Prevalence and risk factors of malaria in HIV-infected pregnant women on anti-retroviral therapy in Enugu, south east Nigeria

Ogboi Sonny Johnbull, Agu P. Uche, Akpoigbe J. Kesiena, Fagbamigbe A. Francis, Audu Oyemocho, I. M. Obianwu, J. Akabueze

Research output: Contribution to journalArticle

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Abstract

Background and objective: Malaria and HIV co-infection pose significant health concerns in many regions of the world. Co-infection significantly increases the burden of these diseases in pregnancy, yet the interactions of these diseases in pregnant women are not well understood. The aim of the study was to determine the prevalence and examine the factors that could be associated with malaria in HIV positive infected pregnant women on antiretroviral therapy.

Methodology: Blood samples were collected from 301 confirmed HIV positive pregnant women in various trimesters and examined for malaria parasite presence and density with other laboratory indices. Baseline socio-demographic information, antenatal information, CD4 levels, and viral load were collected from clinical records. Information on type of treatment, such as intermittent malaria preventive treatment (IPT) and ART therapy/ prophylaxis, was extracted from care cards. Information on the prior use of antimalarial drugs and cotrimoxazole intake was obtained from direct interviews.

Results: The prevalence of malaria among HIV-positive pregnant women was 49.83% and the odds of having malaria doubled with living in a rural community (AOR 2.04, CI [1.07-3.91] P<0.001). Also, being on ART therapy increased the odds of having malaria by 133% (AOR 2.33 CI [1.06-5.10] P<0.05). A higher level of CD4 counts reduced the odds of malaria parasitaemia though not significant. Those whose CD4 count was 200-350 and >350 had reduced odds of malaria parasitaemia (AOR 0.50, CI [0.81-1.44] P=0.202) and (AOR 0.65, CI [0.24-1.73] P=0.391), respectively, compared with those with lower CD4 counts. Malaria parasites were unlikely in those with normal haemoglobin levels (AOR 0.08 CI [0.04-0.16] P<0.001). Pregnant women who were not on treatment before coming to the hospital ANC were about nine times more likely to have malaria parasites than those who had it recently (AOR 9.30, CI [4.44-19.50] P<0.001).

Conclusion: The prevalence of malaria in HIV-positive pregnant women was influenced by the locality, level of haemoglobin and self-medication prior to coming to the hospital. Low haemoglobin, which serves as an index of malnutrition, was also a serious factor that should be evaluated to reduce the scourge and burden of malaria complications, and programs geared towards provision of mosquito and environmental barriers should be improved.

Original languageEnglish
Article number1000321
JournalJournal of AIDS and Clinical Research
Volume5
Issue number7
DOIs
Publication statusPublished - 2014

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Nigeria
Malaria
Pregnant Women
HIV
Therapeutics
Parasites
Hemoglobins
Coinfection
Self Medication
Parasitemia
Sulfamethoxazole Drug Combination Trimethoprim
Antimalarials
Rural Population
CD4 Lymphocyte Count
Culicidae
Viral Load
Malnutrition
HIV Infections
Demography
Interviews

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Dermatology
  • Immunology
  • Virology

Cite this

Johnbull, Ogboi Sonny ; Uche, Agu P. ; Kesiena, Akpoigbe J. ; Francis, Fagbamigbe A. ; Oyemocho, Audu ; Obianwu, I. M. ; Akabueze, J. / Prevalence and risk factors of malaria in HIV-infected pregnant women on anti-retroviral therapy in Enugu, south east Nigeria. In: Journal of AIDS and Clinical Research. 2014 ; Vol. 5, No. 7.
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title = "Prevalence and risk factors of malaria in HIV-infected pregnant women on anti-retroviral therapy in Enugu, south east Nigeria",
abstract = "Background and objective: Malaria and HIV co-infection pose significant health concerns in many regions of the world. Co-infection significantly increases the burden of these diseases in pregnancy, yet the interactions of these diseases in pregnant women are not well understood. The aim of the study was to determine the prevalence and examine the factors that could be associated with malaria in HIV positive infected pregnant women on antiretroviral therapy.Methodology: Blood samples were collected from 301 confirmed HIV positive pregnant women in various trimesters and examined for malaria parasite presence and density with other laboratory indices. Baseline socio-demographic information, antenatal information, CD4 levels, and viral load were collected from clinical records. Information on type of treatment, such as intermittent malaria preventive treatment (IPT) and ART therapy/ prophylaxis, was extracted from care cards. Information on the prior use of antimalarial drugs and cotrimoxazole intake was obtained from direct interviews.Results: The prevalence of malaria among HIV-positive pregnant women was 49.83{\%} and the odds of having malaria doubled with living in a rural community (AOR 2.04, CI [1.07-3.91] P<0.001). Also, being on ART therapy increased the odds of having malaria by 133{\%} (AOR 2.33 CI [1.06-5.10] P<0.05). A higher level of CD4 counts reduced the odds of malaria parasitaemia though not significant. Those whose CD4 count was 200-350 and >350 had reduced odds of malaria parasitaemia (AOR 0.50, CI [0.81-1.44] P=0.202) and (AOR 0.65, CI [0.24-1.73] P=0.391), respectively, compared with those with lower CD4 counts. Malaria parasites were unlikely in those with normal haemoglobin levels (AOR 0.08 CI [0.04-0.16] P<0.001). Pregnant women who were not on treatment before coming to the hospital ANC were about nine times more likely to have malaria parasites than those who had it recently (AOR 9.30, CI [4.44-19.50] P<0.001).Conclusion: The prevalence of malaria in HIV-positive pregnant women was influenced by the locality, level of haemoglobin and self-medication prior to coming to the hospital. Low haemoglobin, which serves as an index of malnutrition, was also a serious factor that should be evaluated to reduce the scourge and burden of malaria complications, and programs geared towards provision of mosquito and environmental barriers should be improved.",
author = "Johnbull, {Ogboi Sonny} and Uche, {Agu P.} and Kesiena, {Akpoigbe J.} and Francis, {Fagbamigbe A.} and Audu Oyemocho and Obianwu, {I. M.} and J. Akabueze",
year = "2014",
doi = "10.4172/2155-6113.1000321",
language = "English",
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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.; Francis, Fagbamigbe A.; Oyemocho, Audu; Obianwu, I. M.; Akabueze, J.

