Prevalence and Risk Factors of Malaria in HIV-Infected Pregnant Women on Anti-Retroviral Therapy in Enugu, South East Nigeria

Johnbull, Ogboi Sonny; Uche, Agu P.; Kesiena, Akpoigbe J; Fagbamigbe, Adeniyi Francis; Oyemocho, Audu; Im, Obianwu; Akabueze, Jude

doi:10.4172/2155-6113.1000321

Cited by 8 publications

(13 citation statements)

References 16 publications

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“…Furthermore, the CD 4 + T cell count was significantly lower in HIV patients coinfected with malaria compared to those without, which confirms the study by Tay et al [14] in which patients with malaria were also observed to have lower CD 4 + T cell count. The finding of a significant association between malaria prevalence and CD 4 + T cell count is contrary to studies performed elsewhere [23, 25]. …”

Section: Discussioncontrasting

confidence: 99%

“…Malaria in Yaounde can be described as holoendemic and seasonal [18]. The prevalence is also very low compared to the prevalence of malaria in the other high risk groups including children (where prevalence could be as high as 98 % in some settings) [24], and pregnant women [25]. The low prevalence of malaria in this group could be attributed to the health seeking attitude of HIV patients.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…Interventions with IPTp-SP3 and CTX for pregnant women with HIV were highly cost-effective, constituting important evidence considering the negative feedback of PAM-HIV coinfection, whose intervention would reduce the negative effects of both. HIV potentiates the consequences of PAM by increasing the parasitic density, anaemia, cerebral and placental malaria, preterm delivery, LBW and neonatal death; PAM, in turn, increases viraemia, the progression to AIDS and the risk of vertical transmission of HIV [ 4 , 62 , 63 , 64 ]. However, the cost-effectiveness of this intervention depends, to a large extent, on close adherence to the daily dose (>80%) [ 43 , 65 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic review of microeconomic analysis of pregnancy-associated malaria

Restrepo-Posada¹,

Carmona‐Fonseca²,

Cardona‐Arias³

2020

Heliyon

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Introduction Pregnancy-associated malaria (PAM) is a health problem with serious clinical, epidemiological and economic effects. Purpose To analyze the microeconomic evaluations of PAM reported in the world scientific literature. Methods Systematic review with 15 different search strategies in PubMed, ScienceDirect, Scielo, Google Scholar and Malaria in Pregnancy (MiP) Library. A search, selection and extraction protocol was applied, which guaranteed completeness and reproducibility in accordance with preferred reporting items for systematic reviews and meta-analysis guidelines. The methodological quality was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guide. The analysis were based on frequencies, costs and average and incremental cost-effectiveness ratios in 2018 US dollars adjusted for purchasing power parity. Results Twenty-two evaluations published between 1990 and 2018 were analyzed, of which 82% addressed cost-effectiveness in Africa. Twelve interventions were studied; of these, intermittent preventive treatment in pregnant women with sulfadoxine-pyrimethamine (IPTp-SP) was the most frequent strategy. The main outcomes were low birth weight, anaemia and DALYs avoided. The best average cost-effectiveness ratio was reported in IPTp-SP with a cost of US$ 2 per DALY avoided, followed by the administration of IPTp-SP in pregnant women with HIV (US$ 14.2). Conclusions The studies focus on Africa with a high heterogeneity in the interventions, outcomes, resources and populations studied. All the interventions were highly cost-effective, which demonstrates the importance of including prevention, care and control resources for PAM as a priority in health sector budgets. This is especially true considering the importance of its intervention for social progress and overcoming poverty in endemic areas.

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“…Malaria, a mosquito-borne parasitic infection caused by species of Plasmodium, is the leading cause of pregnancyassociated death in sub-Saharan Africa (Sanyaolu et al, 2013;Sonny-Johnbull et al, 2014;Gething et al, 2016;Maitland, 2016;Sued et al, 2016). In sub-Saharan Africa, 25 million pregnant women are currently at risk for malaria, accounting for 10,000 maternal and 200,000 neonatal deaths per year (Matangila et al, 2014;Mbah et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Peripheral Parasitaemia and Its Association With Plasma Cytokines Levels in Malaria-Infected Pregnant Women in Aba, Abia State, Nigeria

Ifeanyichukwu

Okamgba

Amilo

et al. 2017

AJID

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Background: Cytokines in pregnant female may not be a normal phenomenon as malarial infection is often associated with strong CD4+ cell activation and up-regulation of pro-inflammatory cytokines. We investigated the relationship between peripheral parasitaemia and plasma levels of cytokines among malaria infected pregnant women in Aba, Abia State, Nigeria. Materials and Methods: A total of 206 non-HIV positive asymptomatic malaria parasitaemic (n=144) and non-parasitaemic (n=62) pregnant women were recruited for this study alongside 80 non-pregnant women who served as positive (n=40) and negative (n=40) controls. Blood samples were aseptically collected from each subject and tested for HIV and malaria parasites using standard methods. Also, plasma levels of cytokines were measured using Th1/Th2 human cytokine ELISA kits (Abcam, UK). Analysis of Variance and Student's t-test were used for Comparison of groups while Pearson's Correlation Coefficient was used for tests of association. Results:The results revealed a mean parasite density of 685.56±484.55 parasites/µl of blood. Malaria infected pregnant subjects showed significantly higher levels of IFN-γ, TNF-α, IL-4, IL-6 and IL-10 when compared with their non-infected counterparts (P< 0.05). The cytokines evaluated were higher in moderate parasitaemia than mild parasitaemia. Positive correlation existed between peripheral parasite density (PPD) and IL-4 (r= 0.24, P=0.004), PPD and IL-6 (r = 0.35, P = 0.001) as well as PPD and IL-10 (r = 0.29, P = 0.001). Conclusion:This study showed that increase in peripheral parasitaemia increased levels of some plasma cytokines (IL-4, IL-6 and IL-10) but not IFN-γ and TNF-α in the malaria infected pregnant women studied.

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Prevalence and Risk Factors of Malaria in HIV-Infected Pregnant Women on Anti-Retroviral Therapy in Enugu, South East Nigeria

Cited by 8 publications

References 16 publications

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

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

Systematic review of microeconomic analysis of pregnancy-associated malaria

Peripheral Parasitaemia and Its Association With Plasma Cytokines Levels in Malaria-Infected Pregnant Women in Aba, Abia State, Nigeria

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