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Severity and mortality of severe Plasmodium ovale infection: A systematic review and meta-analysis

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  • Manas Kotepui
  • Kwuntida Uthaisar Kotepui
  • Giovanni D Milanez
  • Frederick R Masangkay

Abstract

Plasmodium ovale can infect humans, causing malaria disease. We aimed to investigate the severity and mortality of severe P. ovale infection to increase the awareness of physicians regarding the prognosis of this severe disease and outcome-related deaths in countries in which this disease is endemic. Articles that were published in the PubMed, Scopus, and ISI Web of Science databases prior to January 5, 2020 and reported the prevalence of severe P. ovale infection were systematically searched and reviewed. Studies that mainly reported severe P. ovale infection according to the 2014 WHO criteria for the treatment of malaria were included. Two reviewers selected, identified, assessed, and extracted data from studies independently. The pooled prevalence of severe P. ovale mono-infections was estimated using the command “metaprop case population, random/fixed”, which yielded the pooled estimate, 95% confidence interval (CI) and the I2 value, indicating the level of heterogeneity. Meta-analyses of the proportions were performed using a random-effects model to explore the different proportions of severity between patients with P. ovale and those with other Plasmodium species infections. Among the eight studies that were included and had a total of 1,365 ovale malaria cases, the pooled prevalence of severe P. ovale was 0.03 (95% CI = 0.03–0.05%, I2 = 54.4%). Jaundice (1.1%), severe anemia (0.88%), and pulmonary impairments (0.59%) were the most common severe complications found in patients infected with P. ovale. The meta-analysis demonstrated that a smaller proportion of patients with P. ovale than of patients with P. falciparum had severe infections (P-value = 0.01, OR = 0.36, 95% CI = 0.16–0.81, I2 = 72%). The mortality rate of severe P. ovale infections was 0.15% (2/1,365 cases). Although severe complications of P. ovale infections in patients are rare, it is very important to increase the awareness of physicians regarding the prognosis of severe P. ovale infections in patients, especially in a high-risk population.

Suggested Citation

  • Manas Kotepui & Kwuntida Uthaisar Kotepui & Giovanni D Milanez & Frederick R Masangkay, 2020. "Severity and mortality of severe Plasmodium ovale infection: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-15, June.
  • Handle: RePEc:plo:pone00:0235014
    DOI: 10.1371/journal.pone.0235014
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    Citations

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    Cited by:

    1. Rachel Sendor & Kristin Banek & Melchior M. Kashamuka & Nono Mvuama & Joseph A. Bala & Marthe Nkalani & Georges Kihuma & Joseph Atibu & Kyaw L. Thwai & W. Matthew Svec & Varun Goel & Tommy Nseka & Jes, 2023. "Epidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo," Nature Communications, Nature, vol. 14(1), pages 1-13, December.
    2. Polrat Wilairatana & Pattamaporn Kwankaew & Kwuntida Uthaisar Kotepui & Manas Kotepui, 2022. "Low Interleukin-12 Levels concerning Severe Malaria: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(15), pages 1-20, July.
    3. Aongart Mahittikorn & Kwuntida Uthaisar Kotepui & Wanida Mala & Polrat Wilairatana & Manas Kotepui, 2022. "Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis," IJERPH, MDPI, vol. 19(18), pages 1-15, September.
    4. Kwuntida Uthaisar Kotepui & Manas Kotepui, 2021. "Malaria Infection and Risk for Endemic Burkitt Lymphoma: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(11), pages 1-13, May.
    5. Wanida Mala & Polrat Wilairatana & Chutharat Samerjai & Frederick Ramirez Masangkay & Kwuntida Uthaisar Kotepui & Manas Kotepui, 2022. "Prevalence of Signs of Severity Identified in the Thai Population with Malaria: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(3), pages 1-29, January.
    6. Minyahil Tadesse Boltena & Ziad El-Khatib & Abraham Sahlemichael Kebede & Benedict Oppong Asamoah & Andualem Tadesse Boltena & Melese Yeshambaw & Mulatu Biru, 2021. "Comorbidity of Geo-Helminthes among Malaria Outpatients of the Health Facilities in Ethiopia: Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(3), pages 1-15, January.

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