Integrated screening reveals rare co-infections of gambiense human African trypanosomiasis, malaria and loiasis in Banga, northern Angola

ABSTRACT Gambiense human African trypanosomiasis (gHAT), malaria, and loiasis overlap geographically in Central Africa and share non-specific clinical features. As gHAT incidence declines, integrated screening in co-endemic settings must balance sensitivity, specificity, and programmatic efficiency. We conducted a retrospective cross-sectional analysis of data from an integrated active community screening program conducted between June and September 2021 in Banga municipality, Cuanza Norte Province, Angola. Demographic and diagnostic data for malaria ( Plasmodium falciparum ), gHAT ( Trypanosoma brucei gambiense ), and loiasis ( Loa loa ) were analysed. Malaria was diagnosed using rapid diagnostic tests; gHAT was screened serologically with parasitological confirmation; loiasis was detected incidentally during parasitological examinations. Prevalence estimates were stratified by sex, age group, and commune. Associations were assessed using chi-square or Fisher’s exact tests, and multivariable logistic regression was used to evaluate factors associated with malaria infection. Among 6,117 screened individuals, malaria was highly prevalent (62.9%), with substantial heterogeneity by age and commune. Prevalence was highest in children aged 5–14 years (>70%) and decreased progressively with increasing age. Male sex was independently associated with malaria infection (adjusted OR 1.39; 95% CI 1.26–1.53), as was commune of residence (p