Asymptomatic parasitemia is common among schoolchildren living in areas of high malaria transmission, yet little is known about its effect on cognitive function in these settings. To investigate associations between asymptomatic parasitemia, anemia, and cognition among primary schoolchildren living in a high malaria transmission setting, we studied 740 children enrolled in a clinical trial in Tororo, Uganda. Parasitemia, measured by thick blood smears, was present in 30% of the children. Infected children had lower test scores for abstract reasoning (adjusted mean difference [AMD] −0.6, 95% confidence interval [CI] −1.01 to −0.21) and sustained attention (AMD −1.6 95% CI −2.40 to −0.81) compared with uninfected children. There was also evidence for a dose–response relationship between parasite density and scores for sustained attention. No associations were observed between anemia and either test of cognition. Schoolchildren in high transmission settings may experience cognitive benefits, from interventions aimed at reducing the prevalence of asymptomatic parasitemia.

Dihydroartemisinin-piperaquine administered at monthly intervals, but not that dosed once a school term, is a remarkably effective measure for the prevention of incidence of malaria, prevalence of parasitemia, and prevalence of anemia in schoolchildren living in a high-transmission setting.

Although recent data suggest high levels of adherence to expanding antiretroviral therapy (ART) programmes in resource-limited settings, the culture-specific barriers to adherence are poorly understood. In a prospective observational study, we found that 1.2% of patients discontinued ART because of a belief in spiritual healing. Spiritual beliefs should be an important part of ART adherence counselling in resource-limited settings, requiring close collaboration between HIV care programmes and religious leaders to identify common goals and ensure successful treatment.

Objective We evaluated the efficacy of a brief motivational intervention (MI) counseling in reducing alcohol consumption among persons living with HIV/AIDS (PLWHA) in Kampala-Uganda. Methods PLWHA attending an outpatient HIV clinic with alcohol disorders identification test-Consumption component (AUDIT-C) score ≥3 points were randomized to either standardized positive prevention counseling alone or in combination with alcohol brief MI counseling. Mean change in AUDIT-C scores over 6 months were compared by treatment arm. RESULTS The mean (SD) AUDIT-C scores were 6.3(2.3) and 6.8(2.3), for control and MI arms (p=0.1) at baseline and change in mean AUDIT-C score was not statistically different between the treatment arms over the 6 months follow up time (P=0.8). CONCLUSION There was a non-differential reduction in alcohol consumption in both intervention and control arms. Standard positive prevention counseling should be provided to all PLWHA who use alcohol. Studies with more than one counseling session need to be evaluated. Clinical trials.gov trial identifier: NCT01802736.