{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:19:10Z","timestamp":1791569950981,"version":"4.3.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009138","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000}}],"reference-count":89,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"crossref","award":["MR\/S03286X\/1"],"award-info":[{"award-number":["MR\/S03286X\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methodology\/Principal findings<\/jats:title><jats:p>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\u2019s Q and evaluated the severity of heterogeneity using I<jats:sup>2<\/jats:sup>statistics. The included studies were examined for publication bias using a funnel plot and statistical significance was assessed using Egger\u2019s test (bias if p&lt;0.1).<\/jats:p><jats:p>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<jats:italic>Plasmodium<\/jats:italic>-helminth co-infections of 17.7% (95% CI 12.7\u201323.2%). Summary estimates from 14 studies showed a lower odds of<jats:italic>P<\/jats:italic>.<jats:italic>falciparum<\/jats:italic>infection in children co-infected with<jats:italic>Schistosoma spp<\/jats:italic>(OR: 0.65; 95%CI: 0.37\u20131.16). Similar lower odds of<jats:italic>P<\/jats:italic>.<jats:italic>falciparum<\/jats:italic>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\u20130.64).<\/jats:p><jats:p>When adjusted for age, gender, socio-economic status, nutritional status and geographic location of the children, the risk of<jats:italic>P<\/jats:italic>.<jats:italic>falciparum<\/jats:italic>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\u20131.65).<\/jats:p><jats:p>A subset of 16 studies showed that the odds of anaemia were higher in children co-infected with<jats:italic>Plasmodium<\/jats:italic>and STH than in children with<jats:italic>Plasmodium<\/jats:italic>infection alone (OR = 1.20; 95% CI: 0.59\u20132.45), and were almost equal in children co-infected with<jats:italic>Plasmodium-Schistosoma spp<\/jats:italic>or<jats:italic>Plasmodium<\/jats:italic>infection alone (OR = 0.97, 95% CI: 0.30\u20133.14).<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Conclusions\/Significance<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0009138","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T20:20:44Z","timestamp":1613679644000},"page":"e0009138","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":63,"title":["Malaria and helminth co-infections in children living in endemic countries: A systematic review with meta-analysis"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9967-6419","authenticated-orcid":true,"given":"Muhammed O.","family":"Afolabi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8449-3310","authenticated-orcid":true,"given":"Boni M.","family":"Ale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3158-0074","authenticated-orcid":true,"given":"Edgard D.","family":"Dabira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0648-3336","authenticated-orcid":true,"given":"Schadrac C.","family":"Agbla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaya L.","family":"Bustinduy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0450-5551","authenticated-orcid":true,"given":"Jean Louis A.","family":"Ndiaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Greenwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"pntd.0009138.ref001","first-page":"21","article-title":"Multiparasitism a neglected reality on global, regional and local scale.","volume":"73","author":"P Steinmann","year":"2010","journal-title":"Adv Parasitol"},{"issue":"6_Suppl","key":"pntd.0009138.ref002","doi-asserted-by":"crossref","first-page":"88","DOI":"10.4269\/ajtmh.2007.77.88","article-title":"Epidemiology of Plasmodium-Helminth Co-Infection in Africa: Populations at Risk, Potential Impact on Anemia, and Prospects for Combining Control","volume":"77","author":"S Brooker","year":"2007","journal-title":"The American journal of tropical medicine and hygiene"},{"key":"pntd.0009138.ref003","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1186\/1471-2334-12-291","article-title":"Malaria and related outcomes in patients with intestinal helminths: a cross-sectional study.","volume":"12","author":"A Degarege","year":"2012","journal-title":"BMC Infect Dis"},{"issue":"8","key":"pntd.0009138.ref004","doi-asserted-by":"crossref","first-page":"e0006663","DOI":"10.1371\/journal.pntd.0006663","article-title":"Schistosoma haematobium effects on Plasmodium falciparum infection modified by soil-transmitted helminths in school-age children living in rural areas of Gabon.","volume":"12","author":"JC Dejon-Agobe","year":"2018","journal-title":"PLoS neglected tropical diseases."},{"key":"pntd.0009138.ref005","unstructured":"World malaria report 2019. 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