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

AbstractObjectiveThe objective of this study was to evaluate the burden of malaria in Latin America and the Caribbean countries through a systematic review and meta-analysis of published literature, gray literature, and information from countries’ public health authorities for the period 1990 to 2009.MethodsThe random-effects meta-analysis of the prospective studies, carried out in very highly endemic areas, 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 with passive surveillance only.ResultsOverall, the most prevalent species was Plasmodium vivax (77.5%; 95% CI 75.6–79.4) followed by Plasmodium falciparum (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 an estimated pooled crude annual mortality rate of 6 deaths/100,000 people, mainly associated with P. falciparum.ConclusionThis study represents the first systematic review of the burden of malaria in Latin America and the Caribbean, with data from 21 countries