High prevalence of HIV and malaria co-infection in urban Douala, Cameroon

Abstract

A prospective cohort study was undertaken among 684 adult hospital attendees in Douala, Littoral Province, Cameroon. The objectives were to determine the prevalence of HIV/malaria co-infection and to determine and compare the prevalence of some parasitological, haematological and clinical parameters between co-infection and mono-infection with HIV or malaria in the study population. Information was collected on HIV serostatus, and malaria parasitaemia was assessed from blood smears by microscopy. Haemoglobin concentration was measured using the STANBIO STAT-Site MHgb Test System^®, and CD4 cell counts were obtained using the Partec CyFlow Counter^®. The prevalence of HIV/malaria co-infection in the sample was 29.4%. Geometric mean parasitaemia was significantly higher in co-infected patients than in malaria patients (9 868 parasites/µL blood versus 6 134 parasites/µL blood; F = 3.44, p = 0.018). Anaemia was more prevalent in cases of co-infection (43.3%) than in cases of HIV mono-infection (36.8%) or malaria mono-infection (20.4%) (χ² = 12.38, p = 0.006). The mean CD4 cell count between the groups of co-infected and HIV-mono-infected patients was not significantly different (F = 0.004, p = 1.000), but more patients with dual infections had CD4 cell counts corresponding to the chronic and advanced stages of HIV infection. A total of 105 individuals were successfully followed up for six months; twelve deaths were recorded within this period, nine of which were co-infected patients. Our results add to the existing pool of data from similar studies showing that HIV/malaria co-infections have a significant effect on a patient's clinical outcome. The data provide a basis for more elaborate studies with a larger sample size and follow-up of longer duration in the study region.

Keywords: Africa; anaemia; CD4 count; clinical aspects; epidemiology; falciparum malaria; parasitaemia

African Journal of AIDS Research 2008, 7(2): 229–235