Introduction: Malaria infection and HIV infection are major public health
issues in several parts of the world. Together they have caused more than a
million deaths per year. Africa, and Sub-Saharan in particular are the most
affected. Our study objective is to determine the prevalence of Malaria/HIV
co-infection and describe its immunological, virological, parasitic and
biological characteristics. Methodology: This is a descriptive, transversal and
multi centric study done on 18 years old and above HIV positive patients, for a
period extending from December 2008 to October 2009 in 5 different HIV
treatment centres. Parameters studied were gender, age, CD4 count, viral load,
parasite density and haemoglobin level. The HIV diagnosis was made according to
the AIDS National Program and malaria according to the Malaria National
Program. Statistic analyses were done using Epi Info 7 software and the Yates
corrected Chi Square test or the Fischer Exact test (when recommended) was used
to check any link between different parameters studied. Statistical
significance was fixed at <0.05. Results: 405 HIV seropositive patients were
compiled. The malaria prevalence in these patients was 6.9%. Majority of
co-infected patients were aged between 26 and 49 years (67.9%), and had a CD4
count <200 μl (67.9%), a parasitic
density <10,000 trophozoites/μl (75%) and an Hb level <11 g/dl. With regards to correlations between
co-infected patients parasitic density and the CD4 count, viral load and Hb
level, none of the studied parameters showed any statistic significance
difference. Conclusion: A prevalence of 6.9% among HIV/malaria co-infected
patients and 67.7% of these patients had a CD4 count less than 200 cells/μl. Thus, both national programs must promote an
early testing for HIV infected patients and reinforce preventive measures in
the management of malaria.
Cite this paper
Kakisingi, C. , Mukuku, O. , Manika, M. , Mutombo, A. , Kasamba, E. , Tshikuluila, B. , Mawaw, P. , Mwamba, C. and Luboya, O. (2016). Immunological, Virological, Parasitic and Biological Profile of Malaria/HIV Co-Infection in 18 Years Old and Above Patients in Lubumbashi (DR Congo). Open Access Library Journal, 3, e2647. doi: http://dx.doi.org/10.4236/oalib.1102647.
Murray, C.J., Briet,
O.J.T.,
Hardy, D.,
Chitnis, N.,
Maire, N., Di
Pasquale, A.
and Smith, T.A. (2012) Global
Malaria Mortality between 1980 and 2010: A Systematic Analysis. The
Lancet, 379, 413-431. http://dx.doi.org/10.1016/S0140-6736(12)60034-8
Crowell, V.,
Briet, O.J.,
Hardy, D.,
Chitnis, N.,
Maire, N.,
Di, P.A., et al. (2013) Modelling the Cost-Effectiveness of Mass
Screening and Treatment for Reducing Plasmodium Falciparum Malaria Burden. Malaria Journal, 12, 4. http://dx.doi.org/10.1016/S0140-6736(12)60034-8
Martin-Blondel, G., et al. (2007) Impact de l’infection VIH sur l’infection
palustre chez l’adulte. Medicine et Maladies Infectieuses, 37,
629-636. http://dx.doi.org/10.1016/j.medmal.2007.03.018
Chalwe, V., et al. (2009) Increased
Risk for Severe Malaria in HIV-1-Infected Adults, Zambia. Emerging Infectious Diseases, 15, 749-755. http://dx.doi.org/10.3201/eid1505.081009
Hobbs, V.C., et al. (2009) HIV
Protease Inhibitors Inhibit the Development of Preerythrocytic-Stage Plasmodium
Parasites. The Journal of Infectious
Diseases, 199, 134-141. http://dx.doi.org/10.1086/594369
Collaboration TATC (2009) Prognosis of Patients Treated with cART from 36
Months after Initiation, According to Current and Previous CD4 Cell Count and
Plasma HIV-1 RNA Measurements. AIDS, 23, 2199-2208. http://dx.doi.org/10.1097/QAD.0b013e3283305a00
Birku, Y., Mekonnen, E.,
Bjorkman, A. and Wolday, D.
