Malaria and HIV co-infection: available evidence, gaps and possible interventions.
OBJECTIVE
To review the evidence of association between malaria and HIV/AIDS co-infection for purposes of developing strategies for malaria control.


METHODS
Desktop review of literature.


METHODS
Harare, Zimbabwe.


METHODS
Response to treatment, development of severe malaria, malarial immunological response in HIV/AIDS positive people and incidence of malaria in HIV/AIDS positive individuals.


RESULTS
HIV-1 infection increases the incidence of Plasmodium falciparum parasitaemia and is associated with the development of severe malaria, commonly anaemia, cerebral malaria and high parasite density (OR = 2.56; 95% CI = 1.53 to 4.29; p < 0.001). The efficacy of chloroquine and sulphadoxine-pyrimethamine in reducing placental malaria in HIV-1 positive pregnant women was impaired compared to HIV-1 negative pregnant women. However, the situation in non-gravid HIV-1 positive people as regards efficacy of chloroquine and sulphadoxine-pyrimethamine prophylaxis is not known. Also not known is the relationship between malaria parasitaemia without symptoms and HIV-1 infection, the results of which may provide useful information regarding malaria control and prevention in HIV-1 positive people.


CONCLUSIONS
HIV-1 positive people staying in malaria endemic areas are at risk of developing severe malaria. Malaria prevention using insecticide-treated bednets and indoor residual house spraying may be the best available options for these people. Chloroquine and sulphadoxine-pyrimethamine prophylaxis require further studies to verify their efficacy, in the presence of HIV-1/AIDS infection.
Chirenda
J
J
Department of Community Medicine-MPH Programme, University of Zimbabwe, PO Box A1114, Avondale, Harare, Zimbabwe.
Murugasampillay
S
S
D000818:Animals; D000953:Antigens, Protozoan / Q000276:immunology; D003140:Communicable Disease Control; D015897:Comorbidity; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D016778:Malaria, Falciparum / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D010963:Plasmodium falciparum / Q000276:immunology; D012307:Risk Factors
D000953:Antigens, Protozoan