Narrative Review of Co-Infection: Malaria in the Context of HIV, Tuberculosis, and Helminth Infections

Nakawungu Catherine

Department of Pharmaceutical Microbiology and Biotechnology Kampala International University Uganda

Email: catherine.nakawungu@studwc.kiu.ac.ug

ABSTRACT

Malaria co-infection with HIV, tuberculosis (TB), and helminths presents a complex clinical and public health challenge, particularly in sub-Saharan Africa where all four infections are highly endemic. This narrative review synthesises existing evidence on the epidemiology, clinical outcomes, prevention, and research priorities concerning malaria co-infection with these major pathogens. Findings reveal that HIV infection compromises host immunity, exacerbating malaria severity and recurrence, while malaria infection accelerates HIV replication and progression. Co-infection with helminths produces contrasting effects, sometimes reducing malaria severity but increasing chronic susceptibility. Evidence on malaria–TB interactions remains limited, though coinfected individuals often present with altered clinical manifestations and poorer prognoses. The overlapping epidemiology and shared social determinants poverty, poor sanitation, and weak health systems compound disease burden and hinder effective management. Integrated prevention and control approaches, including combined vector control, harmonised diagnostic and treatment protocols, and strengthened health education, have shown promising results but remain under-implemented. Major challenges include poor adherence, drug resistance, and fragmented service delivery. Research gaps persist in understanding co-infection pathogenesis, immune mechanisms, and pharmacological interactions. Advanced methodologies such as geostatistical modelling, cohort studies, and multi-disease surveillance systems are needed to capture disease interactions at population and molecular levels. The review concludes that a unified One Health approach linking human, animal, and environmental health together with sustainable financing, innovation, and coordinated governance, is critical to mitigating the burden of malaria co-infection and improving global health outcomes.

Keywords: Malaria co-infection; HIV/AIDS; Tuberculosis (TB); Helminth infections; and One Health.

CITE AS: Nakawungu Catherine (2025). Narrative Review of Co-Infection: Malaria in the Context of HIV, Tuberculosis, and Helminth Infections. IDOSR JOURNAL OF APPLIED SCIENCES 10(3):178-190. https://doi.org/10.59298/IDOSRJAS/2025/103.178190