Health-related quality of life due to malaria: a systematic review

Purpose: This paper aims to conduct a systematic review (SR) to assess Health-Related Quality of Life (HRQoL) of malaria-exposed populations for different regions where malaria is endemic, considering any health measurements.

Methods: An electronic search of the Medline, Lilacs, and Embase databases was conducted until February 2nd, 2024, to identify and select studies that evaluated HRQoL. No restrictions on place or language were made.

Results: Thirty-seven studies were included, among them 21 focused on African countries. The most investigated HRQoL outcome associated with malaria was Disability-Adjusted Life Years (DALYs). These studies primarily aim to analyze the epidemiological burden of the disease or to conduct economic assessments. Only four studies conducted field research using specific instruments to assess the HRQoL of individuals experiencing malaria episodes. Three of them estimated EQ-5D utility index and found scores varying from 0.349 for severe malaria (Indonesia) to 0.74 (Nigeria). The health domains that are most affected by malaria are pain and discomfort and usual activities (EQ-5D instrument) and physical domains (WHOQOL-BREF). These results reflect the main malaria symptoms which are fever, headache, and generalized pain.

Conclusion: This SR highlights a significant gap in understanding the quality of life among individuals experiencing malaria. Despite being an acute illness, recurrent episodes of malaria can lead to considerable loss in quality of life. Moreover, there are significant equity implications, as malaria remains endemic in socioeconomically disadvantaged populations.