Abstract
Malaria parasitemia and HIV/AIDS coinfection is very common particularly in sub-Saharan Africa where the burden of both infections fall. Therefore, an understanding of how the two infections interact is important for the control of both diseases. In Cameroon some studies have been carried out on the prevalence of malaria parasitemia in HIV with varying results. A high prevalence of malaria parasitemia among these individuals could imply the need for systematic screening and/or treatment of HIV individuals for possible malaria infection hence improving on the care of these individuals. A low prevalence could also imply limiting resources directed towards the diagnosis of malaria in HIV individuals. Objectives: The objective of the study was to determine the prevalence of malaria parasitaemia in HIV/AIDS individuals in Bamenda Regional Hospital (BRH) Treatment Center. Methods: A cross-sectional study was conducted involving 310 HIV-positive individuals attending the BRH HIV/AIDS Treatment Centre during a period of 3 months from 1st of February to April 30th 2018. Participants’ consent was obtained followed by sociodemographic and other useful data via a standardized questionnaire. Capillary blood samples were collected and malaria parasitaemia determined by blood smear microscopy. Results: An overall malaria parasitemia prevalence of 24.5% was observed in this study with mean parasite density of 150 trophozoites/µL. Malaria parasitemia prevalence was significantly higher in HAART naïve (37.5%) individuals than HAART experienced (23.81%) individuals (<i>p</i><0.05). The differences in level of parasite density in relation to gender and marital status were statistically significant (<i>p</i><0.05) while that of the various age groups was not significant (<i>p</i><0.05). Lower CD4 count levels were significantly related to high density malaria parasitemia (<i>p</i><0.05). Also the percentage of parasite density >400 trophozoites/µL was higher (80%) in those not using cotrimoxazole prophylaxis than those on cotrimoxazole prophylaxis (20%). Hence non- use of cotrimoxazole prophylaxis was significantly associated with high density malaria parasitemia (<i>p</i><0.05). Conclusions The prevalence of malaria parasitemia in HIV/AIDS individuals was high in the study area and malaria parasitemia prevalence in HAART naïve individuals was significantly higher than in HAART experienced individuals. Also gender, marital status low CD4 count and non use of cotrimoxazole prophylaxis were significantly related to high density malaria parasitemia.
Highlights
Worldwide, millions of individuals living with HIV reside in areas where malaria parasitemia is endemic and malaria is a leading cause of morbidity among individuals infected with HIV in sub-Saharan Africa [1]
The results showed that the overall prevalence of malaria parasitemia in HIV/AIDS individuals attending the Bamenda Regional Hospital treatment center was 24.5% following microscopy from thick and thin blood films
This study revealed that the prevalence of malaria parasitemia in Highly Active Anti-Retroviral Therapy (HAART) experienced individuals was 23.81% while the prevalence of malaria parasitemia in HAART naïve individuals was 37.5%
Summary
Millions of individuals living with HIV reside in areas where malaria parasitemia is endemic and malaria is a leading cause of morbidity among individuals infected with HIV in sub-Saharan Africa [1]. An interaction in either direction between the two is of great public health importance, for sub-Saharan Africa where the majority of the burden of both infections fall. Among adults living in malaria-endemic areas, HIV-related immune suppression seems to increase vulnerability to malaria parasitemia [1]. Several reports have shown that HIV infection among adults living in areas of high malaria transmission is associated with a modest increase in the frequency of malaria parasitemia [2]. Coinfection with HIV and malaria parasitemia is very common in sub-Saharan Africa and an understanding of how the two infections interact is important for the control of both diseases
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