title: Associations between peripheral Plasmodium falciparum malaria parasitemia, human immunodeficiency virus, and concurrent helminthic infection among pregnant women in Malawi.
abstract: Approximately 2 billion persons worldwide are infected with schistosomiasis and soil-transmitted helminths (STH), many in areas where endemic malaria transmission coexists. Few data exist on associations between these infections. Nested within a larger clinical trial, primigravid and secundigravid women provided blood samples for human immunodeficiency virus (HIV) testing and peripheral malaria films and stool and urine for evaluation of STH and Schistosoma spp. during their initial antenatal clinic visit. The most common parasitic infections were malaria (37.6%), S. haematobium (32.3%), and hookworm (14.4%); 14.2% of women were HIV-infected. S. haematobium infection was associated with lower malarial parasite densities (344 versus 557 parasites/μL blood; P < 0.05). In multivariate analysis, HIV and hookworm infection were independently associated with malaria infection (adjusted odds ratio = 1.9 and 95% confidence interval = 1.2-3.0 for HIV; adjusted odds ratio = 1.9 and 95% confidence interval = 1.03-3.5 for hookworm). Concurrent helminthic infection had both positive and negative effects on malaria parasitemia among pregnant women in Malawi.
authors.affiliation: Malaria Branch, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. mthigpen@cdc.gov
authors.forename: Michael C
authors.initials: MC
authors.lastname: Thigpen
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Filler
authors.forename: Peter N
authors.initials: PN
authors.lastname: Kazembe
authors.forename: Monica E
authors.initials: ME
authors.lastname: Parise
authors.forename: Allan
authors.initials: A
authors.lastname: Macheso
authors.forename: Carl H
authors.initials: CH
authors.lastname: Campbell
authors.forename: Robert D
authors.initials: RD
authors.lastname: Newman
authors.forename: Richard W
authors.initials: RW
authors.lastname: Steketee
authors.forename: Mary
authors.initials: M
authors.lastname: Hamel
mesh_terms: D000293:Adolescent; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006373:Helminthiasis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008295:Malawi / Q000453:epidemiology; D016017:Odds Ratio; D018512:Parasitemia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D019380:Anti-HIV Agents; D000962:Antimalarials