The prevalence of malaria in people living with HIV in Yaounde, Cameroon

Abstract

BackgroundCoinfection with malaria and HIV is common in Sub-Saharan Africa. In the advent of a decline in the global incidence of malaria, it is important to generate updated data on the burden of malaria in people living with HIV (PLWHIV). This study was designed to determine the prevalence of malaria in PLWHIV in Yaounde, Cameroon, as well determine the association between CD4 + T cell count and malaria in the study population.MethodsIn a cross sectional study performed between April 2015 and June 2016, 355 PLWHIV were enrolled and blood samples were collected for analysis. Complete blood count was performed using an automated haematology analyser (Mindray®, BC-2800) and CD4 + T cell count was performed using a flow cytometer (BD FASCount™). Giemsa-stained blood films were examined to detect malaria parasite. The Pearson’s chi-square, student’s T-test, ANOVA, and correlation analysis were all performed as part of the statistical analyses.ResultsThe prevalence of malaria observed in the study was 7.3 % (95 % CI: 4.8–10.6). No significant association was observed between the prevalence of malaria and age or gender. The prevalence of malaria was higher in participants who were not sleeping in insecticide treated bed nets, ITNs (p < 0.001); and in participants who were not on cotrimoxazole prophylaxis (p = 0.002). The prevalence of malaria (p < 0.001) and malaria parasite density (p = 0.005) were observed to be progressively higher in participants with CD4 + T cell count below 200cells/μl. Furthermore, the mean CD4 + T cell count was observed to be lower in participants coinfected with malaria compared to non-coinfected participants (323.5 vs 517.7) (p < 0.001). In this study, a negative correlation was observed between malaria parasite density and CD4 + T cell count (p = 0.019).ConclusionsA low prevalence of malaria was observed in the study population. Some of the factors accounting for the low prevalence of malaria in this study population may include the health seeking habit of PLWHIV, the use of cotrimoxazole based chemoprophylaxis, and their cautious use of ITNs.

Prevalence of Coinfection with Malaria and HIV among Children in Yaound&#233;, Cameroon: A Cross-Sectional Survey Performed in Three Communities in Yaound&#233;

“…The prevalence observed was lower than the malaria prevalence of 35% reported in the general population of Yaoundé [22]. This decrease in malaria prevalence in the current study could be attributed to the relentless effort by Cameroon's government to reduce transmission through the distribution of insecticide-treated bed nets (ITNs) to every household in the country as well as the intense sensitization campaign through media [16] [26]. The malaria prevalence in the current study was also lower compared to the national prevalence of 29% [27].…”

“…This finding is similar to the prevalence of 2.24% reported in Bamenda in the Northwest Region [19]. However, the prevalence of coinfection with malaria and HIV was lower than the 7.3% and 29.4% reported by Njunda et al [16] and Nkuo-Akenji et al [15] respectively. The difference in the prevalence of coinfection reported in these studies and ours could be attributed to differences in the study designs; our study targeted children in the community meanwhile theirs targeted known HIV patients recruited from HIV treatment facilities.…”

“…Due to their overlapping distribution, coinfection with malaria and HIV is therefore bound to be common in the area. Coinfection with malaria and HIV is thought to have a synergistic effect, with studies reporting that repeated infection with malaria leads to a more rapid decline in CD4 + T cells overtime, meanwhile malaria coinfection with HIV results in more episodes of symptomatic malaria [11], and more episodes of severe or complicated malaria including death in both children and adults [12] [13] [14] [15] [16]. The risk of severe anaemia is also higher in HIV patients coinfected with malaria compared to HIV patients without malaria [17] [18].…”

Variation in the immune responses against Plasmodium falciparum merozoite surface protein-1 and apical membrane antigen-1 in children residing in the different epidemiological strata of malaria in Cameroon

“…Similarly the IgG antibody titres were observed to decrease northwards from Limbe (in C strata) where it peaked to Ngaoundere (in HIP strata) where it was lowest (p = 0.001). These observed differences could be attributed to the differences in the transmission intensity of malaria observed in the different epidemiological strata; malaria has been described as hyperendemic in Limbe [ 45 ], holo-endemic in Yaounde [ 46 , 47 ], meso-endemic in Bamenda and Ngaoundere, and hypo-endemic in Maroua [ 33 , 34 ]. The transmission of malaria in Cameroon has been observed to decrease steadily from the south towards the north of the country [ 33 , 34 ].…”

Comparative analysis of IgG Responses to recombinant Qβ phage displayed MSP3 and UB05 in Dual HIV-malaria infected adults living in areas differing in Malaria transmission intensities

“…The temperature in both areas is around 23.7°C with a similar average annual rain fall of 1643 mm. There also have similar rainy (March to June, September to November) and dry seasons (December to February, July–August) (27).…”