Evaluation of Malaria Parasitemia Among HIV/AIDS Individuals Attending the Bamenda Regional Hospital Treatment Center
Central African Journal of Public Health
Volume 5, Issue 2, April 2019, Pages: 65-76
Received: Jan. 12, 2019; Accepted: Feb. 14, 2019; Published: Feb. 28, 2019
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Eyong Clinton Achere, Department of Biomedical Sciences, Faculty of Health Sciences, the University of Bamenda, Bamenda, Cameroon
Kechia Federick Agem, Department of Biomedical Sciences, Faculty of Health Sciences, the University of Bamenda, Bamenda, Cameroon
Tembe Fokunang Estella, Department of Pharmaco-Toxicology & Pharmacokinetics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
Tatang Collins Asaah, Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
Wandum Gangdia Carlson, Department of Biomedical Sciences, Faculty of Health Sciences, the University of Bamenda, Bamenda, Cameroon
Agbor Michael Ashu, Department of Dentistry, Faculty of Health Sciences, University of Bangante, Bangante, Cameroon
Mbanya Dora Shu, Department of Biomedical Sciences, Faculty of Health Sciences, the University of Bamenda, Bamenda, Cameroon
Fokunang Charles Ntungwen, Department of Pharmaco-Toxicology & Pharmacokinetics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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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 (p<0.05). The differences in level of parasite density in relation to gender and marital status were statistically significant (p<0.05) while that of the various age groups was not significant (p<0.05). Lower CD4 count levels were significantly related to high density malaria parasitemia (p<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 (p<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.
Malaria Parasitemia, HIV/AIDS, HAART, Prevalence
To cite this article
Eyong Clinton Achere, Kechia Federick Agem, Tembe Fokunang Estella, Tatang Collins Asaah, Wandum Gangdia Carlson, Agbor Michael Ashu, Mbanya Dora Shu, Fokunang Charles Ntungwen, Evaluation of Malaria Parasitemia Among HIV/AIDS Individuals Attending the Bamenda Regional Hospital Treatment Center, Central African Journal of Public Health. Vol. 5, No. 2, 2019, pp. 65-76. doi: 10.11648/j.cajph.20190502.12
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Molly F. Franke, Donna Spiegelman, Amara Ezeamama, Said Aboud, Gernard I. Msamanga, Saurabh Mehta and Wafaie Fawzi. Malaria Parasitemia and CD4 T Cell Count, Viral Load, and Adverse HIV Outcomes Among HIV-Infected Pregnant Women in Tanzania 2010. 09-0477.
Hochman S, Kim K. The impact of HIV and malaria coinfection: what is known and suggested venues for further study. Interdiscip. Perspect. Infect. Dis. 2009, 617954.
John CC, TandeAJ, MoormannAM et al. Antibodiestopre-erythrocytic Plasmodium falciparum antigens and risk of clinical malaria in Kenyan children. J Infect Dis 2008; 197:519–526.
Langhorne J, Ndungu FM, Sponaas A-M, Marsh K. Immunity to malaria: more questions than answers. Nat Immunol 2008; 9: 725–732
Bousema JT, Gouagna LC, Drakeley CJ, et al. Plasmodium falciparum gametocyte carriage in asymptomatic children in western Kenya. Malar J 2004; 3:18.
Coleman RE, Kumpitak C, Ponlawat A, et al. Infectivityof asymptomatic Plasmodium-infected human populations to Anopheles dirus mosquitoes in western Thailand. J Med Entomol 2004; 41: 201–208.
Cohen C, Karstaedt A, Frean J, et al. Increased prevalence of severe malaria in HIV-infected adults in South Africa. Clin Infect Dis 2005; 41: 1631–1637.
Grimwade K, French N, Mbatha DD, Zungu DD, Dedicoat M, Gilks CF. HIV infection as a cofactor for severe falciparum malaria in adults living in a region of unstable malaria transmission in South Africa. AIDS 2004; 18: 547–554.
Whitworth J, Morgan D, Quigley M, et al. Effect of HIV-1 and increasing immunosuppression on malaria parasitaemia and clinical episodes in adults in rural Uganda: a cohort study. Lancet 2000; 356: 1051–1056.
Iroezindu MO, Agaba EI, Okeke EN, et al. Prevalence of malaria parasitaemia in adult HIV-infected patients in Jos, North-central Nigeria. Niger J Med 2012; 21: 209–213.