(2002)
Delayed Clearance of Plasmodium
falciparum in Patients with Human Immunodeficiency Virus Co-Infection
Treated with Artemisinin. Ethiopian
Medical Journal, 40, 17-26.
Whitworth, J., Morgan,
D., Quigley, M., Smith, A., Mayanja, B., Eotu, H., et al. (2000) Effect
of HIV-1 and Increasing Immunosuppression on Malaria Parasitaemia and Clinical
Episodes in Adults in Rural Uganda: A Cohort Study. Lancet, 356, 1051-1056. http://dx.doi.org/10.1016/S0140-6736(00)02727-6
French, N., Nakiyingi, J., Lugada, E., Watera, C.,
Whitworth, J.A. and Gilks, C.F. (2001) Increasing Rates of Malarial Fever with
Deteriorating Immune Status in HIV-1-Infected Ugandan Adults. AIDS, 15, 899-906. http://dx.doi.org/10.1097/00002030-200105040-00010
Centers for Disease Control and Prevention (2009) Guidelines for Prevention and Treatment of
Opportunistic Infections in HIV-Infected Adults and Adolescents. mMWR, 58, 94-98.
Wumba, D.R., Zanga, J., Aloni, M.N., Mbanzulu, K., Kahindo, A.,
Mandina, M.N., et al. (2015) Interactions between Malaria and HIV Infections
in Pregnant Women: A First Report of the Magnitude, Clinical and Laboratory
Features, and Predictive Factors in Kinshasa, the Democratic Republic of Congo. Malaria Journal, 14, 82. http://dx.doi.org/10.1186/s12936-015-0598-2
Tay, S.C.K., Badu,
K.,
Mensah, A.A.
and Gbedema, S.Y. (2015)
The Prevalence of Malaria among HIV Seropositive Individuals and the Impact of
the Co-Infection on Their Hemoglobin Levels. Annals of Clinical Microbiology and Antimicrobials, 14, 10. http://dx.doi.org/10.1186/s12941-015-0064-6
ter Kuile, F.O.,
Parise, M.E.,
Verhoeff, F.H.,
Udhayakumar, V.,
Newman, R.D.,
van Eijk, A.M.,
Rogerson, S.J. and Steketee, R.W. (2004) The Burden of Co-Infection with Human
Immunodeficiency Virus Type 1 and Malaria in Pregnant Women in Sub-Saharan
Africa. The American Journal of Tropical
Medicine and Hygiene, 71, 41-54.
Adu-Gyasi, D., Fanello, C.I., Baiden, F., Porter, J.D.H.,
Korbel, D., Adjei, G., et al. (2013)
Prevalence of Clinically Captured and Confirmed Malaria among HIV Seropositve
Clinic Attendants in Five Hospitals in Ghana. Malaria Journal, 12, 382. http://dx.doi.org/10.1186/1475-2875-12-382
Mermin, J., Ekwaru, J.P., Liechty, C.A., Were, W., Downing,
R., Ransom, R., et al. (2006)
Effect of Co-Trimoxazole Prophylaxis, Antiretroviral Therapy, and
Insecticide-Treated Bed Nets on the Frequency of Malaria in HIV-1-Infected
Adults in Uganda: A Prospective Cohort Study. Lancet, 367, 1256-1261. http://dx.doi.org/10.1016/S0140-6736(06)68541-3
Browne, E.N.L., Frimpong, E., Sievertsen, J., Hagen, J., Hamelmann, C., Dietz, K., Horstmann, R.D.
