Plasmodium falciparum and Plasmodium vivax Prevalence in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background. Malaria is a protozoan disease caused by the Plasmodium species. Among the five Plasmodium species known to infect human beings, Plasmodium falciparum and Plasmodium vivax malaria are by far the most predominant and widely distributed in Ethiopia. Malaria is one of the leading causes of morbidity and mortality globally, particularly in the sub-Saharan countries including Ethiopia. It is also a major obstacle to socio-economic development in the country. Methods. Articles were searched from PubMed, Google Scholar, and Science Direct databases. The pooled prevalence estimates were analyzed using the DerSimonian-Laird random-effects model and the possible sources of heterogeneity were evaluated through subgroup analysis, metaregression, and sensitivity analysis. Publication bias was analyzed using funnel plots and Egger's test statistics. The data management and analysis were done using STATA 15.1 version software. Results. Among 922 studies initially identified, thirty-five full-text articles fulfilled the inclusion criteria and included in the study. The combined, Plasmodium falciparum, Plasmodium vivax, and mixed infections pooled prevalence estimates were 25.8% (95% CI: 21.3, 30.4), 14.7% (95% CI: 11.4, 18.1), 8.7% (95% CI: 7.0, 10.4), and 1.2% (95% CI: 20.7, 29.9), respectively. Based on agro-ecological subgroup analysis, the highest malaria prevalence (37.6%) was obtained from studies conducted on mixed regions of low lands and midlands while the least (20.7%) was from low lands. In Ethiopia, malaria transmission is seasonal, variable, and coincides with the peak agricultural activities that greatly affected the country's socio-economic development. Conclusions. This systematic review and meta-analysis showed a high malaria prevalence in Ethiopia. Therefore, previous prevention and control measures should be revised and/or strengthened as appropriate and new strategies should be implemented. In addition, technical, financial and material support, and coordination of the regional capacity building and logistics should be adequately implemented.