PREVALENCE OF MALARIA PARASITAEMIA IN HUMAN IMMUNODEFICIENCY VIRUS (HIV)-POSITIVE PREGNANT WOMEN COMPARED WITH HIV-NEGATIVE PREGNANT WOMEN IN LAGOS AREA.

Abstract

Objective: To determine the prevalence of malaria parasitaemia and associated factors in HIV-+ve pregnant women compared with HIV-ve women in Lagos. Design: A cohort study. Setting: The antenatal clinic LUTH, the St. Kizito Primary Health Centre, Nigerian Institute of Medical research (NIMR) and General Hospital Randle Road, Surulere, Lagos. Subjects: 301 HIV+ve pregnant women across these centres as subjects and 352 HIVve pregnant women as controls Main Outcome M easures: Prevalence of malaria parasitaemia. Methods: 301 HIV+ve and 352 HIV-ve pregnant women attending ANC were counselled and informed consent obtained. Structured questionnaires were administered to obtain sociodemographic characteristic, risk/exposure, chemoprophylaxis, treatment given and the value of CD4 count in HIV+ve participants. 5ml of venous blood was obtained from each study participant for laboratory studies for the determination of malaria parasitaemia and haemoglobin. Malaria parasitaemia and parasite densities were determined from thick and thin blood films stained with Giemsa stains. Packed cell volume was determined with the capillary pulse, and the haematocrit centrifuge and haematocrit meter while haemoglobin was measured using the drabkin solution and the haemoglobin standard chart. Results: The sociodemographic characteristics of the participants were comparable in all particulars evaluated except for the HIV status. Malaria parasitaemia was significantly higher in HIV+ve pregnant women compared with HIV-ve pregnant women. P value = 0.00001; parasitaemia increasing with gravidity in the HIV+ve pregnant women (P = 0.001) and in the HIV-ve was higher in the first and third trimesters (P = 0.001). Antiretroviral therapy (ART) was associated with significantly reduced malaria parasitaemia (P = 0.000013); while CD4 count was not significantly associated with malaria parasitaemia (P = 0.16). Conclusion : HIV+ve pregnancy was significantly associated with malaria parasitaemia while antiretroviral therapy was associated with reduced parasitaemia. Provision of antiretroviral therapy and appropriate malaria intervention will reduce malaria parasitaemia and its consequences in HIV+ve pregnant women.

PREVALENCE OF MALARIA PARASITAEMIA IN HUMAN IMMUNODEFICIENCY VIRUS (HIV)-POSITIVE PREGNANT WOMEN COMPARED WITH HIV-NEGATIVE PREGNANT WOMEN IN LAGOS AREA.