The objectives of this study is to (1) characterize profiles of HIV coinfection with TB and malaria; (2) estimate the severity of outcome associated with each type of coinfection; (3) identify most severe coinfection type, and populations most affected. Data on 1,302 HIV/AIDS patients were collected from hospital record books for 2007 and 2008. Distribution patterns of types of HIV coinfection with TB and malaria were assessed among low and high SES (socioeconomic status) inpatients. Case fatality rate for each type of coinfection was estimated as the ratio of number of deaths associated with a specific type of coinfection over the number of cases, times 100. Case fatality rates were compared among coinfection types and between low and high SES inpatients. Four types of coinfections were identified: single-HIV, HIV-TB, HIV-malaria and HIV-TB-malaria. Single-HIV infection was the most prevalent, and predominant among high SES inpatients; HIV-TB was the second most prevalent, and predominant among low SES inpatients; HIV-malaria and HIV-TB-malaria coinfections were the least prevalent, they were relatively comparable between both SES groups. HIV-TB coinfection was the deadliest type of coinfection, followed by HIV-TB-malaria and HIV-malaria. Single-HIV infection was the least deadly of the four conditions. Aside from HIV-malaria, the proportion of fatalities associated with each coinfection type was higher among low SES inpatients when compared with high SES inpatients. HIV/AIDS treatment and care programs in communities with limited resources and high prevalence of malaria and TB should give priority attention to low socioeconomic status patients coinfected with TB to prevent unnecessary deaths among those living with HIV.

IntroductionThe emergence of Plasmodium falciparum resistance to artemisinin combination therapy (ACT) is a worrying development. It calls for close surveillance to monitor the efficacy of the drugs. The objectives of this study were to determine the performance of SD Bioline malaria AgPf(HRP-2/pLDH) 3 band Rapid Diagnostic Test (RDT) against Giemsa-stained blood smear and evaluate the suitability of this test in assessing the therapeutic efficacy of ACT in pediatric malaria patients in the Democratic Republic of the Congo (DRC).MethodsFive hundred and one patients with malaria symptoms were screened for P. falciparum in Kinshasa, DRC. Of the 166 patients who tested positive for P. falciparum at recruitment (day 0), 103 consented to participate in this study and were followed up and retested for P. falciparum on day 3, day 7, day 14, day 21 and day 28.ResultsSensitivity and specificity of the test were significantly high on day 0 and so were their positive and negative predictive values. Higher proportions of false positive cases were observed on the HRP-2 band irrespective of patient parasite densities during the follow up but these were barely seen on the pLDH band. Some patients turned positive during follow up but pLDH readings remained consistent with blood smear readings.ConclusionSD Bioline malaria AgPf(HRP-2/pLDH) RDT demonstrated high performance in DRC. Thus, the test can be employed to assess the efficacy of ACT in pediatric malaria patients and prioritize areas that require the deployment of advanced testing like polymerase chain reaction (PCR).

Objective: (i) Highlight ield realities on proportions of parturient mothers who use during pregnancy intermittent preventive treatment-sulfadoxine-pyrimethamin (IPT-SP) without insecticide-treated net (ITN), IPT-SP in combination with ITN or ITN without IPT-SP; (ii) investigate associations existing between these preventive approaches with low prevalence of peripheral parasitemia, placental malaria, low birth weight (LBW) and anemia. Materials and Methods: Proportions of parturient mothers who utilize any of these approaches during pregnancy were estimated as well as associated rates of peripheral parasitemia, placental malaria, anemia and LBW; associations were investigated by comparing each group with participants who never utilized IPT-SP or ITN during pregnancy. Results and Conclusions: Of the 705 participants, 121 (17.2%) never used IPT-SP or ITN during pregnancy; 83 (11.8%) utilized ITN without IPT-SP and 501 (71.0%) utilized IPT-SP of those, 97% used IPT-SP1 and 3% used IPT-SP2/SP3. 275 (39%) used IPT-SP without ITN and 226 (32%) used IPT-SP in combination with ITN. While signi icant associations were found between: (i) Combined utilization of IPT-SP with ITN and low prevalence of peripheral parasitemia, placental malaria and LBW, (ii) utilization of IPT-SP without ITN and low prevalence of LBW and (iii) utilization of ITN without IPT-SP and low prevalence of placental malaria, no associations were seen between any of these approaches and low prevalence of anemia. Neither IPT nor ITN alone reduced as much adverse outcomes as when used together in combination, suggesting that in areas of moderate or high transmission of malaria, combined utilization of IPT-SP1/SP2 with ITN was the most effective approach for malaria prevention in pregnancy.