Does a child with schistosomiasis have higher odds of having malaria?

Yes. A child with schistosomiasis (a parasitic infection from freshwater snails) is more likely to also have malaria. A 2026 meta-analysis pooled data from 30 studies across 12 African countries and found that schistosomiasis infection was linked to 1.27 times higher odds of malaria co-infection ⁴¹¹. This means that if a child has schistosomiasis, their chance of having malaria is about 27% higher than a child without schistosomiasis. The link is strongest in older children and adolescents, typically ages 8 to 17 ⁴¹¹.

What the research says

A 2026 systematic review and meta-analysis, which combined results from 23 studies, found that schistosomiasis infection was associated with 1.27 times higher odds of malaria (odds ratio 1.27; 95% CI: 1.17-1.39) ⁴¹¹. This is a statistically significant increase, meaning the association is unlikely to be due to chance. The same review noted that the risk of co-infection peaks in older children and adolescents, typically between 8 and 17 years old ⁴¹¹.

An earlier 2016 meta-analysis also examined this relationship in children in sub-Saharan Africa. It included 12 studies with over 9,000 children and found that Schistosoma infection was associated with an increased odds of Plasmodium falciparum infection, though the exact effect size varied across studies ¹⁰. This earlier review highlighted that the interaction between the two parasites is complex and may depend on factors like the species of Schistosoma and the intensity of infection ¹⁰.

Beyond just the odds of co-infection, having both infections can worsen health outcomes. A 2023 study of school children in Ghana found that co-infection with malaria and Schistosoma mansoni was associated with a higher risk of anaemia (low hemoglobin) ⁹. In that study, 7.7% of children had both infections, and anaemia was present in 40.5% of the whole group ⁹. This suggests that co-infection may have additive effects on health, particularly for anaemia.

It is important to note that these studies are observational, so they cannot prove that schistosomiasis causes malaria. Instead, they show that the two infections often occur together, likely because they share risk factors like living in areas where both parasites are common and having limited access to clean water and healthcare ⁴¹¹.

What to ask your doctor

• Should my child be tested for malaria if they have schistosomiasis, even if they don't have symptoms?
• What are the signs of malaria I should watch for in my child, given they have schistosomiasis?
• Could my child's anaemia be related to having both infections, and what should we do about it?
• Are there any preventive measures, like bed nets or antimalarial drugs, that are recommended for children with schistosomiasis?
• How often should my child be screened for both malaria and schistosomiasis if we live in an area where both are common?