Table 1 Characteristics of the included studies

1

Amare 2017 [30]

Ethiopia (2010–2016)

Retrospective cohort study

VL and malaria co-infection (123), VL mono-infected patients (387)

Co-infection, mean 24.1 ± 7.9 years

[0–9 years (n = 5), 10–19 years (n = 23), 20–29 years (n = 65), ≥ 30 years (n = 29); VL cases, mean 25.3 ± 7.8 years [0–9 years (n = 9), 10–19 years (n = 66), 20–29 years (n = 210), ≥ 30 years (n = 99)]

Co-infection, 121, 98.4%; VL, 381, 98.4%

Malaria detection, thick blood film examination, RDT; VL detection, serologic tests, DAT, bone marrow or lymph node aspiration (smear)

123

NS

387

2

Aschale et al. 2019 [20]

Ethiopia (2016)

Cross-sectional study

Migrant laborers aged ≥ 15 years (178)

All participants, mean 26.1 ± 8.6 years [15–29 years (n = 132), 30–44 years (n = 38), 45–59 years (n = 4), ≥ 60 years (n = 4); co-infection [age 15–29 years (80%)]

All participants 163, 91.6%

No report

5

40

17

3

de Beer et al. 1991 [27]

Sudan (NS)

Prospective cohort study

Patients with various clinical disorders (2714), patients with suspected VL (1195)

NS

NS

Malaria detection, thin and thick blood film examination; VL detection, ICT using anti-Leishmania donovani antibody

70

NS

584

4

Ferede et al. 2017 [21]

Ethiopia (2014)

Cross-sectional study

Patients with suspected VL (384)

All participants, mean 28.1 ± 11.8 years [< 5 years (n = 6), 5–14 years (n = 20), 15–29 years (n = 227), 30–44 years (n = 99), ≥ 45 years (n = 32)]; co-infection [< 5 years (n = 2), 5–14 years (n = 0), 15–29 years (n = 9), 30–44 years (n = 5),  ≥ 45 years (n = 0)]; individuals without malaria and VL co-infection [< 5 years (n = 4), 5–14 years (n = 20), 15–29 years (n = 218), 30–44 years (n = 94), ≥ 45 years (n = 32)]

334, 87% Co-infection, 15, 93.8%; individuals without malaria and VL co-infection, 319, 95.5%

Malaria detection, thin and thick blood film examination; VL detection, DAT, microscopy

16

45 (40 Plasmodium falciparum, five Plasmodium vivax)

83 (Individuals without malaria and VL co-infection)

5

Kolaczinski et al. 2008 [28]

Uganda (2006)

Case–control study

Patients with VL (93)

Confirmed VL, median 11 (IQR 8–16) years

All participants 55, 59.1%

Malaria detection, RDT; VL detection, ICT using anti-L. donovani antibody

6

NS

87

6

Mohammed et al. 2016 [31]

Sudan (2013–2014)

Retrospective cross-sectional study

Patients with VL (313)

All participants, mean 31.4 ± 11.9; co-infection, mean 27.3 ± 10.1; patients with VL (256), mean 31.5 ± 12.3

237, 75.7%

Co-infection, 23, 79.3%; patients with VL (256), 192, 75%

Malaria detection, thick blood film examination; VL detection, serologic tests, DAT, bone marrow or lymph node aspiration (smear)

29

NS

256

7

Mueller et al. 2009 [29]

Uganda (2000–2005)

Retrospective cross-sectional study

Patients with suspected VL (3483), patients with confirmed VL (1858)

Confirmed VL [< 5 years (n = 335), 6–15 years (n = 818), 16–45 years (n = 650), ≥ 45 years (n = 31)]

All participants 1283, 69%

Malaria detection, thin and thick blood film examination; VL detection, ICT using anti-L. donovani antibody, microscopic examination, DAT

387

NS

1471

8

Nandy et al. 1995 [22]

India (1995)

Cross-sectional study

Patients with suspected VL (68)

Co-infection (5–35 years)

Co-infection, 2, 50%

Malaria detection, thin and thick blood film examination; VL detection, DAT and bone marrow aspiration (smear and culture)

4

NS

64

9

Sarker et al. 2003 [23]

Bangladesh (2002)

Cross-sectional study

Patients with VL (81)

NS

All participants 59, 72.8%

No report

1

NS

80

10

Tekalign et al. 2020 [24]

Ethiopia (2013–2018)

Descriptive retrospective cohort study

Patients with VL (434)

Confirmed VL [< 5 years (n = 34), 5–15 years (n = 63), ≥ 15 years (n = 91)]

All participants 151, 80%

Malaria detection, thin and thick blood film examination; VL detection, ICT using anti-L. donovani antibody

12

NS

422

11

van den Bogaart et al. 2012 [25]

Uganda (2000–2006)

Descriptive retrospective cohort study

Patients with suspected VL (4428), patients with confirmed VL (2511)

Co-infection, median 10 (IQR 6–16) years [< 5 years (n = 82), 5–9 years (n = 133), 10–19 years (n = 145), 20–29 years (n = 55), ≥ 30 years (n = 32)]; patients with VL, median 12 (IQR 7–21) years [< 5 years (n = 234), 5–9 years (n = 451), 10–19 years (n = 687), 20–29 years (n = 354), ≥ 30 years (n = 219)]

Co-infection, 311, 69.1%; patients with VL, 1350, 68.7%

Malaria detection, thin and thick blood film examination; VL detection, ICT using anti-L. donovani antibody, microscopic examination, DAT

450

NS

1964

12

van den Bogaart et al. 2013 [26]

Sudan (2005–2010)

Retrospective case–control study

Patients with VL (1324)

Co-infection [< 5 years (n = 120), 5–9 years (n = 77), 10–19 years (n = 92), 20–29 years (n = 50), ≥ 30 years (n = 61)]; VL cases [< 5 years (n = 176), 5–9 years (n = 180), 10–19 years (n = 225), 20–29 years (n = 135), ≥ 30 years (n = 137)]

Co-infection, 212, 52.5%; patients with VL, 501, 57.6%

Malaria detection, thin and thick blood film examination; VL detection, ICT using anti-L. donovani antibody, microscopic examination, DAT

404

NS

870