Malaria is a parasitic disease caused is a major public health problem and affecting over million individuals globally. Susceptibility or resistance to malaria infection depends on host-parasite interaction associated with intrinsic factors of red blood cell. It is linked with Glucose-6-phosphate dehydrogenase enzyme and Duffy blood group system. However, the susceptibility and resistance rate of malaria in Duffy blood group system is controversial.

Objective: The main objective of this evidence based review was determining the pooled proportion of P. vivax among Duffy positive individuals.

Methods: Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. For studies meeting the eligibility criteria, the first author’s name, year of publication, study design and area, total sample size, number of cases and proportion were extracted using Microsoft-excel and followed exported to stata 11 for further statistical analysis. Random effect model was done to estimate the pooled proportion. Higgin’s (I²) statistics was used to check heterogeneity. Egger’s statistical test and funnel plot were used to measure publication bias.

Results: A total of, 10 articles with 25,555 study participants were retrieved to determine the pooled proportion of plasmodium vivax among Duffy variant phenotype. The overall pooled proportion of plasmodium vivax among Duffy positive individuals was 25.6%; 95%, CI : 20.30-30.10, I²: 98.4%, p < 0.001. The proportion in Duffy variant phenotype were 32.30%; 95% CI: 20.11%-44.46%, I²: 97.8%, p < 0.001, 26.50%; 95% CI: 15.42%-37.58%, I²: 98.1%, p < 0.001 and 18.33%; 95%CI: 11.16%-25.50%, I²: 97.6%, p < 0.001 in FY (a+b+), FY (a+ b−) and FY (a−b+), respectively.

Conclusion

The proportion of plasmodium pivax was high among Duffy positive individuals. The FY (a+b+) phenotypype accounts highest proportion of P.vivax, suggesting that FY (a+b+) individaulas may be prone to P. vivax infection. Hence, the genetic polymorhism of Duffy blood group system can be multifactorial genetic factor for susceptibility to Plasmodium vivax infection. It is important to consider Duffy positive individuals in Plsamodium vivax endemic areas for malaria surveillance.