title: Malaria and helminthic co-infection among HIV-positive pregnant women: prevalence and effects of antiretroviral therapy.
abstract: The impact of malaria on anemia and the interplay with helminths underline the importance of addressing the interactions between HIV/AIDS, malaria and intestinal helminth infections in pregnancy. The aim of this study was to determine the prevalence of malaria-helminth dual infections among HIV positive pregnant mothers after 12 months of ART. A cross sectional study was conducted on intestinal helminths and malaria dual infections among HIV-positive pregnant women attending antenatal health centers in Rwanda. Stool and malaria blood slide examinations were performed on 328 women residing in rural (n=166) and peri-urban locations (n=162). BMI, CD4 cell count, hemoglobin levels, type of ART and viral load of participants were assessed. Within the study group, 38% of individuals harbored helminths, 21% had malaria and 10% were infected with both. The most prevalent helminth species were Ascaris lumbricoides (20.7%), followed by Trichuris trichiura (9.2%), and Ancylostoma duodenale and Necator americanus (1.2%). Helminth infections were characterized by low hemoglobin and CD4 counts. Subjects treated with a d4T, 3TC, NVP regimen had a reduced risk of T. trichiura infection (OR, 0.27; 95% CIs, 0.10-0.76; p<0.05) and malaria-helminth dual infection (OR, 0.29; 95% CI, 0.11-0.75; p<0.05) compared to those receiving AZT, 3TC, NVP. This study shows a high prevalence of malaria and helminth infection among HIV-positive pregnant women in Rwanda. The differential effect of ARTs on the risk of helminth infection is of interest and should be examined prospectively in larger patient groups.
authors.affiliation: Department of Biomedical Laboratory Sciences, Kigali Health Institute, Rwanda. emil.ivank@gmail.com
authors.forename: Emil
authors.initials: E
authors.lastname: Ivan
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Crowther
authors.forename: Aniceth T
authors.initials: AT
authors.lastname: Rucogoza
authors.forename: Lawrence O
authors.initials: LO
authors.lastname: Osuwat
authors.forename: Elizaphane
authors.initials: E
authors.lastname: Munyazesa
authors.forename: Eugene
authors.initials: E
authors.lastname: Mutimura
authors.forename: Kato J
authors.initials: KJ
authors.lastname: Njunwa
authors.forename: Kakoma J B
authors.initials: KJ
authors.lastname: Zambezi
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D001769:Blood / Q000469:parasitology; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006373:Helminthiasis / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000473:pathology; D008288:Malaria / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000473:pathology; D015995:Prevalence; D012424:Rural Population; D012432:Rwanda / Q000453:epidemiology; D014505:Urban Population; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents