Incidence of Malaria in Khyber Pakhtunkhwa Pakistan - A Meta-Analysis

Background: Malaria is a fatal disease normally transmitted through the bite of an infected Anopheles mosquito. It is usually found in tropical and subtropical climates where the parasites responsible for causing the disease live. Five types of malaria parasites infect humans: Plasmodium (P) falciparum, P . vivax, P . ovale, P . malariae and P . knowlesi. P. vivax and P . falciparum are present in Khyber Pakhtunkhwa province of Pakistan, but no actual prevalence data is yet recorded. This study was commenced to precisely estimate the prevalence rate of Malaria across the province through a review of papers reporting prevalence data in the region. Methods: The essential target of this efficient survey and meta-analysis was to describe the detailed clinical quality and the geographical variety of the prevalence of severe malaria, found in literature search from the databases, since 2003 to 2017. Abstracts and results of twenty-one papers were considered and the information was extracted, based on prevalence rate of malaria in general and local population. Results: Out of the 21 studies chosen, on the basis of inclusive criteria, 18 studies were finally selected for further analysis. The combined estimate from the random effect model gave 13.81% prevalence. The prevalence of malaria sharply increased from 2013 onwards compared to the previous years. Highly significant (p-value < 0.0001) heterogeneity is observed among the studies. Further it is found that study no. 16, and 9 out of those included possess maximum contribution to the heterogeneity and are highly influential. The corresponding funnel plot reveals significant considerable asymmetry and publication bias. Conclusion: Despite of malaria control program in recent years, the incidence of malaria is still in alarming situation at KP-Pakistan. Further analysis based on general population screening will be required to figure out the actual situation of malaria at KP-Pakistan.