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Relationship Between Fever and Malaria Parasitaemia in Adults: Does HIV Infection Make any Difference?
Abstract
Background: Malaria and HIV are two important causes of febrile illness in sub-Saharan Africa and both may co-exist. We conducted a survey on the relationship between fever and malaria parasitaemia in adult Nigerians and further determined if HIV infection makes any difference in this relationship.
Methodology: One hundred and thirty adults 18 years and above who presented at the Jos University Teaching Hospital, Nigeria for HIV counseling and testing were evaluated in a cross sectional study during the rainy season from August to October, 2009. Those with obvious features of systemic infections were excluded from the study. Each participant had a clinical evaluation, thick and thin blood films for malaria parasites, and HIV testing.
Results: Out of 130 subjects recruited, 82 (63.1%) were females and 63 (48.5%) were HIV positive. The proportion of fevers (axillary temperature ≥ 37.5 °C) attributable to malaria parasitaemia (AF) in the entire subjects was 42.5%. HIV positive subjects had a significantly higher AF of 42.3% compared to 27.3% in HIV negative subjects (p=0.04). Overall, there was a strong correlation between parasite density and body temperature (r=0.66, p<0.0001).When analysed according to HIV status, this relationship remained strong for both HIV positive patients (r=0.64, p=0.002) and HIV negative individuals (r=0.70, p=0.09).
Conclusion: Our study demonstrated a positive relationship between fever and malaria parasitaemia in adults residing in a malaria endemic area and HIV infection possibly potentiates this positive relationship. This information is valuable in malaria case management for HIV positive patients.
Methodology: One hundred and thirty adults 18 years and above who presented at the Jos University Teaching Hospital, Nigeria for HIV counseling and testing were evaluated in a cross sectional study during the rainy season from August to October, 2009. Those with obvious features of systemic infections were excluded from the study. Each participant had a clinical evaluation, thick and thin blood films for malaria parasites, and HIV testing.
Results: Out of 130 subjects recruited, 82 (63.1%) were females and 63 (48.5%) were HIV positive. The proportion of fevers (axillary temperature ≥ 37.5 °C) attributable to malaria parasitaemia (AF) in the entire subjects was 42.5%. HIV positive subjects had a significantly higher AF of 42.3% compared to 27.3% in HIV negative subjects (p=0.04). Overall, there was a strong correlation between parasite density and body temperature (r=0.66, p<0.0001).When analysed according to HIV status, this relationship remained strong for both HIV positive patients (r=0.64, p=0.002) and HIV negative individuals (r=0.70, p=0.09).
Conclusion: Our study demonstrated a positive relationship between fever and malaria parasitaemia in adults residing in a malaria endemic area and HIV infection possibly potentiates this positive relationship. This information is valuable in malaria case management for HIV positive patients.
