Over-dispersion in malaria-schistosoma co-infection: insights from a meta-analytical approach and systematic review.

Authors

Célia Koellsch-Amet, Jérôme Boissier, Ronaldo Augusto

Published in

Infectious diseases of poverty. Volume 15. Issue 1. Oct 09, 2026. Epub Oct 09, 2026.

Abstract

Malaria and schistosomiasis are two major parasitic diseases that are co-endemic in many regions of sub-Saharan Africa. Despite their frequent geographical overlap, the potential epidemiological patterns and potential interactions associated with Plasmodium--Schistosoma co-infection remain poorly characterized. This study aimed to systematically assess the epidemiology of malaria-schistosomiasis co-infection and to quantify whether co-infections occur more frequently than expected under an assumption of independence between the two infections.
We conducted a systematic review and meta-analysis in accordance with the PRISMA 2020 guidelines. A total of 192 studies published between 1996 and 2023 were included in the qualitative synthesis, of which 59 studies involving 73,383 individuals were included in the meta-analysis. Pooled odds ratio (ORs) were estimated to compare observed and expected co-infection prevalence.
The pooled analysis showed that Plasmodium-Schistosoma co-infection occurs more frequently than expected by chance (overall OR = 1.20, 95% CI 1.02-1.40), despite substantial heterogeneity across studies (I² = 89%). Reported co-infection prevalence ranged from 1.1% in Benin to 36.6% in Mali. School-age children and pregnant women were disproportionately affected. Subgroup analyses revealed no consistent differences according to sex or parasite species.
These findings indicate a non-random distribution of malaria-schistosomiasis co-infection in sub-Saharan Africa, consistent with epidemiological over-dispersion. Although the underlying biological and immunological mechanisms remain uncertain, the widespread co-occurrence of these parasites highlights the importance of integrated surveillance and control strategies that account for polyparasitism in endemic settings.

PMID:
42855707
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.