Schistosoma hematobium infection is associated with significantly reduced lipid profile parameters in West Africa: A systematic review and meta-analysis

Abstract

Despite being a major cause of morbidity and mortality in Africa and other continents, studies have shown that infection with Schistosoma haematobium is associated with improved host metabolic homeostasis. There is however little consolidated evidence on the overall effect of S. haematobium on the lipid profile of infected individuals. We conducted a systematic review and meta-analysis to assess the effect of schistosomiasis on lipid profile in West Africa. This review employed the PRISMA guidelines for conducting and reporting systematic reviews. Employing ‘free terms’ and ‘indexed terms’ funnelled using the Boolean operators OR and AND, we conducted a literature search in MEDLINE via PubMed and Scopus as well as Google Scholar between June 21 to June 26, 2022 for case-control, cross-sectional, and prospective or retrospective cohort studies and randomized controlled trials that have reported lipid profile derangements among individuals infected with S. haematobium between January 1, 1980 to December 31, 2021 in West Africa. Data on continuous outcomes were presented using the weighted mean difference (WMD) between cases and controls and the effect estimates (mean difference) of each study with the pooled effects estimate plotted using forest plots. Due to observed large heterogeneity, the random effects model was used whereas the DerSimonian-Laird random effects method was used as the between study variance estimator in estimating the pooled effect estimate and its confidence interval. A P-value of < 0.05 was considered statistically significant. The MedCalc statistical software version 14 and OpenMeta [Analyst] meta-analysis tools were used for the meta-analysis. The results showed an overall pooled WMD in the levels of HDL-C, LDL-C and TC between S. haematobium infected cases and control cases as -0.188 (95%CI: -0.41 to 0.03) mmol/L, -0.88 (95% CI: -2.63 to 0.86) mmol/L and -0.447 (95% CI: -0.88 to -0.01) mmol/L and a pooled raw mean difference of -0.32 (95%CI: -0.43 to -0.29) mmol/L for TG levels; substantial difference was only observed for TG and TC levels. The evidence from this review indicates a lowering effect of S. haematobium infection on serum lipids particularly TC and TG levels of human host in West African. Studies are required to elucidate the regulatory pathways and biomarkers responsible for these alterations for utilization as prognostic markers and to understand the pathophysiology and the long-term pathophysiologic effect of S. haematobium infection on the host system.