and Burchard, G.D. (2000) Malariometric Update for the Rainforest and
Savannah of Ashanti Region, Ghana. Annals
of Tropical Medicine and Parasitology, 94, 15-22. http://dx.doi.org/10.1080/00034980057572
Sanyaolu, A.O., Fagbenro-Beyioku,
A.F.,
Oyibo, W.A.,
Badaru, O.S.,
Onyeabor, O.S. and Nnaemeka, C.I. (2013) Malaria and HIV Co-Infection and Their Effect
on Haemoglobin Levels from Three Healthcare Institutions in Lagos, Southwest
Nigeria. African Health Sciences, 13,
295-300. http://dx.doi.org/10.4314/ahs.v13i2.14
Cohen, C., Karstaedt, A., Frean, J., Thomas, J., Govender, N., Prentice, E., Dini, L., Galpin, J. and Crewe-Brown, H. (2005) Increased Prevalence of Severe Malaria in
HIV-Infected Adults in South Africa. Clinical
Infectious Diseases, 41, 1631-1637. http://dx.doi.org/10.1086/498023
Onyenekwea, C.C., Ukibe, N., Meludu, S.C., Ilika, A., Aboh, N., Ofiaeli, N., Ezaeni, M.
and Onochie, A. (2007) Prevalence of Malaria as Co-Infection in
HIV-Infected Individuals in a Malaria Endemic Area of Southeastern Nigeria. Journal of Vector Borne Diseases, 44, 250-254.
Savage, E.J., Msyamboza,
K.,
Gies, S.,
D’Alessandro, U. and Brabin, B.J. (2007)
Maternal Anaemia as an Indicator for Monitoring Malaria Control in Pregnancy in
Sub-Saharan Africa. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 1222-1231. http://dx.doi.org/10.1111/j.1471-0528.2007.01420.x
Rutto, E.K., Nyagol, J., Oyugi, J.,
Ndege, S., Onyango, N., Obala, A., et al. (2015)
Effects of HIV-1 Infection on Malaria Parasitemia in Milo Sub-Location, Western
Kenya. BMC Research Notes, 8, 303. http://dx.doi.org/10.1186/s13104-015-1270-1
Bloland, P.B., Wirima,
J.J.,
Steketee, R.W.,
Chilima, B., Hightower, A. and Breman, J.G. (1995) Maternal HIV Infection and Infant Mortality in
Malawi: Evidence for Increased Mortality Due to Placental Malaria Infection. AIDS, 9, 721-726. http://dx.doi.org/10.1097/00002030-199507000-00009
Cuadros, D.F., Branscum,
A.J.
and Crowley, P.H. (2011)
Effects of Malaria on the Prevalence of HIV in East Sub-Saharan Africa. International Journal of Epidemiology, 40, 931-939. http://dx.doi.org/10.1093/ije/dyq256
Mermin, J., Lule, J., Ekwaru, J.P., Malamba, S., Downing, R.,
Ransom, R., et al. (2004)
Effect of Co-Trimoxazole Prophylaxis on Morbidity, Mortality, CD4-Cell Count,
and Viral Load in HIV Infection in Rural Uganda. Lancet, 364, 1428-1434. http://dx.doi.org/10.1016/S0140-6736(04)17225-5
Murray, C.J., Bri?t,
O.J.T.,
Hardy, D.,
Chitnis, N.,
Maire, N., Di
Pasquale, A.
