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

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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.
    @article{4cba935da9ec4f2ab62d0a6eea9521cb,
    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",
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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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