English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat  Plasmodium -mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of  Plasmodium -mixed infection. The results of the study may provide benefits in the management of  Plasmodium -mixed infection in co-endemic regions.    Methods  This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with  Plasmodium -mixed infection. The primary outcome was the pooled prevalence of  Plasmodium  parasitemia after initiating antimalarial treatment for  Plasmodium -mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in  Plasmodium -mixed infection compared with those in  Plasmodium falciparum  and  Plasmodium vivax  mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of  Plasmodium  parasitemia was compared in subgroup analysis.    Results  Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of  Plasmodium -mixed parasitemia was 30% (95% confidence interval (CI) 16–43;  I  2 : 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of  Plasmodium -mixed parasitemia compared with the treatment of  P. falciparum  was 1.22 ( p : 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93;  I  2 : 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of  P. falciparum  ( p : 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05;  I  2 : 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity ( p : 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834;  I  2 : 0%).    Conclusions  The present findings showed a high prevalence of malarial recurrence after the initial treatment of  Plasmodium -mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs.    Graphic AbstractSupplementary Information  The online version contains supplementary material available at 10.1186/s13071-021-04792-5.

parasites and vectors

The high risk of malarial recurrence in patients with Plasmodium-mixed infection after treatment with antimalarial drugs: a systematic review and meta-analysis