In: Journal of AIDS and Clinical Research, Vol. 5, No. 7, 1000321, 2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence and risk factors of malaria in HIV-infected pregnant women on anti-retroviral therapy in Enugu, south east Nigeria

AU - Johnbull, Ogboi Sonny

AU - Uche, Agu P.

AU - Kesiena, Akpoigbe J.

AU - Francis, Fagbamigbe A.

AU - Oyemocho, Audu

AU - Obianwu, I. M.

AU - Akabueze, J.

PY - 2014

Y1 - 2014

N2 - Background and objective: Malaria and HIV co-infection pose significant health concerns in many regions of the world. Co-infection significantly increases the burden of these diseases in pregnancy, yet the interactions of these diseases in pregnant women are not well understood. The aim of the study was to determine the prevalence and examine the factors that could be associated with malaria in HIV positive infected pregnant women on antiretroviral therapy.Methodology: Blood samples were collected from 301 confirmed HIV positive pregnant women in various trimesters and examined for malaria parasite presence and density with other laboratory indices. Baseline socio-demographic information, antenatal information, CD4 levels, and viral load were collected from clinical records. Information on type of treatment, such as intermittent malaria preventive treatment (IPT) and ART therapy/ prophylaxis, was extracted from care cards. Information on the prior use of antimalarial drugs and cotrimoxazole intake was obtained from direct interviews.Results: The prevalence of malaria among HIV-positive pregnant women was 49.83% and the odds of having malaria doubled with living in a rural community (AOR 2.04, CI [1.07-3.91] P<0.001). Also, being on ART therapy increased the odds of having malaria by 133% (AOR 2.33 CI [1.06-5.10] P<0.05). A higher level of CD4 counts reduced the odds of malaria parasitaemia though not significant. Those whose CD4 count was 200-350 and >350 had reduced odds of malaria parasitaemia (AOR 0.50, CI [0.81-1.44] P=0.202) and (AOR 0.65, CI [0.24-1.73] P=0.391), respectively, compared with those with lower CD4 counts. Malaria parasites were unlikely in those with normal haemoglobin levels (AOR 0.08 CI [0.04-0.16] P<0.001). Pregnant women who were not on treatment before coming to the hospital ANC were about nine times more likely to have malaria parasites than those who had it recently (AOR 9.30, CI [4.44-19.50] P<0.001).Conclusion: The prevalence of malaria in HIV-positive pregnant women was influenced by the locality, level of haemoglobin and self-medication prior to coming to the hospital. Low haemoglobin, which serves as an index of malnutrition, was also a serious factor that should be evaluated to reduce the scourge and burden of malaria complications, and programs geared towards provision of mosquito and environmental barriers should be improved.

AB - Background and objective: Malaria and HIV co-infection pose significant health concerns in many regions of the world. Co-infection significantly increases the burden of these diseases in pregnancy, yet the interactions of these diseases in pregnant women are not well understood. The aim of the study was to determine the prevalence and examine the factors that could be associated with malaria in HIV positive infected pregnant women on antiretroviral therapy.Methodology: Blood samples were collected from 301 confirmed HIV positive pregnant women in various trimesters and examined for malaria parasite presence and density with other laboratory indices. Baseline socio-demographic information, antenatal information, CD4 levels, and viral load were collected from clinical records. Information on type of treatment, such as intermittent malaria preventive treatment (IPT) and ART therapy/ prophylaxis, was extracted from care cards. Information on the prior use of antimalarial drugs and cotrimoxazole intake was obtained from direct interviews.Results: The prevalence of malaria among HIV-positive pregnant women was 49.83% and the odds of having malaria doubled with living in a rural community (AOR 2.04, CI [1.07-3.91] P<0.001). Also, being on ART therapy increased the odds of having malaria by 133% (AOR 2.33 CI [1.06-5.10] P<0.05). A higher level of CD4 counts reduced the odds of malaria parasitaemia though not significant. Those whose CD4 count was 200-350 and >350 had reduced odds of malaria parasitaemia (AOR 0.50, CI [0.81-1.44] P=0.202) and (AOR 0.65, CI [0.24-1.73] P=0.391), respectively, compared with those with lower CD4 counts. Malaria parasites were unlikely in those with normal haemoglobin levels (AOR 0.08 CI [0.04-0.16] P<0.001). Pregnant women who were not on treatment before coming to the hospital ANC were about nine times more likely to have malaria parasites than those who had it recently (AOR 9.30, CI [4.44-19.50] P<0.001).Conclusion: The prevalence of malaria in HIV-positive pregnant women was influenced by the locality, level of haemoglobin and self-medication prior to coming to the hospital. Low haemoglobin, which serves as an index of malnutrition, was also a serious factor that should be evaluated to reduce the scourge and burden of malaria complications, and programs geared towards provision of mosquito and environmental barriers should be improved.

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