Sandison TG, Homsy J, Arinaitwe E, et al. Protective efficacy of co-trimoxazole prophylaxis against malaria in HIV exposed children in rural Uganda: a randomised clinical trial. BMJ 2011; 342: d1617.
Mermin J, Ekwaru JP, Liechty CA, et al. Effect of co-trimoxazole prophylaxis, antiretroviral therapy, and insecticide-treated bednets on the frequency of malaria in HIV-1-infected adults in Uganda: a prospective cohort study. Lancet 2006; 367: 1256–1261.
Noormahomed EV, Orlov M, do Rosario V, et al. A cross-sectional study of subclinical Plasmodium falciparum infection in HIV-1 infected and uninfected populations in Mozambique, South-Eastern Africa. Malar J 2012; 11:252-259
Onyenekwe CC, Ukibe N, Meludu SC, Ilika A, Aboh N, Ofiaeli N, Ezaeni M, Onochie A. Prevalence of malaria as co-infection in HIV-infected individuals in a malaria endemic area of Southeastern Nigeria. Journal of Vector Borne Disease. 2007; 44: 250–254.
Akenji TN, Tevoufouet E, Nzang F, Ngufor N, Fon E. High prevalence of HIV and malaria co-infection in urban Douala, Cameroon. African Journal of AIDS Research. 2008; 7 (2): 229–235.
Tchinda GG, Atashili J, Achidi EA, Kamga HL, Njunda AL, Ndumbe PN. Impact of malaria on hematological parameters in people living with HIV/AIDS attending the Laquintinie Hospital in Douala, Cameroon. PLoS One. 2012; 7 (7): e40553. doi: 10.1371/ journal. pone.0040553.
Njunda LA, Kamga HL, Nsagha DS, Assob JC, Tebit EK. Low malaria prevalence in HIV-positive patients in Bamenda, Cameroon. Journal of Microbiology. 2012; 2 (3): 56–59.
Anne Frances Gasasira. Interactions between HIV Infection and Malaria in Children Living in sub-Saharan Africa in the Era of Widening Access to Improved Interventions 2010 2 (3): 10-17.
A. C. Nwuzo1, O. Ogbu1, I. R. Iroha1, F. N. Afiukwa1, M. C. Ominyi4, A. C. Uhuo2 and M. E. Ogbanshi. The rate of distribution of malaria (Plasmodium falciparum) among HIV positive individuals visiting Saint Theresa’s Hospital Abakpa Nike Enugu, Enugu State, Nigeria. European Journal of Experimental Biology, 2013, 3 (5): 516-520.
WHO. World Malaria Report 2013. Geneva: World Health Organization, 2013, 312pp.
Lia florey DHS Analytical Studies No. 43 Measures of Malaria Parasitemia Prevalence in National Surveys: Agreement between Rapid Diagnostic Tests and Microscopy. September 2014, 13: (2): 10-18.
CDC - Malaria - About Malaria - Where Malaria Occurs [Internet]. [cited 2017 Apr 5]. Available from: https://www.cdc.gov/malaria/about/distribution.html.
Francis EG Cox. History of the discovery of the malaria parasites and their vectors. Parasites & Vectors. 2010; 3 (1). 21-29.
Centers for Disease Control and Prevention. Malaria biology. Available at: http: // www.cdc.gov/malaria/about/biology/index.html. 2016 26 (1): 14-31.
WHO Global Malaria Programme. World Malaria Report 2014. Geneva, Switzerland: WHO Press; 2014, 35pp..
L. Renia, S. M. Potter, et al. Co-infection of malaria with HIV: an immunological perspective. Parasite immunology. 2006; 28:589–595.
Ian A Clark, Alison C Budd, Lisa M Alleva, William B Cowden. Human malarial disease: a consequence of inflammatory cytokine release. Malaria Journal. 2006; 5 (8): 312-317.
Obi RK, Okangba CC, Nwanebu FC, Ndubuisi UU, Orji NM. Premunition in Plasmodium falciparum malaria. Afr J Biotechnol. 2010; 9 (10): 1397–1401.
Laishram DD, Sutton PL, Nanda N, Sharma VL, Sobti RC, Carlton JM, et al. The complexities of malaria disease manifestations with a focus on asymptomatic malaria. Malar J. 2012 Jan 31; 11 (1): 29-35.
Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: Severe malaria. Crit Care Lond Engl. 2003 Aug; 7 (4): 315–323.
WHO. Management of severe malaria-A practical handbook. 2014, 205pp.
WHO Criteria for Severe Falciparum Malaria [Internet]. [cited 2014 Mar 5]. Available from: http: //www.mymedal.org/index.php?n=Military.240107.
Cheesbrough M. District Laboratory Practice In Tropical Countries. Part 1. Second Edition. Cambridge, UK: Cambridge University Press; 2009, 519pp.
Centers for Disease Control and Prevention. CDC Treatment Guidelines for Malaria. Atlanta, United States of America: CDC; 2013, 115pp.
Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA. Review of Human Immunodeficiency Virus type 1-related opportunistic infections in sub-Saharan Africa. Clinical Infectious Disease. 2003; 36: 652–662.
Joint United Nations Programme on HIV/AIDS. UNAIDS Report on the global AIDS epidemic 2013. Geneva, Switzerland: WHO Press; 2013.
World Health Organization. Global summary of the AIDS epidemic. Geneva, Switzerland: WHO Press; 2012, 41pp.
Joint United Nations Programme on HIV/AIDS. UNAIDS 2013 Global fact sheet. Geneva, Switzerland: WHO Press; 2013., 107pp.
Freed EO. HIV-1 replication. Somat Cell Mol Genet. 2001 Nov; 26 (1-6): 13–33.
Kaslow RA, Phair JP, Friedman HB. Infection with the human immunodeficiency virus: clinical manifestations and their relationship to immune deficiency. A report from the Multicenter AIDS Cohort Study. Ann Intern Med. 1987; 107: 474–480
Tebit DM, Ndembi N, Weinberg A, Quinones-Mateu ME. Mucosal transmission of human immunodeficiency virus. Curr HIV Res. 2012; 10 (1): 3–8.
Gupta K, Menki L, Leostand D. Acute immunosuppression with HIV seroconversion. N Eng J Med. 1993; 32 (8): 288–299.
Chung A, Rollman E, Johansson S, Kent S., Stratov I. The utility of ADCC responses in HIV infection. Curr HIV Res. 2008; 8: 515–519.
Brooks J KJ, Holmes K, Benson C, Pau A, Masur H. HIV-associated opportunistic infections-going, going, but not gone: the continued need for prevention and treatment guidelines. Clin Infect Dis. 2009; 48: 609–611.
Fanales-Belasio E, Raimondo M, Suligoi B, Butto S. HIV virology and pathogenetic mechanisms of infection: a brief overview. Ann Ist Super Sanita. 2010; 46 (1): 5–14.
Centers for Disease Control and Prevention. Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged <18 months and for HIV Infection and AIDS Among Children Aged 18months to <13years. Atlanta, United States of America: CDC; 2008, 63pp.
Smith AJ, Daniel R. Following the path of the virus: the exploitation of host DNA repair mechanisms by retroviruses. ACS Chemical Biology. 2006; 1 (4): 217–226.
Gilbert P. Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal. Statistics in Medicine. 2003; 22 (4): 573–593
Smith AJ, Daniel R. Following the path of the virus: the exploitation of host DNA repair mechanisms by retroviruses. ACS Chemical Biology. 2006; 1 (4): 217–226.
Piatak M, Saag MS, Yang LC, Clark SJ, Kappes JC, Luk KC. High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR. Science. 1993; 259 (5102): 1749–1754.
Luft S, Seme K, Poljak M. Laboratory diagnosis of Human Immunodeficiency Virus infection. Acta Dermatoven APA. 2004; 13 (2): 45–49.
Wilkins EGL. HIV Infection and AIDS. In: Nicki RC, Brian RW, Stuart HR. (eds.) Davidson’s Principles and Practise of Medicine. 21st Edition. Edinburgh, UK: Elsevier Limited; 2010: p. 384-407
World Health Organisation. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. Geneva, Switzerland: WHO Press; 2013, 25pp.
World Health Organisation, in partnership with UNICEF and UNAIDS. Global update on HIV Treatment 2013: Results, Impact and Opportunities. Geneva, Switzerland: WHO Press; 2013, 93pp.
