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Hidden Malaria Threatens Millions of School-Aged Children Worldwide

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MalariaSystematic reviewAsymptomatic infec…

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This is a protocol for a systematic review and meta-analysis investigating asymptomatic malaria infections among school-aged children in Ethiopia. The study will synthesize existing evidence on prevalence, Plasmodium species distribution, and risk factors by searching multiple databases and conducting pooled analyses using standardized methods. School-aged children are increasingly recognized as potential reservoirs for malaria transmission due to partial immunity that allows infections to remain clinically silent.


The findings will provide critical evidence to inform malaria control and elimination strategies in Ethiopia, particularly for targeting interventions toward school-aged populations. Results could strengthen school-based surveillance programs and help address a hidden reservoir of malaria transmission that complicates elimination efforts.


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Malaria 22 articles Explore Concept → Systematic review Concept coming soon Asymptomatic infection Concept coming soon

by Philmon Dejen, Belay Beyene, Tizazu Zenebe Zelelie, Amanuel Kelem, Abiel Teshome, Mahider Ayalew, Techalew Shimelis

Background

Asymptomatic malaria infection remains a major challenge for malaria control and elimination efforts, particularly in endemic settings such as Ethiopia. School-aged children are increasingly recognized as a potential reservoir for malaria transmission due to frequent exposure to infection and the development of partial immunity that allows infections to remain clinically silent. However, available evidence on the burden, species distribution, and determinants of asymptomatic malaria in this population is fragmented and inconsistent. This systematic review and meta-analysis aim to synthesize evidence on the prevalence, Plasmodium species distribution, and risk factors of asymptomatic malaria among school-aged children in Ethiopia.

Methods

This protocol was developed in accordance with the PRISMA-P guidelines. A comprehensive literature search will be conducted in electronic databases (PubMed, Scopus, CINAHL, and ScienceDirect) and additional sources, including Google Scholar and African Journals Online. Eligible studies will include observational studies reporting asymptomatic malaria among school-aged children in Ethiopia. Two independent reviewers will conduct study selection, data extraction, and quality assessment using the Joanna Briggs Institute critical appraisal tool for prevalence studies. A random-effects meta-analysis will be performed using R software to estimate the pooled prevalence. Heterogeneity will be assessed using Cochran’s Q test and I2 statistics, and subgroup analyses will be conducted by diagnostic method, study area, study design, years of actual data collection, and transmission season during data collection. Where sufficiently comparable adjusted estimates are available, associations between prespecified factors and AMI will also be quantitatively synthesized.

Conclusion

The findings will generate comprehensive evidence to support malaria control and elimination strategies in Ethiopia by highlighting the epidemiological importance of school-aged children as a potential reservoir for infection. The results are expected to inform targeted interventions and strengthen school-based malaria surveillance and prevention programs.

Source: Burden of asymptomatic malaria among school-aged children: Protocol for a systematic review and meta-analysis