Human Immunodeficiency Virus and Malaria in a Representative Sample of Childbearing Women in Kigali, Rwanda

Abstract

In 1986-1987 a consecutive sample of 3702 women presenting to prenatal and pediatric clinics at the only hospital in Kigali, Rwanda, was screened for human immunodeficiency virus (HIV) and malaria infection. The prevalence of HIV antibodies was 29%, and that of malaria parasites was 9%. HIV antibodies were more prevalent in women from the urban center than in those from the outskirts (31% vs. 20%, P < .001), and malaria parasites showed the opposite prevalence pattern (8% vs. 15%, P < .001); after stratifying by location, there was no association between HIV and the presence or degree of malaria parasitemia. HIV prevalence was 45% in women who had received a blood transfusion between 1980-1985 (before screening of donated blood began), and 28% among the great majority (94%) who had never been transfused. HIV prevalence was 44% in single mothers, 34% in women in common law unions, and 20% in those in legal marriages. These high rates of infection in the general population of Kigali highlight the need to develop effective programs for preventing further spread of sexually transmitted HIV.

HIV infection, malaria, and pregnancy: a prospective cohort study in Kigali, Rwanda.

“…15 In contrast, another study performed in Kigali, where the prevalence of positive thick drop was 9%, did not find a relationship between HIV infection and malaria. 10 The fact that pregnant women in Allen and colleagues' study 10 lived in various areas of Kigali and only within the city limits in our study could explain this difference.…”

“…Most studies, however, suggest that there is no significant biological relation between HIV infection and P. falciparum malaria in adults and children. [7][8][9][10] Recently, studies have found an interaction between malaria and HIV infection during pregnancy and a possible role of placental malaria infection in increasing the risk of vertical transmission of HIV. [11][12][13][14][15] The aim of the present report is to estimate the incidence of malaria infection during pregnancy and the postpartum period and to examine the relationship between HIV and malaria infections in Kigali, the capital city of Rwanda.…”

Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

“…Multiple cross-sectional studies performed across sub-Saharan Africa showed no association between malaria and HIV-1 infection [19,[84][85][86]. Two subsequent crosssectional studies of pregnant women from Malawi found that the prevalence of malaria parasitemia on the first prenatal visit was higher among HIV-1-infected women (32% and 54%, respectively) than among HIV-1-seronegative women (19% and 42%, respectively), a trend more pronounced with multigravidity [87,88].…”

Pregnancy, Hormonal Contraceptive Use, and HIV-Related Death in Rwanda

“…The sampling design for this cohort has been described in detail elsewhere. 22 Between October 1986 and March 1987, a consecutive sample of 3702 women from 18-35 years of age was recruited from pediatric and prenatal clinics at the Centre Hospitalier de Kigali, the only community hospital in the capital city. The prevalence of HIV infection in this initial sample was 29%.…”

“…The prevalence of HIV infection in this initial sample was 29%. 22 In 1988, 1458 of these women (460 HIV positive and 998 HIV negative), selected by stratified random sampling, were enrolled in a prospective study. 23 The 1458 enrolled were similar to the 2244 women not enrolled with respect to the prevalence of HIV, age, marital status, and partner's profession.…”