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A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and HIV/AIDS infection

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  • Ludoviko Zirimenya
  • Fatima Mahmud-Ajeigbe
  • Ruth McQuillan
  • You Li

Abstract

Background: Urogenital schistosomiasis and HIV/AIDS infections are widespread in sub-Saharan Africa (SSA) leading to substantial morbidity and mortality. The co-occurrence of both diseases has led to the possible hypothesis that urogenital schistosomiasis leads to increased risk of acquiring HIV infection. However, the available evidence concerning this association is inconsistent. The aim of this study was to systematically review and quantitatively synthesize studies that investigated the association between urogenital schistosomiasis and HIV/AIDS infection. Methods: A systematic review basing on PRISMA guidelines was conducted. It is registered with PROSPERO, number CRD42018116648. We searched four databases, MEDLINE, EMBASE, Global Health and Global Index Medicus for studies investigating the association between urogenital schistosomiasis and HIV infection. Only studies published in English were considered. Results of the association were summarised by gender. A meta-analysis was performed for studies on females using random-effects model and a pooled OR with 95% confidence interval was reported. Results: Of the 993 studies screened, only eight observational studies met the inclusion criteria. Across all studies, the reported unadjusted OR ranged from 0.78 to 3.76. The pooled estimate of unadjusted OR among females was 1.31 (95% CI: 0.87–1.99). Only four of the eight studies reported an adjusted OR. A separate meta-analysis done in the three studies among females that reported an adjusted OR showed that the pooled estimate was 1.85 (95% CI: 1.17–2.92). There were insufficient data to pool results for association between urogenital schistosomiasis and HIV infection in the males. Conclusion: Our investigation supports the hypothesis of an association between urogenital schistosomiasis with HIV/AIDS infection in females. Due to insufficient evidence, no conclusion could be drawn in males with urogenital schistosomiasis. Large-scale prospective studies are needed in future. Author summary: Urogenital schistosomiasis, caused by parasitic trematode Schistosoma haematobium is a significant source of morbidity in sub Saharan Africa. HIV infection caused by a retrovirus is of two subtypes HIV 1 and HIV 2, with subtype HIV 1 being found worldwide and more aggressive, leading to HIV/AIDS. Research on both of these diseases in the same settings, has shown that these diseases cross paths. This has led to the suggestion that there could be a possible association between the two. Here we describe a systematic review that was carried out to determine if there is an association between UGS and HIV/AIDS infections. We searched all published articles available in MEDLINE, EMBASE, Global Health (CABI), and Global Index Medicus before 28th January 2020. We found eight observational studies eligible to be included in the systematic review and no intervention study. Six of these studies were included in the meta-analysis. A summarized meta-analysis of the study findings with adjusted OR showed that there was a likely association between urogenital schistosomiasis and HIV/AIDS infections in females. However, due to limited papers in males, no conclusion could be drawn.

Suggested Citation

  • Ludoviko Zirimenya & Fatima Mahmud-Ajeigbe & Ruth McQuillan & You Li, 2020. "A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and HIV/AIDS infection," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(6), pages 1-13, June.
    • Handle: RePEc:plo:pntd00:0008383
    DOI: 10.1371/journal.pntd.0008383
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    1. Sergey Yegorov & Vineet Joag & Ronald M. Galiwango & Sara V. Good & Juliet Mpendo & Egbert Tannich & Andrea K. Boggild & Noah Kiwanuka & Bernard S. Bagaya & Rupert Kaul, 2019. "Schistosoma mansoni treatment reduces HIV entry into cervical CD4+ T cells and induces IFN-I pathways," Nature Communications, Nature, vol. 10(1), pages 1-12, December.
    2. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    3. Chalotte Stecher & Per Kallestrup & Eyrun Kjetland & Birgitte Vennervald & Eskild Petersen, 2015. "Considering treatment of male genital schistosomiasis as a tool for future HIV prevention: a systematic review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(7), pages 839-848, November.
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