and Smith, T.A. (2012) Global
Malaria Mortality between 1980 and 2010: A Systematic Analysis. The
Lancet, 379, 413-431. http://dx.doi.org/10.1016/S0140-6736(12)60034-8
Crowell, V.,
Briet, O.J.,
Hardy, D.,
Chitnis, N.,
Maire, N.,
Di, P.A., et al. (2013) Modelling the Cost-Effectiveness of Mass
Screening and Treatment for Reducing Plasmodium Falciparum Malaria Burden. Malaria Journal, 12, 4. http://dx.doi.org/10.1016/S0140-6736(12)60034-8
Martin-Blondel, G., et al. (2007) Impact de l’infection VIH sur l’infection
palustre chez l’adulte. Medicine et Maladies Infectieuses, 37,
629-636. http://dx.doi.org/10.1016/j.medmal.2007.03.018
Chalwe, V., et al. (2009) Increased
Risk for Severe Malaria in HIV-1-Infected Adults, Zambia. Emerging Infectious Diseases, 15, 749-755. http://dx.doi.org/10.3201/eid1505.081009
Hobbs, V.C., et al. (2009) HIV
Protease Inhibitors Inhibit the Development of Preerythrocytic-Stage Plasmodium
Parasites. The Journal of Infectious
Diseases, 199, 134-141. http://dx.doi.org/10.1086/594369
Collaboration TATC (2009) Prognosis of Patients Treated with cART from 36
Months after Initiation, According to Current and Previous CD4 Cell Count and
Plasma HIV-1 RNA Measurements. AIDS, 23, 2199-2208. http://dx.doi.org/10.1097/QAD.0b013e3283305a00
Birku, Y., Mekonnen, E.,
Bj?rkman, A. and Wolday, D.
(2002)
Delayed Clearance of Plasmodium
falciparum in Patients with Human Immunodeficiency Virus Co-Infection
Treated with Artemisinin. Ethiopian
Medical Journal, 40, 17-26.
Whitworth, J., Morgan,
D., Quigley, M., Smith, A., Mayanja, B., Eotu, H., et al. (2000) Effect
of HIV-1 and Increasing Immunosuppression on Malaria Parasitaemia and Clinical
Episodes in Adults in Rural Uganda: A Cohort Study. Lancet, 356, 1051-1056. http://dx.doi.org/10.1016/S0140-6736(00)02727-6
French, N., Nakiyingi, J., Lugada, E., Watera, C.,
Whitworth, J.A. and Gilks, C.F. (2001) Increasing Rates of Malarial Fever with
Deteriorating Immune Status in HIV-1-Infected Ugandan Adults. AIDS, 15, 899-906. http://dx.doi.org/10.1097/00002030-200105040-00010
Centers for Disease Control and Prevention (2009) Guidelines for Prevention and Treatment of
Opportunistic Infections in HIV-Infected Adults and Adolescents. mMWR, 58, 94-98.
Wumba, D.R., Zanga, J., Aloni, M.N., Mbanzulu, K., Kahindo, A.,
Mandina, M.N., et al. (2015) Interactions between Malaria and HIV Infections
in Pregnant Women: A First Report of the Magnitude, Clinical and Laboratory
Features, and Predictive Factors in Kinshasa, the Democratic Republic of Congo. Malaria Journal, 14, 82. http://dx.doi.org/10.1186/s12936-015-0598-2
Tay, S.C.K., Badu,
K.,
Mensah, A.A.
and Gbedema, S.Y. (2015)
The Prevalence of Malaria among HIV Seropositive Individuals and the Impact of
the Co-Infection on Their Hemoglobin Levels. Annals of Clinical Microbiology and Antimicrobials, 14, 10. http://dx.doi.org/10.1186/s12941-015-0064-6
ter Kuile, F.O.,
Parise, M.E.,
Verhoeff, F.H.,
Udhayakumar, V.,
Newman, R.D.,
van Eijk, A.M.,
Rogerson, S.J. and Steketee, R.W. (2004) The Burden of Co-Infection with Human
Immunodeficiency Virus Type 1 and Malaria in Pregnant Women in Sub-Saharan
Africa. The American Journal of Tropical
Medicine and Hygiene, 71, 41-54.
