A Systematic Review and Meta-Analysis of Malaria Test Positivity Outcomes and Programme Interventions in Low Transmission Settings in Southern Africa, 2000–2021

Olukunle O. Oyegoke, Olusegun P. Akoniyon, Ropo E. Ogunsakin, Michael O. Ogunlana, Matthew A. Adeleke, Rajendra Maharaj and Moses Okpeku
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Olukunle O. Oyegoke: Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
Olusegun P. Akoniyon: Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
Ropo E. Ogunsakin: Biostatistics Unit, Discipline of Public Health Medicine, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
Michael O. Ogunlana: Department of Physiotherapy, Federal Medical Centre, Abeokuta 110118, Nigeria
Matthew A. Adeleke: Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
Rajendra Maharaj: Malaria Research Group, South African Medical Research Council, Durban 4000, South Africa
Moses Okpeku: Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban 4000, South Africa

IJERPH, 2022, vol. 19, issue 11, 1-17

Abstract: Malaria is one of the most significant causes of mortality and morbidity globally, especially in sub-Saharan Africa (SSA) countries. It harmfully disturbs the public’s health and the economic growth of many developing countries. Despite the massive effect of malaria transmission, the overall pooled proportion of malaria positivity rate in Southern Africa is still elusive. Therefore, the objective of this systematic review and meta-analysis is to pool estimates of the incidence of the malaria positivity rate, which is the first of its kind in South African countries. A literature search is performed to identify all published articles reporting the incidence of malaria positivity in Southern Africa. Out of the 3359 articles identified, 17 studies meet the inclusion for systematic review and meta-analysis. In addition, because substantial heterogeneity is expected due to the studies being extracted from the universal population, random-effects meta-analyses are carried out to pool the incidence of the malaria positivity rate from diverse diagnostic methods. The result reveals that between-study variability is high ( τ 2 = 0.003; heterogeneity I 2 = 99.91% with heterogeneity chi-square χ 2 = 18,143.95, degree of freedom = 16 and a p -value < 0.0001) with the overall random pooled incidence of 10% (95%CI: 8–13%, I 2 = 99.91%) in the malaria positivity rate. According to the diagnostic method called pooled incidence estimate, the rapid diagnostic test (RDT) is the leading diagnostic method (17%, 95%CI: 11–24%, I 2 = 99.95%), followed by RDT and qPCR and RDT and loop mediated isothermal amplification (LAMP), respectively, found to be (3%, 95%CI: 2–3%, I 2 = 0%) and (2%, 95%CI: 1–3%, I 2 = 97.94%).Findings of the present study suggest high malaria positive incidence in the region. This implies that malaria control and elimination programmes towards malaria elimination could be negatively impacted and cause delays in actualising malaria elimination set dates. Further studies consisting of larger samples and continuous evaluation of malaria control programmes are recommended.

Keywords: malaria; reactive case detection; rapid diagnostic test; PCR; Southern Africa; surveillance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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