Erick Kipkoech Rutto, Joshua Nyago, Julius Oyugi, Samson Ndege, Noel Onyango, Andrew Obala, Chrispinus J Simiyu, Gye Boor, Winfrida Chelangat Cheriro, Barasa Otsyula and Ben Estambale. Effects of HIV-1 infection on malaria parasitemia in milo sub-location, Western Kenya. 2015, 35pp.
Anne Frances Gasasira. Interactions between HIV infection and malaria in children living in sub-Saharan Africa in the era of widening access to improved interventions 2010 45pp.
Chandramohan D, Greenwood BM. Is there an interaction between human immunodeficiency virus and Plasmodium falciparum? International Journal of Epidemiology. 1998; 27 (2): 296–301.
Good MF, Doolan DL. Immune effector mechanisms in malaria. Current Opinion Immunology. 1999; 11: 412–419.
Moore JM, Ayisi J, Nahlen BL, Misore A, Lal AA, Venkatachalam U. Immunity to placental malaria. II: Placental antigen-specific cytokine responses are impaired in human immunodeficiency virus-infected women. Journal of infectious diseases. Journal of infectious diseases. 2000; 182: 960–964.
Froebel K, Howard W, Schafer JR, Howie F, Whitworth J, Kaleebu P. Activation by malaria antigens renders mononuclear cells susceptible to HIV infection and re-activates replication of endogenous HIV in cells from HIV-infected adults. Parasite Immunology. 2004; 26: 213–217.
Tkachuk AN, Moormann AM, Poore JA, Rochford RA, Chensue SW, Mwapasa V. Malaria enhances expression of CC chemokine receptor 5 on placental macrophages. Journal of Infectious Disease. 2001; 183: 967–972.
Kublin JG, Patnaik P, Jere CS, Miller WC, Hoffman IF, Chimbiya N. Effect of Plasmodium falciparum malaria on concentration of HIV-1 RNA in the blood of adults in rural Malawi: a prospective cohort study. Lancet. 2005; 365: 233–240.
Cohen C, Karstaedt A, Frean J, Juno T, Govender N, Prentice E, Dini L, Galpin J, Crewe-Brown H. Increased prevalence of severe malaria in HIV-Infected adults in South Africa. Clinical Infectious Disease. 2005; 41 (11): 1631–1637.
Kimbi HK, Njoh DT, Ndamukong KJN, Lehman LG. Malaria in HIV/AIDS patients at different CD4+ T cell levels in Limbe, Cameroon. Journal of Bacteriology and Parasitology. 2013; 4: 164-167.
Saracino A, Nacarapa EA, Massinga AC, Martinelli D, Scacchetti M, Oliveira C, Antonich A, Galloni D, Ferro JJ, Macome CA. Prevalence and clinical features of HIV and malaria co-infection in hospitalized adults in Beira, Mozambic. Malaria Journal. 2012; 11:241-246.
Anglaret A, Patnaik R. Early chemoprophylaxis with trimethoprim/sulphamethoxazole for HIV-1 infected adults in Abidjan, Cote d’Ivoire: a randomized trial. Lancet. 2005; 353: 1463–1468.
WHO (2008) Basic malaria microscopy: part I. Learner’s guide, p 88
Reiter P. Global warming and vector-borne disease in temperate regions and at high altitude. Lancet. 1998; 351: 839–840.
Pro-climate International. Climate of Cameroon. http://www.proclimate-international.org/ tourism/climate/cameroon.htm (accessed 5 Apr 2015).
Wiktor SZ, Sassan-Morokro M, Grant AD, Abouya L, Karon JM, Maurice C, Djomand G, Ackah A, Domoua K, Kadio A, Yapi A, Combe P, Tossou O, Roels TH, Lackritz EM, Coulibaly D, De Cock KM, Coulibaly IM, Greenberg AE. Efficacy of trimethoprim-sulfamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Cote d’Ivoire: a randomised controlled trial. Lancet. 1999; 353: 1469-1471.
Hamel MJ, Greene C, Chiller T, Ouma P, Polyak C, Otieno K, Williamson J, Shi YP, Feikin DR, Marston B, Brooks JT, Poe A, Zhou Z, Ochieng B, Mintz E, Slutsker L. Does co-trimoxazole prophylaxis for the prevention of HIV-associated opportunistic infections select for resistant pathogens in Kenyan adults? American Journal of Tropical Medicine and Hygiene. 2008; 79: 320-322.
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