Abstract
BACKGROUND: Anopheles stephensi has been a primary cause of malaria spread in urban areas. The World Health Organization announced a threat alert in 2019 that highlighted the An. stephensi outbreak in the Horn of Africa. Currently, there is insufficient information on the prevalence of An. stephensi. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of An. stephensi in Horn of Africa. METHODS: Systematic search was performed to retrieve articles from PubMed, Scopus, Science Direct databases, and Google Scholar search engine. Fourteen potential studies that provided important data on An. stephensi were systematically reviewed and analyzed. The prevalence of An. stephensi was extracted separately into Microsoft Excel and analyzed using STATA 17.0. The Inverse of variance was done to evaluate heterogeneity across studies. A funnel plot and an Egger's test were used to evaluate the potential publication bias. A trim-and-fill-meta-analysis was carried out to generate a bias-adjusted effect estimate. A random effect model was used to determine the pooled prevalence of An. stephensi. Subgroup analysis was performed based on year of publication and country. RESULTS: A total of 14 studies were included for this systematic review and meta-analysis. From this meta-analysis, the pooled prevalence of An. stephensi was 41.26%. The subgroup analysis based on year of publication showed that the pooled prevalence of An. stephensi in studies conducted 2014-2018 was 99%, while it was 36.82% in studies conducted 2019-2024. On the other hand, country-based analysis showed that the pooled prevalence of An. stephensi in Djibouti, Eritrea, Ethiopia, Kenya, Somaliland, and Sudan was 10.5%, 17.3%, 55.30%, 9.90%, 48.70%, and 24.63%, respectively. CONCLUSIONS: This systematic review and meta-analysis reveal a high prevalence of An. stephensi across the Horn of Africa region. This underscores the significant challenges in managing malaria infections transmitted by An. stephensi in the region. Health officials must adjust current vector control measures to incorporate An. stephensi with the local malaria vector species. Also, regular identification and limiting of An. stephensi must be sustained to ensure the effectiveness of malaria prevention.