Global prevalence of congenital malaria: A systematic review and meta-analysis

Objective: The aim of this systematic review and meta-analysis is to pool the prevalence of congenital malaria.

Study design: The guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was strictly followed. The published studies were searched in international and national databases. Quality assessment for studied was performed using the modified Newcastle - Ottawa scale. Pooled Meta logistic regression was computed using OpenMeta Analyst software. The heterogeneity was explored by the subgroup and meta-regression method.

Results: Twenty-four studies enrolling 8148 newborns were conducted. All the studies were high-quality studies. The prevalence of congenital malaria ranged from 0.0 % in Colombia to 46.7 % in Nigeria. The overall prevalence of congenital malaria was 6.9 % (95 % CI: 4.8-7.9 %) (562/8148). There was large heterogeneity in prevalence of congenital malaria estimates among the different settings (I² = 96.1 %). Hence the random effect model was used. In subgroup analyses, with respect to the type of malaria transmission, the prevalence of congenital malaria was significantly higher in areas characterized by unstable malaria transmission vs. the rate in areas with stable malaria transmission [16.8 % (95 % CI: 8.0-25.6 %) vs. 3.5 % (95 % CI: 2.3-4.6 %), Coefficient = 0.111; P = 0.035]. The results of additional sub- group (meta-regression) analyses showed a non-significant difference in prevalence of congenital malaria in study-sample sizes (Coefficient = -0.001, 95 % CI: -0.001 to 0.001), P-value = 0.534) and year of publication (C = -0.005; 95 % CI: -0.016 to 0.006), P-value = 0.369).

Conclusion: This meta-analysis showed a varied prevalence of congenital malaria across endemic areas and it was higher in areas with unstable malaria transmissions.