Association of HIV-induced immunosuppression and clinical malaria in Nigerian adults

Authors

  • Michael O Iroezindu Department of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.
  • Emmanuel I Agabar
  • Comfort A Daniyam
  • Edith N Okeke
  • Oche O Agbaji
  • Patricia A Agaba
  • Godwin E Imade
  • John A Idoko

Keywords:

HIV, Immunosuppression, Clinical malaria, Adults

Abstract

Background: Despite the growing body of evidence on the interaction between HIV and malaria in sub-Saharan Africa, there is a dearth of data on clinical malaria in HIV-infected patients in Nigeria. We determined the burden of clinical malaria in HIV-infected adult Nigerians and further investigated the association between their immunological status and the rates of clinical malaria. Methods: Ninety seven antiretroviral treatment-naïve HIV-infected adults were enrolled in a cross-sectional study from August to December, 2009. The participants had a complete clinical evaluation, thick and thin blood films for malaria parasites and CD4 cell count quantification. Clinical malaria was defined as having fever (temperature ≥ 37.5oC or history of fever within 48 hours) and a malaria parasite density above the median value obtained for subjects with co-existing fever and parasitaemia. Results: Clinical malaria was diagnosed in 10 out of 97 patients (10.3%). Lower CD4 cell counts were associated with increasing rates of clinical malaria which was 0% at CD4 cell count of ≥ 500, 2.6% at 200-499 and 30% at <200 cells/µL (χ2= 18.3, p=0.0001). This association remained significant after controlling for other factors in a multivariate analysis (AOR=22.98, 95% C.I: 2.62-20.14, p=0.005). An inverse relationship between CD4 cell count and parasite density was demonstrated (regression co-efficient= - 0.001, p=0.0002). Conclusion: More aggressive malaria control measures are highly needed in severely immunosuppressed HIV-infected patients.

Author Biography

Michael O Iroezindu, Department of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.

Department of Medicine, College of Medicine, University of Nigeria. Lecturer I & Consultant Physician

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Published

2012-05-22

How to Cite

Iroezindu, M. O., Agabar, E. I., Daniyam, C. A., Okeke, E. N., Agbaji, O. O., Agaba, P. A., Imade, G. E., & Idoko, J. A. (2012). Association of HIV-induced immunosuppression and clinical malaria in Nigerian adults. African Journal of Infectious Diseases (AJID), 6(2), 48–53. Retrieved from https://journals.athmsi.org/index.php/AJID/article/view/1470

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Articles