Systematic review and meta-analysis of the interaction between Plasmodium falciparum and Plasmodium vivax in humans

Objectives: This study aimed to quantify the interaction between Plasmodium falciparum and P. vivaxand the sources of heterogeneity between studies.Methods: We systematically reviewed three databases: Medline (1966–2001), Embase (1980–2001)and CAB-health (1976–2001). Random effects meta-analysis was applied to the data of 62 selectedpopulations. Meta-regression was used to assess the following potential sources of heterogeneity: agegroup,presence of fever, continent, temporal and spatial span of studies, and endemicity level.Results: The summary odds ratio (OR) between P. falciparum and P. vivax was 0.6 (95% CI: 0.49–0.79). The minimum and maximum observed ORs were 0.01 and 10.9, respectively, and theheterogeneity test was highly significant (τ2= 0.92, p