Adu-Gyasi, D., Fanello, C.I., Baiden, F., Porter, J.D.H.,
Korbel, D., Adjei, G., et al. (2013)
Prevalence of Clinically Captured and Confirmed Malaria among HIV Seropositve
Clinic Attendants in Five Hospitals in Ghana. Malaria Journal, 12, 382. http://dx.doi.org/10.1186/1475-2875-12-382
Mermin, J., Ekwaru, J.P., Liechty, C.A., Were, W., Downing,
R., Ransom, R., et al. (2006)
Effect of Co-Trimoxazole Prophylaxis, Antiretroviral Therapy, and
Insecticide-Treated Bed Nets on the Frequency of Malaria in HIV-1-Infected
Adults in Uganda: A Prospective Cohort Study. Lancet, 367, 1256-1261. http://dx.doi.org/10.1016/S0140-6736(06)68541-3
Browne, E.N.L., Frimpong, E., Sievertsen, J., Hagen, J., Hamelmann, C., Dietz, K., Horstmann, R.D.
and Burchard, G.D. (2000) Malariometric Update for the Rainforest and
Savannah of Ashanti Region, Ghana. Annals
of Tropical Medicine and Parasitology, 94, 15-22. http://dx.doi.org/10.1080/00034980057572
Sanyaolu, A.O., Fagbenro-Beyioku,
A.F.,
Oyibo, W.A.,
Badaru, O.S.,
Onyeabor, O.S. and Nnaemeka, C.I. (2013) Malaria and HIV Co-Infection and Their Effect
on Haemoglobin Levels from Three Healthcare Institutions in Lagos, Southwest
Nigeria. African Health Sciences, 13,
295-300. http://dx.doi.org/10.4314/ahs.v13i2.14
Cohen, C., Karstaedt, A., Frean, J., Thomas, J., Govender, N., Prentice, E., Dini, L., Galpin, J. and Crewe-Brown, H. (2005) Increased Prevalence of Severe Malaria in
HIV-Infected Adults in South Africa. Clinical
Infectious Diseases, 41, 1631-1637. http://dx.doi.org/10.1086/498023
Onyenekwea, C.C., Ukibe, N., Meludu, S.C., Ilika, A., Aboh, N., Ofiaeli, N., Ezaeni, M.
and Onochie, A. (2007) Prevalence of Malaria as Co-Infection in
HIV-Infected Individuals in a Malaria Endemic Area of Southeastern Nigeria. Journal of Vector Borne Diseases, 44, 250-254.
Savage, E.J., Msyamboza,
K.,
Gies, S.,
D’Alessandro, U. and Brabin, B.J. (2007)
Maternal Anaemia as an Indicator for Monitoring Malaria Control in Pregnancy in
Sub-Saharan Africa. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 1222-1231. http://dx.doi.org/10.1111/j.1471-0528.2007.01420.x
Rutto, E.K., Nyagol, J., Oyugi, J.,
Ndege, S., Onyango, N., Obala, A., et al. (2015)
Effects of HIV-1 Infection on Malaria Parasitemia in Milo Sub-Location, Western
Kenya. BMC Research Notes, 8, 303. http://dx.doi.org/10.1186/s13104-015-1270-1
Bloland, P.B., Wirima,
J.J.,
Steketee, R.W.,
Chilima, B., Hightower, A. and Breman, J.G. (1995) Maternal HIV Infection and Infant Mortality in
Malawi: Evidence for Increased Mortality Due to Placental Malaria Infection. AIDS, 9, 721-726. http://dx.doi.org/10.1097/00002030-199507000-00009
Cuadros, D.F., Branscum,
A.J.
and Crowley, P.H. (2011)
Effects of Malaria on the Prevalence of HIV in East Sub-Saharan Africa. International Journal of Epidemiology, 40, 931-939. http://dx.doi.org/10.1093/ije/dyq256
Mermin, J., Lule, J., Ekwaru, J.P., Malamba, S., Downing, R.,
Ransom, R., et al. (2004)
Effect of Co-Trimoxazole Prophylaxis on Morbidity, Mortality, CD4-Cell Count,
and Viral Load in HIV Infection in Rural Uganda. Lancet, 364, 1428-1434. http://dx.doi.org/10.1016/S0140-6736(04)17225-5