Pooled prevalence of malaria and associated factors among vulnerable populations in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Malaria is a serious, fatal disease, and a high-risk determinant for human health globally. Children, pregnant women, and migrants are vulnerable groups for malaria infection in African regions. Recently, malaria is an endemic disease in Ethiopia.

Objectives: This study aimed to determine the pooled prevalence of malaria and its determinant factors among the most vulnerable populations in Ethiopia.

Methods: Electronic databases, including PubMed, Google Scholar, Web of Science, Semantic Scholar, and Scopus were used for searching articles published since the 2020 Gregorian calendar and onwards. All peer-reviewed Ethiopian journals, health institutions, and Universities were considered for article searching. A PRISMA flow chart and Endnote software were used for article screening, and to remove duplications, respectively. The modified version of the Newcastle-Ottawa Scale was used for potential risk of bias assessments. The heterogeneity among the included studies was evaluated using the indicator of heterogeneity (I²). Egger's test and funnel plot were used to examine the possible publication bias. A random-effects analysis was used to assess the pooled prevalence of malaria, and its determinant factors with a 95% CI. The screening process, data extraction, and quality assessment were done independently, and any disagreements were resolved through discussions.

Results: A total of twelve studies were included in this study. The pooled malaria prevalence was 11.10% (95% CI: 6.10, 16.11). Stagnant water (AOR: 4.19, 95% CI: 2.47, 7.11), no insecticide-treated net utilization (AOR: 3.15, 95% CI: 1.73, 5.73), and staying outdoors at night (AOR: 5.19, 95% CI: 2.08, 12.94) were the pooled estimated statistically risk factors for malaria prevalence. Whereas, insecticide-treated bed net utilization (AOR: 1.59, 95% CI: 0.23, 10.95) reduces the risk of malaria infection.

Conclusions: The pooled prevalence of malaria is high among vulnerable populations. Creating awareness regarding utilization of insecticide-treated bed nets, and draining stagnant water from the environment are possible interventions to reduce the prevalence of malaria.

Keywords: Ethiopia; Malaria; Meta-analysis; Prevalence; Systematic review.

Fig. 1

PRISMA flow chart showing screening of the identified studies

Fig. 2

Random effect analysis for the pooled prevalence of malaria in Ethiopia

Fig. 3

Random effect analysis for subgroup analysis of malaria among vulnerable populations

Fig. 4

Funnel plot for spotting publication bias among the included studies

Fig. 5

Egger’s funnel plot for spotting publication bias among the included studies

Fig. 6

Begg’s funnel plot for spotting publication bias among the included studies

Fig. 7

Graphical illustration of pooled significant factors associated with malaria, where ITN stands for insecticide-treated net