PREVALENCE AND PATTERN OF MALARIA AMONG FEBRILE HIV INFECTED CHILDREN SEEN AT USMANU DANFODIYO UNIVERSITY TEACHING HOSPITAL, SOKOTO, NIGERIA

Abstract

BACKGROUND
Malaria and HIV infection are among the major health problems facing the world today.
Combined, malaria and HIV infection cause more than two million deaths each year. SubSaharan
Africa which is home to just 10 per cent of world’s population harbours more than half the burden
of malaria and HIV infection. Given the geographical overlap of both malaria and HIV infection in
Sub-Saharan Africa, studies have reported co-infection among the people. The prevalence and
outcome of malaria and HIV co-infection have been understudied in children, who are at increased
risk of both infections.
OBJECTIVES
The main objective of the study was to determine the prevalence and pattern of malaria among
febrile-HIV infected children aged 3 months to 15 years, seen at Usmanu Danfodiyo University
Teaching Hospital Sokoto, Nigeria.
METHOD
The study design was partly descriptive (observational) cross-sectional and partly analytical
(observational) case-control, among HIV infected children and their control cohort aged 3months
to 15 years. The study was carried out between May 2016 and October 2016, at Usmanu Danfodiyo
University Teaching Hospital, Sokoto, Nigeria. The following investigations were carried out for
both the subjects and the controls; malaria parasite, packed cell volume, random blood sugar,
retroviral test. In addition, CD4 cell count was carried out for only HIV-infected children.

RESULT
A total of 140 febrile HIV infected children aged 3 months to 15 years and 140 febrile HIV negative
age and gender matched were recruited for the study. The prevalence of malaria among the febrile
HIV infected children was 71.4% (100/140) which was significantly lower than the prevalence of
94.3% (132/140) among the control (χ2 27.72, p=0.001).
The mean parasite density among the HIV-infected children was 66,000+ 48,786.486 which was
significantly lower than the mean parasite density of 123,951 + 68,538.880 among the controls (
t=7.186, ,p=0.0001).
Out of the 100 febrile HIV infected children that had malaria, 54(54.0%) had uncomplicated malaria
while 46(46.0%) had severe malaria while among the 132 controls that had malaria,
48(36.4%) had uncomplicated malaria while 84(63.6%) had severe malaria (χ2 =7.184, p=0.007).
There was a negative weak correlation between CD4+ T lymphocyte level and malaria parasite
density among the subjects, however, this correlation was not statistically significant (r= -0.082,
p=0.33).
CONCLUSION
It was concluded that malaria is not much of a problem in HIV infected children compared with
non-HIV infected children but high in both. Antimalarial effect of some of the antiretroviral drugs
and cotrimoxazole might have been responsible for the lower prevalence of malaria in the subjects
compared with the controls.
As nearly half of the febrile HIV-infected children who had malaria were found to have severe form
of malaria, it is hereby recommended that health promotion, early diagnosis and prompt effective
treatment be instituted for febrile HIV infected children with malaria as necessary. This may go a
long way to prevent severe form of malaria and its attendant mortality.

PREVALENCE AND PATTERN OF MALARIA AMONG FEBRILE HIV INFECTED CHILDREN SEEN AT USMANU DANFODIYO UNIVERSITY TEACHING HOSPITAL, SOKOTO, NIGERIA