Burden of malaria-HIV coinfection and associated adverse outcomes in Ethiopia: a systematic review and meta-analysis.

BACKGROUND

The co-occurrence of malaria and HIV represents a significant health crisis in sub-Saharan Africa, particularly in Ethiopia, where both diseases are prevalent. This synergistic burden aggravates health inequalities, strains healthcare infrastructure, and challenges socioeconomic stability. Investigating the relationship between these co-infections is crucial for enhancing treatment, prevention, diagnosis, and control strategies for malaria in individuals living with HIV. Therefore, this systematic review and meta-analysis aimed to determine the overall burden of malaria-HIV co-infection, as well as the rates of severe anemia, hyperparasitemia, and CD4 + T-cell counts.

METHODS

A comprehensive literature search was conducted using several electronic databases, including PubMed, Science Direct, Scopus, and Cochrane, as well as search engines like Google Scholar. A random-effects model was used to calculate pooled burden estimates. Subgroup analysis and funnel plots were utilized to evaluate heterogeneity and publication bias, respectively.

RESULT: Of the 429 studies initially reviewed, ten articles met the criteria for inclusion in the final analysis. The pool prevalence estimate of malaria-HIV co-infection was 9% (95% CI 3-15). When grouped by the year of conduct, studies from 2013 to 2025 exhibited the highest malaria burden at 10% (95% CI -4-24), while those conducted from 2002 to 2012 showed the lowest burden at 9% (95% CI 1-16). The overall combined prevalence rates for specific clinical conditions were 31% (95% CI 12-50) for severe anemia, 41% (95% CI -8-90) for hyperparasitemia, and 35% (95% CI 14-56) for low CD4 counts (≤ 200 cells/µL).

CONCLUSION

This meta-analysis found that the overall burden of malaria-HIV co-infection in Ethiopia is 9%.