Helminthic Infections Rates and Malaria in HIV-Infected Pregnant Women on Anti-Retroviral Therapy in Rwanda

Ivan, Emil; Crowther, Nigel J.; Mutimura, Eugene; Osuwat, Lawrence Obado; Janssen, Saskia; Grobusch, Martin P.

doi:10.1371/journal.pntd.0002380

Cited by 38 publications

(37 citation statements)

References 38 publications

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“…Reminder is done through phone calls, as well as home-based care approach, in order to enhance adherence to ARV drugs and other medications including co-trimoxazole prophylaxis. A similar study conducted in Rwanda reported that HIV-infected pregnant women benefit from continuous health education alongside hygiene intervention on malaria prevention during pregnancy 33. This study also reported that emphasis on co-trimoxazole prophylaxis during pregnancy is key to enhance the adherence to co-trimoxazole prophylaxis.…”

Section: Discussionmentioning

confidence: 57%

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Kamuhabwa

Gordian

Mutagonda

2016

DHPS

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BackgroundIn 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed.AimTo assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania.MethodologyThe study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered.ResultsTwenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors causing poor implementation of co-trimoxazole prophylaxis for prevention of malaria in HIV-infected pregnant women.ConclusionThere is a need to continue sensitization of pregnant women and communities about the importance of early attendance to the ANCs for testing of HIV and provision of co-trimoxazole prophylaxis. Availability of co-trimoxazole in the health facilities, regular training, and sensitization of health care providers are necessary for effective implementation of this policy.

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Section: Discussionmentioning

confidence: 57%

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Kamuhabwa

Gordian

Mutagonda

2016

DHPS

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“…An HIV infection increases the risk of malaria by impairing the immune response, thus decreasing the ability to withstand malaria infection (Verhoeff et al, 1999), and by reducing the drug's efficacy (González et al, 2012). High malaria prevalence rates among HIV positive pregnant women were also confirmed in Rwanda (Ladner et al, 2002), particularly in urban areas (Ivan et al, 2012(Ivan et al, , 2013.…”

Section: Biological Susceptibilitymentioning

confidence: 79%

Modelling homogeneous regions of social vulnerability to malaria in Rwanda

Bizimana¹,

Kienberger²,

Hagenlocher³

et al. 2016

Geospat Health

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Despite the decline in malaria incidence due to intense interventions, potentials for malaria transmission persist in Rwanda. To eradicate malaria in Rwanda, strategies need to expand beyond approaches that focus solely on malaria epidemiology and also consider the socioeconomic, demographic and biological/disease-related factors that determine the vulnerability of potentially exposed populations. This paper analyses current levels of social vulnerability to malaria in Rwanda by integrating a set of weighted vulnerability indicators. The paper uses regionalisation techniques as a spatially explicit approach for delineating homogeneous regions of social vulnerability to malaria. This overcomes the limitations of administrative boundaries for modelling the trans-boundary social vulnerability to malaria. The utilised approach revealed high levels of social vulnerability to malaria in the highland areas of Rwanda, as well as in remote areas where populations are more susceptible. Susceptibility may be due to the populations' lacking the capacity to anticipate mosquito bites, or lacking resilience to cope with or recover from malaria infection. By highlighting the most influential indicators of social vulnerability to malaria, the applied approach indicates which vulnerability domains need to be addressed, and where appropriate interventions are most required. Interventions to improve the socioeconomic development in highly vulnerable areas could prove highly effective, and provide sustainable outcomes against malaria in Rwanda. This would ultimately increase the resilience of the population and their capacity to better anticipate, cope with, and recover from possible infection. IntroductionDespite various interventions to reduce the burden of malaria, the disease persists in many countries of the developing world. In 2012 there were approximately 562,000 malaria deaths in Africa, despite a slow decline since 2004 (WHO, 2014. Malaria decrease in Sub-Saharan Africa was generally associated with intense interventions and reduced vector density due to changing rainfall patterns (Meyrowitsch et al., 2011). Although considerable progress has been made in many countries, the general malaria burden remains high, particularly in young children and pregnant women (Roll Back Malaria, 2005). The Plasmodium (P.) falciparum prevalence rates in Rwanda increased until the late 1990s and early 2000s, after which a marked decrease was noted (Stern et al., 2011). Since 2004, interventions to prevent and control malaria in Rwanda have resulted in a substantial decline in malaria transmission, particularly as a result of improved access to effective treatment, increased use of bed nets, and indoor residual spraying (Karema et al., 2012). However, malaria incidence increased again between 2011 and 2012, revealing the fragility of the gains achieved (WHO, 2013). The results of an entomological survey of more than 50% exophile entomological inoculation rate (EIR) around Kigali City is also an indicator of potential transmission ga...

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“…Ivan et al reported 6.6% co-infection while investigating prevalence of helminth and malaria infections in pregnant HIV-positive Rwandan women receiving anti-retroviral therapy (ART) [45]. The current rate was however thrice lower than that recorded by Yatich et al who reported 16.6% [12].…”

Section: Discussionmentioning

confidence: 99%

Parasitic infections and maternal anaemia among expectant mothers in the Dangme East District of Ghana

2017

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BackgroundParasitic infections are of public health concern globally, particular among at risk groups such as pregnant women in developing countries. The presence of these parasites during pregnancy potentiate adverse effects to both the mother and the unborn baby. This study sought to establish the prevalence of some parasitic agents among antenatal attendees in the Dangme East District of Ghana. A cross-sectional prospective study was conduct between April and July, 2012. Venous blood specimens were collected from each participant for haemoglobin estimation and malaria microscopy. In addition participants’ early morning mid-stream urine and stool specimens were analyzed microscopically for parasitic agents.ResultsA total of 375 pregnant women were involved in the study, of which anaemia was present in 66.4% (249/375). However, parasitic infections associated anaemia prevalence was 49.6% (186/375). In all, 186 cases of parasitic infections were observed; 171 (44.0%) were single isolated infections while 15 (4.0%) were co-infections. Plasmodium species were significantly associated with anaemia (13.3%, χ2 = 23.290, p < 0.001). Also, the presence of Schistosoma haematobium (3.7%, χ2 = 7.267, p = 0.008), Schistosoma mansoni (5.3%, χ2 = 5.414, p = 0.023) and hookworm (3.7%, χ2 = 11.267, p = 0.008) were significantly associated with anaemia in pregnancy. Except where co-infections exist (3.7%, χ2 = 11.267, p = 0.001), the rest of the single infections were insignificantly associated with anaemia. Collectively, intestinal helminthes were predominantly significant with anaemia in pregnancy (p = 0.001, χ2 = 107.800).ConclusionThe study revealed relatively high prevalence of parasitic infections among the study population, suggesting that about three-quarters of the anaemic mothers are either single or co-infected with parasitic agents.

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Helminthic Infections Rates and Malaria in HIV-Infected Pregnant Women on Anti-Retroviral Therapy in Rwanda

Cited by 38 publications

References 38 publications

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Modelling homogeneous regions of social vulnerability to malaria in Rwanda

Parasitic infections and maternal anaemia among expectant mothers in the Dangme East District of Ghana

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