Malaria and intestinal parasite co-infections and impact on haematological parameters among people living with HIV in Buea, Southwest Cameroon

Abstract

Background: Both malaria and intestinal parasites are endemic in Cameroon, and their co-infection can be of great impact on haematological parameters among people living with HIV (PLWH). This cross-sectional study determined the prevalence and impact of malaria/intestinal parasite co-infections on haematological parameters in PLWH and HIV negative individuals in Buea, Cameroon from March-August 2019.Methods: The study population (500) comprised of 190 PLWH, 216 HIV consenting negative individuals from the Buea community and 94 HIV negative patients at the Buea Hospital out-patient department (OPD). Participants were examined clinically, and the collected blood sample was used for malaria parasite (MP) detection, HIV diagnosis and full blood count analysis. Stool samples were examined for the detection of intestinal parasites (IPs) using the formol-ether concentration and modified Zheil-Neelsen techniques. Proportions were compared using Pearson’s Chi-square test and association of anaemia with the independent variables was evaluated using multivariate logistic regression analysis Results: Overall, MP, IPs and MP/IPs co-infection prevalences were 17.0% (85), 13.0% (65) and 2.2% (11) respectively. When compared with HIV negative participants from the communities, PLWH had the highest prevalence of MP (16.3%, P = 0.17), IPs (23.7%, P ˂ 0.001) and MP/IPs co-infection (3.7%, P = 0.04). Plasmodium falciparum was the only malaria parasite identified. Detected protozoa (10.2%) were Cryptosporidium species and Entamoeba histolytica while detected helminths (3.8%) were Ascaris lumbricoides, Schistosoma mansoni, hookworm, Dipylidium caninum, Hymenolepis nana and Taenia species. Cryptosporidium species (16.8%, 32) was the most prevalent protozoan IP while hookworm (2.6%, 5) was the most prevalent helminth among PLWH. The significant risk factors associated with anaemia included being aged 21-30 years (P=0.029), a male (P<0.001), MP positive (P<0.001), HIV positive (P<0.001) and feverish (P<0.001). Participants co-infected with HIV, MP and IP had a significantly lower mean haemoglobin value (10.56 ±1.21 g/dl). Conclusion: Malaria and intestinal parasites are still public health concern among PLWH and co-infections have negative influence on haematological parameters especially haemoglobin concentration. Routine screening for malaria and IPs in PLWH is recommended, as well as haemoglobin concentration monitoring.