Prevalence of malaria in Tanzania: A Systematic Review and Meta-analysis

BackgroundUnderstanding malaria epidemiology in Tanzania is a step toward achieving malaria control and elimination targets by 2030. This meta-analysis derived robust estimates of malaria prevalence and Plasmodium species from studies in Tanzania published from 2014 - 2024. MethodsFollowing the PRISMA guidelines, we searched PubMed, Google Scholar, and Science Direct using the PICOS framework for study selection. We used the Simonian-Laird random-effects model to obtain the pooled malaria prevalence. Study quality was assessed using Covidence, with heterogeneity quantified by the I2 index. ResultsWe included 31 high-quality studies. Pooled malaria prevalence was 17% (95% CI: 11-22, I{superscript 2} = 98.1%, p < 0.001) by microscopy, 19% (95% CI: 12-25, I{superscript 2} = 99.8%, p < 0.0001) by RDT, and 8% (95% CI: 2-14, I{superscript 2} = 94.8%, p < 0.001) by PCR. Children had the highest rates: 22% (RDT), 19% (microscopy), and 20% (PCR); adults had 11%, 14%, and 36%, respectively. Common mixed infections involved P. falciparum with P. ovale (22%) or P. malariae (18%). P. vivax co-infections were rare (5%). Lake zone regions had the highest disease prevalence (36.5%). ConclusionMalaria disproportionately affects children in Tanzania, underscoring their vulnerability to infection. The predominance of P. falciparum mixed infections underscores the complex epidemiology in the country. The high burden in Lake zones emphasizes the need for targeted interventions. Enhanced diagnostics, focused control strategies, and surveillance are essential in reducing the disease burden and advancing control efforts in the country.