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This synergistic burden aggravates health inequalities, strains healthcare infrastructure, and challenges socioeconomic stability. Investigating the relationship between these co-infections is crucial for enhancing treatment, prevention, diagnosis, and control strategies for malaria in individuals living with HIV. Therefore, this systematic review and meta-analysis aimed to determine the overall burden of malaria-HIV co-infection, as well as the rates of severe anemia, hyperparasitemia, and CD4\u2009+\u2009T-cell counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted using several electronic databases, including PubMed, Science Direct, Scopus, and Cochrane, as well as search engines like Google Scholar. A random-effects model was used to calculate pooled burden estimates. Subgroup analysis and funnel plots were utilized to evaluate heterogeneity and publication bias, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Of the 429 studies initially reviewed, ten articles met the criteria for inclusion in the final analysis. The pool prevalence estimate of malaria-HIV co-infection was 9% (95% CI 3\u201315). When grouped by the year of conduct, studies from 2013 to 2025 exhibited the highest malaria burden at 10% (95% CI -4-24), while those conducted from 2002 to 2012 showed the lowest burden at 9% (95% CI 1\u201316). The overall combined prevalence rates for specific clinical conditions were 31% (95% CI 12\u201350) for severe anemia, 41% (95% CI -8-90) for hyperparasitemia, and 35% (95% CI 14\u201356) for low CD4 counts (\u2264\u2009200 cells\/\u00b5L).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis found that the overall burden of malaria-HIV co-infection in Ethiopia is 9%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13609-8","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T03:25:54Z","timestamp":1779161154000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Burden of malaria-HIV coinfection and associated adverse outcomes in Ethiopia: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Temesgen Mitiku","family":"Yeshanew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bokretsion","family":"Gidey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betelhem","family":"Abebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemechis","family":"Waktole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birhan","family":"Getie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temesgen","family":"Getu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nega","family":"Birhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"13609_CR1","doi-asserted-by":"crossref","unstructured":"Venkatesan P. 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