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An In Vitro Model for Measuring Immune Responses to Malaria in the Context of HIV Co-infection
Published on: October 6, 2015
MALARIA PARASITAEMIA AMONG FEBRILE CHILDREN INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS IN THE CONTEXT OF PROPHYLACTIC
Insights
Malaria parasitaemia remains high in febrile HIV-infected children in Kenya, despite cotrimoxazole prophylaxis. Findings suggest a need to expand malaria prevention to older children.
Area of Science:
- Pediatric Infectious Diseases
- Global Health
- HIV/AIDS Research
Background:
- Malaria and HIV co-infection pose significant challenges in endemic regions.
- Cotrimoxazole prophylaxis is a standard intervention for febrile illnesses in HIV-infected children.
Purpose of the Study:
- To determine the prevalence of malaria parasitaemia in febrile, HIV-infected children in Western Kenya.
- To identify factors associated with malaria parasitaemia in this population.
Main Methods:
- A cross-sectional study was conducted with 245 febrile HIV-infected children (<14 years) at a pediatric HIV clinic in Western Kenya.
- Systematic sampling was used, and blood samples were analyzed for malaria parasites. Clinical and demographic data were collected.
Main Results:
- Malaria prevalence was high at 81.9% among the participants.
- Factors associated with malaria included male sex, parental caretaking, advanced HIV disease (WHO stages 3 & 4), and high CD4 counts, though only caretaking was statistically significant.
- Despite 97% receiving cotrimoxazole prophylaxis, malaria rates were high.
Conclusions:
- High malaria parasitaemia persists in febrile HIV-infected children, even with widespread cotrimoxazole use.
- A shift towards older children experiencing fever suggests a need to reassess and expand malaria prevention strategies to include this age group.
Objective:
To document the prevalence of malaria parasitaemia among the HIV infected febrile children in a malaria endemic area.
Design:
A cross-sectional study.
Setting:
An ambulatory paediatric HIV clinic in Western Kenya, between November 2011 and December 2012.
Subjects:
A total of 245 febrile HIV infected children aged less than 14 years attending the HIV clinic in the Webuye level IV hospital were included in the study. A systematic sampling method was used.
Main Outcomes:
A blood sample was taken for malaria parasite testing. Presence or absence of malaria parasites was documented. Clinical and socio-demographic characteristics of the participants were also recorded.
Results:
A total of 245 participants were recruited mean age being 5.53 years. Malaria prevalence was 81.9%. Most participants (97%) were on cotrimoxazole prophylaxis. Some of the factors found to be positively associated with malaria parasitaemia were; male sex, care taker category (parent), WHO stage 3 and 4 of HIV disease, and a high absolute CD4 count. However, only the caretaker association was statistically significant.
Conclusion:
The frequency of malaria parasitaemia among febrile HIV infected children is still high regardless of the high cotrimoxazole prophylaxis uptake. It is also noted that there is a shift in the age group of fever among children toward the older age group. This implies that policies may need to be relooked at to include the older age group in the aggressive malaria prevention measures to avoid losing on the already made gains.
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