Assessment of malaria parasitemia in people living with HIV/AIDS in Kumba, Cameroon

Abstract

Background: Malaria parasitemia and HIV infections are globally important public health concerns. People residing in regions where these two infections are endemic are prone to develop co-infection. Sub-Saharan Africa has the greatest burden of both diseases and Cameroon particularly the South West Region has been reported as one of the regions with the highest malaria and HIV prevalence. Hence, there is a need for continuous monitoring and epidemiologic inquiry to generate updated data on the burden of malaria parasitemia on HIV/AIDS. The aim of this study was to determine the prevalence of malaria parasitemia and the association between viral load and malaria parasite density in people living with HIV/AIDS in Kumba, Cameroon. Methods: A cross-sectional study was conducted involving 250 people living with HIV/AIDS selected from five main Community Based Organizations in Kumba during a period of 5 months from April to August 2021. Participants’ consent was obtained followed by socio-demographic and other useful data via a standardized questionnaire. Capillary blood samples were collected and Giemsa-stained blood films were examined to detect malaria parasitemia. The recent viral loads were collected from the participants’ medical files. Pearson’s chi-square was used for the comparison of proportions and correlation analysis to determine the association between parasite density and viral load. Statistical significance was set at p < 0.05. Results: An overall prevalence of malaria parasitemia in people living with HIV/AIDS in Kumba was 27.2%; [95% CI: 21.8% – 33.2%]. Among 215 participants who were HAART-experienced, 49(22.79%); [95% CI: 17.6% – 27.9%] were found to be positive for malaria parasitemia while 19(54.29%); [95% CI: 48.1% – 60.5%] out of the 35 HAART naïve individuals were positive for malaria parasitemia. This difference in prevalence was statistically significant (X2 = 15.078, df = 1, N = 250, p < 0.000). Also, malaria parasite density was significantly dependent on viral load (X2 = 61.065, df = 6, N = 49, p < 0.000). HAART-experienced participants with high viral load(>1000copies/ml) had significantly higher malaria parasite density(>400trophozoites/µL) than HAART-experienced participants with ‘not detectable’ viral load. Conclusion: The prevalence of malaria parasitemia in the study population was 27.2%. HAART naïve individuals had significantly higher malaria parasitemia prevalence and malaria parasite density than HAART-experienced individuals. Malaria parasite density was significantly dependent on viral load in HAART-experienced individuals.

Comparative Diagnostic Performance of Microscopy, SD-Bioline Rapid Diagnostic Test, and Polymerase Chain Reaction in the Detection of Malaria Infection among Pregnant Women at Delivery in Kumba Health District Area in the Southwest Region of Cameroon

“…Te result of a previous study showed a prevalence of 90.3% malaria infection among feverish patients in the Kumba health district [23], while among HIV patients, the prevalence is around 27.2% [24]. However, the prevalence of malaria among pregnant women reported by Asoba and collaborators is 43.2%, 25.2%, and 6.8% in the frst, second, and third trimester of pregnancy, respectively [25].…”

“…Nevertheless, to achieve the zero-malaria elimination goal [17], efective tools for malaria diagnosis are needed as clinical diagnosis of this infection remains the key, before making an informed choice on antimalarial medication. It is therefore critical to assess current malaria diagnostic tools at the national level, particularly in resource-limited settings, to determine which tool is more suitable for the detection of malaria infection among pregnant women, as accurate diagnosis of this infection must be followed by immediate treatment, as studies have shown that malaria, particularly in pregnancy, is associated with postpartum complications such as mastitis [18], and excessive uterine blood loss [19]. Tis will guide policy on the clinical management of pregnant women and strategy toward the elimination of malaria in pregnancy.…”