Prevalence and Risk Factors of Malaria in HIV-Infected Pregnant Women on Anti-Retroviral Therapy in Enugu, South East Nigeria
- *Corresponding Author:
- Ogboi Sonny Johnbull
Malaria and Human Development
Dept of Life Sciences and Public Health
University of Camerino
62032 Camerino (MC), Italy
E-mail: [email protected]
Received Date: May 21, 2014; Accepted Date: June 25, 2014; Published Date: July 07, 2014
Citation: Johnbull OS, Uche AP, Kesiena AJ, Francis FA, Oyemocho A, et al. (2014) Prevalence and Risk Factors of Malaria in HIV-Infected Pregnant Women on Anti-Retroviral Therapy in Enugu, South East Nigeria. J AIDS Clin Res 5:321. doi:10.4172/2155-6113.1000321
Copyright: © 2014 Johnbull OS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background and objective: Malaria and HIV co-infection pose significant health concerns in many regions of the world. Co-infection significantly increases the burden of these diseases in pregnancy, yet the interactions of these diseases in pregnant women are not well understood. The aim of the study was to determine the prevalence and examine the factors that could be associated with malaria in HIV positive infected pregnant women on antiretroviral therapy.
Methodology: Blood samples were collected from 301 confirmed HIV positive pregnant women in various trimesters and examined for malaria parasite presence and density with other laboratory indices. Baseline socio-demographic information, antenatal information, CD4 levels, and viral load were collected from clinical records. Information on type of treatment, such as intermittent malaria preventive treatment (IPT) and ART therapy/ prophylaxis, was extracted from care cards. Information on the prior use of antimalarial drugs and cotrimoxazole intake was obtained from direct interviews.
Results: The prevalence of malaria among HIV-positive pregnant women was 49.83% and the odds of having malaria doubledwith living in a rural community (AOR 2.04, CI [1.07-3.91] P<0.001). Also, being on ART therapy increased the odds of having malaria by 133% (AOR 2.33 CI [1.06-5.10] P<0.05). A higher level of CD4 counts reduced the odds of malaria parasitaemia though not significant. Those whose CD4 count was 200-350 and >350 had reduced odds of malaria parasitaemia (AOR 0.50, CI [0.81-1.44] P=0.202) and (AOR 0.65, CI [0.24-1.73] P=0.391), respectively, compared with those with lower CD4 counts. Malaria parasites were unlikely in those with normal haemoglobin levels (AOR 0.08 CI [0.04-0.16] P<0.001). Pregnant women who were not on treatment before coming to the hospital ANC were about nine times more likely to have malaria parasites than those who had it recently (AOR 9.30, CI [4.44-19.50] P<0.001).
Conclusion: The prevalence of malaria in HIV-positive pregnant women was influenced by the locality, level of haemoglobin and self-medication prior to coming to the hospital. Low haemoglobin, which serves as an index of malnutrition, was also a serious factor that should be evaluated to reduce the scourge and burden of malaria complications, and programs geared towards provision of mosquito and environmental barriers should be improved.