy-negative individuals: a systematic review and meta-analysis

Abstract

A better understanding of the occurrence and risk of Plasmodium vivax infection among Duffy-negative individuals is required to guide further research on these infections across Africa. To address this, we used a meta-analysis approach to investigate the prevalence of P. vivax infection among Duffy-negative individuals and assessed the risk of infection in these individuals when compared with Duffy-positive individuals. This study was registered with The International Prospective Register of Systematic Reviews website (ID: CRD42021240202) and followed Preferred Reporting Items for Systematic review and Meta-Analyses guidelines. Literature searches were conducted using medical subject headings to retrieve relevant studies in Medline, Web of Science, and Scopus, from February 22, 2021 to January 31, 2022. Selected studies were methodologically evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Tools to assess the quality of cross-sectional, case–control, and cohort studies. The pooled prevalence of P. vivax infection among Duffy-negative individuals and the odds ratio (OR) of infection among these individuals when compared with Duffy-positive individuals was estimated using a random-effects model. Results from individual studies were represented in forest plots. Heterogeneity among studies was assessed using Cochrane Q and I2 statistics. We also performed subgroup analysis of patient demographics and other relevant variables. Publication bias among studies was assessed using funnel plot asymmetry and the Egger’s test. Of 1593 retrieved articles, 27 met eligibility criteria and were included for analysis. Of these, 24 (88.9%) reported P. vivax infection among Duffy-negative individuals in Africa, including Cameroon, Ethiopia, Sudan, Botswana, Nigeria, Madagascar, Angola, Benin, Kenya, Mali, Mauritania, Democratic Republic of the Congo, and Senegal; while three reported occurrences in South America (Brazil) and Asia (Iran). Among studies, 11 reported that all P. vivax infection cases occurred in Duffy-negative individuals (100%). Also, a meta-analysis on 14 studies showed that the pooled prevalence of P. vivax infection among Duffy-negative individuals was 25% (95% confidence interval (CI) − 3%–53%, I2 = 99.96%). A meta-analysis of 11 studies demonstrated a decreased odds of P. vivax infection among Duffy-negative individuals (p = 0.009, pooled OR 0.46, 95% CI 0.26–0.82, I2 = 80.8%). We confirmed that P. vivax infected Duffy-negative individuals over a wide prevalence range from 0 to 100% depending on geographical area. Future investigations on P. vivax infection in these individuals must determine if Duffy-negativity remains a protective factor for P. vivax infection.

Elevation of serum interleukin-1β levels as a potential indicator for malarial infection and severe malaria: a meta-analysis

“…Egger’s test was used to assess funnel plot symmetry [ 25 ]. Egger’s test with statistical significance ( p < 0.05) might indicate that funnel plot asymmetry was due to a small-study effect [ 26 ]. A contour-enhanced funnel plot was used to explore the cause (s) of funnel plot symmetry [ 27 ].…”

African Plasmodium vivax malaria improbably rare or benign

“…A PCR survey of 952 residents of Ghana proved that they were wholly negative for P. vivax [49]. In 2022, Wilairatana et al [50] reported a systematic review and meta-analysis of the prevalence and risk of P. vivax in Duffy-negative individuals.…”

Novel highly-multiplexed AmpliSeq targeted assay for Plasmodium vivax genetic surveillance use cases at multiple geographical scales

“…; Obaldia et al., 2018 ; Silva-Filho et al., 2020 ; Kho et al., 2021 ). There are an increasing number of reports of P. vivax infections now being detected with sensitive tools in Sub-Saharan Africa where it was long thought to have been absent due to the high proportion of Duffy-negative phenotype in the population ( Culleton et al., 2009 ; Oboh et al., 2020 ; Quaye et al., 2021 ; Wilairatana et al., 2022 ).…”

“…Furthermore, recent studies suggest a much more widespread reservoir of P. vivax transmission, with a potential role for extravascular niches where the parasite can survive while it is not detected (Dechavanne et al;Obaldia et al, 2018;Silva-Filho et al, 2020;Kho et al, 2021). There are an increasing number of reports of P. vivax infections now being detected with sensitive tools in Sub-Saharan Africa where it was long thought to have been absent due to the high proportion of Duffy-negative phenotype in the population (Culleton et al, 2009;Oboh et al, 2020;Quaye et al, 2021;Wilairatana et al, 2022).…”