Epidemiology of Malaria in Latin America and the Caribbean from 1990 to 2009: Systematic Review and Meta-Analysis

Abstract

Objective: The objective of this study was to evaluate the burden ofmalaria in Latin America and the Caribbean countries through asystematic review and meta-analysis of published literature, grayliterature, and information from countries? public health authoritiesfor the period 1990 to 2009. Methods: The random-effects metaanalysis of the prospective studies, carried out in very highly endemicareas, showed an annual incidence rate of 409.0 malaria episodes/1000 person-years (95% confidence interval [CI] 263.1?554.9), considering all ages, which was 40-fold the one estimated from areas withpassive surveillance only. Results: Overall, the most prevalent specieswas Plasmodium vivax (77.5%; 95% CI 75.6?79.4) followed by Plasmodiumfalciparum (20.8%; 95% CI 19.0?22.6) and Plasmodium malariae (0.08%;95% CI 0.07?0.010). Data from regional ministries of health yielded anestimated pooled crude annual mortality rate of 6 deaths/100,000people, mainly associated with P. falciparum. Conclusion: This studyrepresents the first systematic review of the burden of malaria inLatin America and the Caribbean, with data from 21 countries.