METHODS

Strategy
This review article was reported according to the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines. Related published articles were searched
from online public databases such as PubMed, Google Scholar, and ScienceDirect, which
reported the prevalence of malaria among adults in Ethiopia from 2010 to May 2020. The
search approach used to retrieve related articles were “prevalence,” “malaria,” “adults,” and
“Ethiopia.”

The search articles comprised different study designs (cross-sectional surveys and longitudinal studies)
with reported malaria prevalence results (positive-negative cases and parasites) in well-defined
populations. Articles were searched without time restriction by using the key terms “malaria prevalence,”
“burden of malaria,” “distribution of Plasmodium species,” “malaria parasites,” and “malaria
epidemiology in Ethiopia.”
From the total reviewed articles, those studies published in peer-reviewed journals such as PubMed,
Scopus, Google Scholar, Science Direct, Web of Science, and other related journals that report the
prevalence of malaria in the Southern region of Ethiopia, were included in the review.

Eligibility Criteria
All studies were original research articles published in English and contained the basic
information concerning sample size, diagnostic methods, prevalence, and status of malaria
infection among adults in different parts of Ethiopia.

All studies included in the systematic review were original research articles published in English and
contained the basic information concerning sample size, diagnostic methods, prevalence, and status of
malaria infection among all target populations, pregnant women, and children in different parts of the
Southern region of Ethiopia.

Data Analysis
 The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal
checklist. The meta-analysis was computed using STATA version 14. The pooled prevalence
estimates with 95% confidence interval were analyzed using a random-effect model, and
the possible source of heterogeneity across studies was indicated through subgroup
analysis, inverse of variance (I2), and time series analysis. The presence of publication bias
was evaluated using funnel plots and Egger's regression test.
The data extraction protocol was developed by the researcher and evaluated . The quality of articles was
assessed using Joana Brigg’s Institute (JBI) critical appraisal checklist for simple prevalence.  Once the
data were extracted using Microsoft Excel, data manipulation and statistical analysis were done using
STATA 16 version software. The presence of publication bias was evaluated using funnel plots
and Egger's regression test.

Critical appraisal tools provide analytical evaluations of the quality of the study, in

particular the methods applied to minimise biases in a research project