The interaction between malaria and human immunodeficiency virus infection in severely anaemic Malawian children: a prospective longitudinal study

Abstract

Abstractobjective Malaria and human immunodeficiency virus (HIV) infection are co-prevalent in subSaharan Africa and cause severe anaemia in children. Interactions between these infections occur in adults, although these are less clear in children. The aim of study was to determine their interaction in a cohort of severely anaemic children.methods Severely anaemic Malawian children were enrolled, tested for HIV and malaria, transfused and followed for 18 months for malaria incidence. Antiretrovirals were not widely available in Malawi during the study period.results Of 381 children (haemoglobin <5 g/dl), 357 consented for HIV testing, 12.6% were HIVinfected, and 59.5% had malaria parasitaemia. At enrolment, HIV-infected children had similar malaria parasitaemia prevalence (59.1% vs. 58.7%; P = 0.96) and parasite density (geometric mean [parasites/ll] 6903 vs. 12417; P = 0.18) as HIV-negative children. There were no differences in mean CD4%, or prevalence of severe immunosuppression, between those with and without malaria parasitaemia. Plasma viral load correlated negatively with log parasitaemia (r = À0.78; P = 0.01). During follow-up, HIV-infected children did not experience more frequent parasitaemias or symptomatic malaria episodes. Adjusted risk estimates (95% CI) for malaria parasitaemia in HIVinfected children at 6 and 18 months follow-up were 0.39 (0.13-1.14) and 0.40 (0.11-1.51), respectively.

The Effect of Malaria and HIV Co-Infection on Anemia

“…Among these, 13 studies reported prevalence of HIV in malaria-infected patients, 22–24,27,28,30,35,37–40,42,43 whereas 10 studies on prevalence of malaria in HIV positives. 7,25,26,29,31–34,36,41 …”

“…22 Nine studies (with 10 datasets) compared mean Hb levels between those who had dual infection and those who had malaria or HIV infection. 7,25,26,30–32,35,36,40 Thirteen studies compared proportions of anemia between those who were co-infected and those who had monoinfected. 22,24,27–29,33,34,37–39,41–43 Anemia was comparable between the monoinfected and co-infected adults (summary OR: 1.49, 95% CI: 0.93–2.37) and increased by 49% in co-infected pregnant women (summary OR: 1.49, 95% CI: 1.14–1.94) (Figure 3).…”

Characterization of Plasmodium vivax-associated admissions to reference hospitals in Brazil and India

“…The occurrence of co-morbidities has been associated with higher morbidity of malaria in different African locations, starting with HIV infection but also including other viral and bacterial co-infections [ 51 - 54 ], stressing the importance of investigating their occurrence and possibly promoting joint management strategies for common concurrent conditions in many tropical areas [ 55 ]. Bacterial systemic concurrent infections were rarely observed in Manaus, which could be a potential reflection that among adult patients the concomitant occurrence of bacterial infection seems much rarer than that among P. falciparum -infected children [ 56 ].…”

Profil de l'hémogramme chez les enfants paludéens de 0 à 5 ans sous quinine, cas de la République Démocratique du Congo

“…Le taux d'hémoglobine tombe alors brutalement en dessous des valeurs acceptables. Un collapsus peut survenir; la solution la plus urgente est de transfuser l'enfant avec du culot globulaire tout en soutenant le cœur avec des tonicardiaques [ 1 , 2 ].…”

“…C'est de loin la parasitose qui touche le plus grand nombre de personnes et provoque le plus de décès [ 1 ]. Il traduit l'agression directe du globule rouge et sa destruction par le plasmodium; il est à la base de l'hémolyse dite intra-vasculaire et d'autre part, la destruction par érythrocytose des globules rouges infectés ou non par le système réticulo-endothélial entrainant l'hémolyse dite extra-vasculaire [ 2 , 3 ].…”