Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Nov 25;22(1):359.
doi: 10.1186/s12936-023-04794-x.

Evidence of malarial chemoprophylaxis among travellers who died from malaria: a systematic review and meta-analysis

Manas Kotepui  1 , Kwuntida Uthaisar Kotepui  2 , Frederick Ramirez Masangkay  3 , Polrat Wilairatana  4
Affiliations
Meta-Analysis

Evidence of malarial chemoprophylaxis among travellers who died from malaria: a systematic review and meta-analysis

Manas Kotepui et al. Malar J. .

Abstract

Background: Chemoprophylaxis is a prevention method for malaria during travel in malaria-endemic countries. This study aimed to collate and synthesize the evidence of malarial chemoprophylaxis among malaria death cases.

Methods: Studies documenting malarial chemoprophylaxis related to malaria deaths were searched in PubMed, Scopus, MEDLINE, Embase, and CENTRAL until 3 July 2022. The pooled proportion of malarial chemoprophylaxis among death cases was synthesized using logit transformation and back transformation to a proportion performed using generalized linear mixed models. The pooled log odds ratio (log-OR) with a 95% confidence interval (CI) of malarial chemoprophylaxis in death cases compared to survivors were synthesized.

Results: Fifty-eight studies were included in the systematic review and the meta-analysis. Of 602 pooled malaria death cases, the number of patients who took chemoprophylaxis was 187 (30%) (95% CI 22-40, P < 0.01, 58 studies), and those who took adequate chemoprophylaxis were 24 (5%) (95% CI 2-13, P < 0.01, 42 studies). A comparable log-OR of underwent chemoprophylaxis was observed between malaria death cases and survivors (P = 0.94, pooled log-OR: - 0.02, 95% CI - 0.46-0.42, I2: 0%, 17 studies). Similarly, a comparable log-OR of adequate chemoprophylaxis was identified between malaria death cases and survivors (P = 0.15, pooled log-OR: 0.83, 95% CI - 0.30-1.97, I2: 47.08%, 11 studies).

Conclusions: Among the studies where malarial chemoprophylaxis was reported, approximately 30% of malaria death cases had taken such prophylaxis. Notably, only 5% of these cases adhered fully or adequately to the recommended chemoprophylactic regimen. However, the analysis did not reveal a significant difference in the odds of malarial chemoprophylaxis between malaria death cases and survivors.

Keywords: Chemoprophylaxis; Compliance; Deaths; Malaria; Travelers.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Global distribution of imported malaria deaths and countries visited by infected individuals. 1 Africa; 2 Africa (East); 3 Africa (South); 4 Africa (West); 5 Africa (Central); 6 Sub-Saharan Africa; 7 Angola; 8 Benin; 9 Botswana; 10 Burkina Faso; 11 Cameroon; 12 Cape Verde; 13 Chad; 14 China; 15 Democratic Republic of Congo (Zaire); 16 Dominican Republic; 17 Ecuador; 18 Egypt; 19 Equatorial Guinea; 20 Ethiopia; 21 Gabon; 22 Gambia; 23 Ghana; 24 Guatemala; 25 Guinea; 26 Guyana; 27 Haiti; 28 Honduras; 29 India; 30 Kenya; 31 Liberia; 32 Madagascar; 33 Malawi; 34 Mali; 35 Mauritius; 36 Mexico; 37 Mozambique; 38 Nicaragua; 39 Nigeria; 40 Papua New Guinea; 41 Philippines; 42 Puerto Rico; 43 Republic of Congo; 44 Rwanda; 45 Senegal; 46 Sierra Leone; 47 Somalia; 48 South America; 49 Sudan; 50 Switzerland; 51 Tanzania; 52 Thailand; 53 Togo; 54 Uganda; 55 United States of America (USA); 56 Yemen; 57 Zambia; 58 Zimbabwe. The map was generated by authors using the map freely available at https://mapchart.net/. Authors are allowed to use, edit and modify any map created with mapchart.net for publication freely by adding the reference to mapchart.net
Fig. 3
Fig. 3
The pooled proportion of malaria death cases who took any chemoprophylaxis
Fig. 4
Fig. 4
The pooled proportion of malaria death cases who took adequate chemoprophylaxis
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Mahittikorn A, Masangkay FR, Kotepui KU, Milanez GJ, Kotepui M. Comparison of Plasmodium ovale curtisi and Plasmodium ovale wallikeri infections by a meta-analysis approach. Sci Rep. 2021;11:6409. doi: 10.1038/s41598-021-85398-w. - DOI - PMC - PubMed
    1. Sukkanon C, Masangkay FR, Mala W, Kotepui KU, Wilairatana P, Chareonviriyaphap T, et al. Prevalence of Plasmodium spp. in Anopheles mosquitoes in Thailand: a systematic review and meta-analysis. Parasit Vectors. 2022;15:285. doi: 10.1186/s13071-022-05397-2. - DOI - PMC - PubMed
    1. Mahittikorn A, Masangkay FR, Kotepui KU, Milanez GJ, Kotepui M. Quantification of the misidentification of Plasmodium knowlesi as Plasmodium malariae by microscopy: an analysis of 1569 P. knowlesi cases. Malar J. 2021;20:179. doi: 10.1186/s12936-021-03714-1. - DOI - PMC - PubMed
    1. Vliegenthart-Jongbloed K, de Mendonca Melo M, van Wolfswinkel ME, Koelewijn R, van Hellemond JJ, van Genderen PJ. Severity of imported malaria: protective effect of taking malaria chemoprophylaxis. Malar J. 2013;12:265. doi: 10.1186/1475-2875-12-265. - DOI - PMC - PubMed
    1. Mace KE, Lucchi NW, Tan KR. Malaria surveillance—United States, 2017. MMWR Surveill Summ. 2021;70:1–35. doi: 10.15585/mmwr.ss7002a1. - DOI - PMC - PubMed