Over-dispersion in Malaria–Schistosoma Co-infection: Insights from a Meta-analytical Approach and Systematic Review
Abstract
Background 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. Methods 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. Results 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. Conclusions 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.
Related
- Sex-specific correlates of Schistosoma haematobium infection in a rural Zambian setting: A pilot study focusing on immune and hematological factors
- Spatio-Temporal Assessment of Atmospheric Pollutants and Dispersion Mechanisms over West Bengal (2019–2024): Insights from Sentinel-5P, GEOS-CHEM, and HYSPLIT Models
- Assessing tidal sensitivity to bottom friction: analytical insights for model optimization
- Higher--order gradient modeling of velocity dispersion in tight sandstones with implications to agroseismology
- Relative dispersion and eddy diffusivity in laboratory experiments of β-plane turbulence
BibTeX
@article{koellsch2026overdispersion,
title = {{Over-dispersion in Malaria–Schistosoma Co-infection: Insights from a Meta-analytical Approach and Systematic Review}},
author = {Célia Koellsch and Jérôme Boissier and Ronaldo de Carvalho Augusto},
journal = {Infectious Diseases of Poverty},
year = {2026},
month = oct,
doi = {10.1186/s40249-026-01490-1},
url = {https://hal.science/hal-05467375v2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Over-dispersion in Malaria–Schistosoma Co-infection: Insights from a Meta-analytical Approach and Systematic Review
AU - Célia Koellsch
AU - Jérôme Boissier
AU - Ronaldo de Carvalho Augusto
PY - 2026
DA - 2026/10/09
JO - Infectious Diseases of Poverty
DO - 10.1186/s40249-026-01490-1
UR - https://hal.science/hal-05467375v2
AB - Background 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. Methods 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. Results 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. Conclusions 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.
SN - 2095-5162
SN - 2049-9957
ER -