Malaria parasite prevalence and Haematological parameters in HIV seropositive patients attending the regional hospital Limbe, Cameroon: a hospital-based cross-sectional study

Abstract

BackgroundMalaria and the human immunodeficiency virus (HIV) infection constitute public health problems in Cameroon including the South West Region (SWR). This study determined the prevalence of malaria parasites and haematological abnormalities in HIV positive patients in Limbe, Cameroon from April–July 2014.MethodsThe study was cross-sectional and involved 411 participants who were administered structured questionnaires to record socio-demographic and clinical data. Three hundred and nine (309) HIV positive patients and one hundred and two (102) HIV negative individuals were examined clinically and venous blood collected for malaria parasite detection, HIV infection diagnosis and full blood count analysis.ResultsOverall malaria parasite prevalence was 14.1% (58/411). This prevalence was significantly higher (P < 0.001) in the HIV negative participants (33.3%, 34/102) compared to the HIV positive patients (7.8%, 24/309). Amongst HIV positive participants, malaria parasite prevalence was significantly higher in female patients (P = 0.003), febrile patients (P < 0.001), anaemic patients (P = 0.015) and in patients who were not on antiretroviral treatment (ART) (P = 0.03) when compared with their respective counterparts. Among the HIV negative group, though not significant, malaria parasite prevalence was higher in females, febrile and anaemic patients when compared with their respective counterparts. Overall anaemia prevalence was 52.1% (214/309) and was significantly higher (P = 0.004) in HIV positive patients (56%, 173) than in HIV negative participants (40.2%, 41). Malaria/HIV co-infected patients had a significantly lower mean value of Hb (P = 0.002), RBC (P = 0.002) and Hct (P = 0.001) when compared with HIV-infected patients.ConclusionHIV negative participants had a higher prevalence of malaria parasites than their HIV positive counterparts. Anaemia prevalence was higher in HIV positive patients than in HIV negative participants. Malaria/HIV co-infected patients presented with more red blood cell abnormalities than HIV-infected patients.

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

“…The prevalence of malaria parasite among PLWH was 16.4%, which is high compared to the prevalence reported in PLWH in other areas of the South West Region of Cameroon. This included the 7.8% reported in Limbe [10] and 2.3% in Buea [31] It was also observed in this study that despite the efforts made to scale up insecticide-treated nets (ITNs) distribution so that universal coverage can be attained, coverage remains low and this could have contributed to this rise in malaria prevalence among PLWH.…”

“…HIV-negative participants included persons who consented to be screened for HIV during the process and were negative while apparently healthy HIV-negative individuals were those enrolled through HIV outreach programs in their homes and o ces in the Buea neighbourhoods (Molyko, Bonduma, Great Soppo, GRA, Buea town, Bokwaongo, Bokova, Mile 18, Clerks and Federal quarters). The sample size was determined using the formula n = Z 2 pq/d 2 [25] where n represented the sample size evaluated, Z was 1.96, which is the standard normal deviate (for the 95% con dence interval, CI), p was 14.1% [10] and 82.6% [15], the prevalence of malaria and IPIs in PLWH and HIV negative participants respectively, q was 1-p and d was 0.05. The sample size calculated for malaria parasite prevalence was 186 while that for IPIs prevalence was 220 given an optimum sample size for the study of 406 participants.…”

“…WHO reported Cameroon as the fourth Sub-Saharan African country behind Nigeria, Democratic Republic of Congo and Mozambique responsible for the malaria cases in the region [5]. Many studies have consistently reported an association between HIV infection and malaria in Cameroon [6,7,8,9,10] In Cameroon, each region shows varied prevalence of both malaria and HIV infection. HIV prevalence is approximately 3.7% [3] while malaria transmission is stable throughout the year, with an overall malaria test positivity rate of 62% registered in 2017 [11].…”

“…Although, ART in combination with cotrimoxazole confers a level of immunity to infections in PLWH, it has been reported to have adverse effects on the red blood cell indices of these patients, thereby causing anaemia [19]. Although malaria and intestinal parasites as well as ART are known etiological factors in anaemia [20,21,15,10], the extent to which their interaction might enhance the risk of the haematological abnormalities merits further investigations. Previous studies have reported on the in uence of malaria/HIV co-infection on the occurrence of anaemia [22,18,10].…”

“…Although malaria and intestinal parasites as well as ART are known etiological factors in anaemia [20,21,15,10], the extent to which their interaction might enhance the risk of the haematological abnormalities merits further investigations. Previous studies have reported on the in uence of malaria/HIV co-infection on the occurrence of anaemia [22,18,10]. The situation regarding PLWH co-infected with malaria and intestinal parasites in the area following the intensi cation of different control strategies such free availability of ART and cotrimoxazole, access to viral load testing and community ART dispensation is unknown.…”