{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:27:28Z","timestamp":1791390448366,"version":"4.3.3"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009781","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000}}],"reference-count":108,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n \n Ethiopia is one of the scarce African countries where\n Plasmodium vivax<\/jats:italic>\n and\n P<\/jats:italic>\n .\n falciparum<\/jats:italic>\n co-exist. There has been no attempt to derive a robust prevalence estimate of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n in the country although a clear understanding of the epidemiology of this parasite is essential for informed decisions. This systematic review and meta-analysis, therefore, is aimed to synthesize the available evidences on the distribution of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n infection by different locations\/regions, study years, eco-epidemiological zones, and study settings in Ethiopia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This study was conducted in accordance with Preferred Reposting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Studies conducted and published over the last two decades (2000 to 2020) that reported an estimate of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n prevalence in Ethiopia were included. The Cochrane Q (\u03c7\n 2<\/jats:sup>\n ) and the I\n 2<\/jats:sup>\n tests were used to assess heterogeneity, and the funnel plot and Egger\u2019s test were used to examine publication bias. A p-value of the \u03c7\n 2<\/jats:sup>\n test <0.05 and an I\n 2<\/jats:sup>\n value >75% were considered presence of considerable heterogeneity. Random effect models were used to obtain pooled estimate of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n infection prevalence. This study is registered with PROSPERO (International Prospective Register of Systematic Reviews): ID CRD42020201761.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We screened 4,932 records and included 79 studies that enrolled 1,676,659 confirmed malaria cases, from which 548,214 (32.69%) were\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n infections and 1,116,581 (66.59%) were due to\n P<\/jats:italic>\n .\n falciparum<\/jats:italic>\n . The rest were due to mixed infections. The pooled estimate of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n prevalence rate was 8.93% (95% CI: 7.98\u20139.88%) with significant heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n = 100%, p<0.0001). Regional differences showed significant effects (p<0.0001, and\n I<\/jats:italic>\n \n 2<\/jats:italic>\n <\/jats:sup>\n = 99.4%) on the pooled prevalence of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n , while study years (before and after the scaling up of interventional activities) did not show significant differences (p = 0.9,\n I<\/jats:italic>\n \n 2<\/jats:italic>\n <\/jats:sup>\n = 0%). Eco-epidemiological zones considered in the analysis did show a significant statistical effect (p<0.001,\n I<\/jats:italic>\n 2<\/jats:sup>\n = 78.5%) on the overall pooled estimate prevalence. Also, the study setting showed significant differences (p = 0.001, and\n I<\/jats:italic>\n \n 2<\/jats:italic>\n <\/jats:sup>\n = 90.3%) on the overall prevalence, where significant reduction of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n prevalence (4.67%, 95%CI: 1.41\u20137.93%, p<0.0001) was observed in studies conducted at the community level. The studies included in the review demonstrated lack of publication bias qualitatively (symmetrical funnel plot) and quantitatively [Egger\u2019s test (coefficient) = -2.97, 95% CI: -15.06\u20139.13, p = 0.62].\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The estimated prevalence of\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n malaria in Ethiopia was 8.93% with\n P<\/jats:italic>\n .\n vivax<\/jats:italic>\n prevailing in the central west region of Ethiopia, but steadily extending to the western part of the country. Its distribution across the nation varies according to geographical location, study setting and study years.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009781","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T14:03:40Z","timestamp":1631714620000},"page":"e0009781","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":39,"title":["Plasmodium vivax epidemiology in Ethiopia 2000-2020: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9339-5835","authenticated-orcid":true,"given":"Tsige","family":"Ketema","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6286-5689","authenticated-orcid":true,"given":"Ketema","family":"Bacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kefelegn","family":"Getahun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5278-3452","authenticated-orcid":true,"given":"Hernando A. del","family":"Portillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0875-7596","authenticated-orcid":true,"given":"Quique","family":"Bassat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,9,15]]},"reference":[{"key":"pntd.0009781.ref001","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/S0140-6736(19)31096-7","article-title":"Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000\u201317: a spatial and temporal modelling study","volume":"394","author":"KE Battle","year":"2019","journal-title":"Lancet"},{"issue":"1","key":"pntd.0009781.ref002","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1186\/s12936-018-2509-9","article-title":"Anaemia and malaria","volume":"17","author":"NJ White","year":"2018","journal-title":"Malar J."},{"key":"pntd.0009781.ref003","first-page":"3346","article-title":"African origin of the malaria parasite Plasmodium vivax","volume":"5","author":"W Liu","year":"2014","journal-title":"Nature"},{"key":"pntd.0009781.ref004","author":"World Health Organization","year":"2019","journal-title":"Switzerland: World Health Organization"},{"issue":"6","key":"pntd.0009781.ref005","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1056\/NEJM197608052950602","article-title":"The resistance factor to Plasmodium vivax in blacks. 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