ABSTRACT
BACKGROUND: The number of persons infected with COVID-19 continues to increase with deaths reported daily across the globe. High income countries such as the US, the UK, Italy and Belgium have reported high COVID-19 related deaths but low-and-middle-income countries have recorded fewer deaths despite having poor healthcare system. This study aimed to investigate the association between malaria prevalence and COVID-19 mortality. METHODS: An ecological study was conducted with data from 195 countries. Spearman's correlation was used to test the association between the population variables and COVID-19 mortality. Generalized linear model with Poisson distribution was used to determine the significant predictors of COVID-19 mortality. RESULTS: There was a significant positive correlation between median age, life expectancy, 65+ mortality and COVID-19 mortality while malaria prevalence, sex ratio and cardiovascular mortality were negatively correlated with COVID-19 mortality. Malaria prevalence, life expectancy and mortality rate were significant on multivariate regression analysis. CONCLUSION: The results of this study support the hypotheses that there are reduced COVID-19 deaths in malaria endemic countries, although the results need to be proved further by clinical trials.