Mode
Text Size
Log in / Sign up

Schistosomiasis infection increases odds of malaria co-infection by 1.27 in children and adolescentsSchistosomiasis infection increases risk of malaria in African children

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note that schistosomiasis and direct water contact are associated with increased odds of malaria co-infection in children.

This systematic review and meta-analysis evaluated the relationship between schistosomiasis and malaria co-infection among children and adolescents across 12 African countries. The analysis included 30 studies, with a specific meta-analysis of 23 studies to determine odds of co-infection based on infection status, sex, age, and water contact.

The synthesis found that schistosomiasis infection was associated with 1.27 times higher odds of malaria (OR 1.27; 95% CI: 1.17-1.39). Additionally, direct water contact was strongly associated with co-infection (OR 2.53; 95% CI: 1.60-4.00). Regarding sex, males in community-based studies showed higher odds of co-infection (OR 2.08; 95% CI: 1.64-2.63), whereas no significant association was found for males in school-based studies (OR 0.87; 95% CI: 0.64-1.19).

The authors note high heterogeneity (I2 > 80%) as a primary limitation of the data. Because these findings are based on observational studies, they identify risk factors rather than causative links. The results suggest that overlapping environmental and behavioral exposures, particularly water contact in older children, may drive the observed co-infection rates.

How this fits prior evidence

This meta-analysis addresses a gap in understanding how concurrent infections impact pediatric populations in Sub-Saharan Africa. While previous coverage noted that malaria vaccines RTS,S/AS01 and R21/Matrix-M reduce malaria risk in children, this study highlights the additional risk factor of schistosomiasis co-infection. The finding of 1.27 times higher odds for malaria in those with schistosomiasis provides a specific metric for assessing co-infection risks in regions where both diseases are endemic.

Living with two different infections at once can make health management much harder for families. New data shows that children and adolescents in Sub-Saharan Africa who have schistosomiasis are more likely to also be infected with malaria. Specifically, these children had 1.27 times higher odds of having both diseases.

Researchers looked at 30 different studies across 12 countries to see what drives this link. They found that direct contact with water is a major factor, showing a strong connection to getting both infections. While the study also looked at how age and sex play a role, the results were mixed: boys in community settings showed higher odds of co-infection, but no significant difference was found for boys in school settings.

It is important to note that these findings show an association, not a direct cause. Because the studies included were very different from one another, the results should be viewed with some caution. These findings highlight how shared environments and behaviors, like water contact, can put children at risk for multiple illnesses at once.

What this means for you:
Children with schistosomiasis have higher odds of also having malaria, especially those who touch water directly.

Common questions

Does having schistosomiasis mean a child will definitely get malaria?

Not necessarily. The study shows that children with schistosomiasis have 1.27 times higher odds of also having malaria, but this is an association rather than a guaranteed cause. Other factors like environment and behavior also play a role in these risks.

What specific behaviors increase the risk of both infections?

Direct contact with water is strongly associated with co-infection, showing 2.53 times higher odds. This suggests that environmental factors and behaviors related to water are key links between these two conditions.

Does the risk of both infections differ by gender?

The results were mixed regarding sex. In community-based studies, boys had higher odds of co-infection (2.08). However, in school-based studies, no significant difference was found between boys and girls.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up204.0 mo
PublishedJun 2026
View Original Abstract ↓
BACKGROUND: Malaria and schistosomiasis are co-endemic across sub-Saharan Africa, where both diseases often co-occur, yet the shared risk factors for co-infection remain poorly synthesized. METHODS: We conducted a systematic review and meta-analysis to identify shared risk factors for malaria-Schistosoma co-infection and to narratively synthesize the statistical methodologies applied in the literature. We searched PubMed/MEDLINE, Embase, Web of Science, Global Index Medicus, and Global Health from inception to February 19, 2025 (PROSPERO CRD420250648824). We pooled effect sizes for risk factors across sociodemographic, environmental, and behavioral dimensions. Fixed-effects meta-analysis with inverse variance weighting was used to calculate pooled Odds Ratios (OR) and 95% confidence intervals (CIs). Study quality was assessed using a modified version of the Quality Assessment tool for Observational Cohort and Cross-Sectional Studies by the National Institutes of Health. RESULTS: We screened 1,345 records and included 30 studies conducted across 12 African countries. A meta-analysis of 23 studies showed that schistosomiasis infection was associated with 1.27 times higher odds of malaria (OR 1.27; 95% CI: 1.17-1.39). Narrative synthesis identified age as an important predictor, with risk consistently peaking in older children and adolescents (typically 8-17 years). Associations with sex were setting-dependent: males had significantly higher odds of co-infection in community-based studies (OR 2.08; 95% CI: 1.64-2.63), whereas no significant association was found in school-based studies (OR 0.87; 95% CI: 0.64-1.19). Direct water contact was strongly associated with co-infection (OR 2.53; 95% CI: 1.60-4.00). Heterogeneity was high (I2 > 80%), warranting caution during interpretation. Only one study was categorized as high risk of bias. CONCLUSION: The association between malaria and schistosomiasis appears to be associated with overlapping environmental and behavioral exposures, specifically water contact in older children.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.