Clinical burden and correlates of HIV and malaria co-infection, in northwest Nigeria.
The clinical burden of malaria and HIV/AIDS in sub-Saharan Africa is well-described, but the dynamics of the interaction between the two diseases remain poorly understood. Using a cross-sectional study design, we assessed the prevalence and predictors of malaria infection among HIV-positive patients attending a referral center in urban Kano, northwest Nigeria. Structured questionnaires covering socio-demographic characteristics, HIV diagnosis and treatment, malaria preventive practices, clinical events and treatment were administered to HIV-infected adults (n=363). Information from questionnaires was supplemented with data from case notes. In the preceding year, nearly a third of respondents (32.2%; 95% CI=27.4-37.3) had at least one episode of fever, diagnosed as malaria on blood film examination. Half of all respondents (53.5%) admitted to using insecticide treated nets (ITN). One-third (35.8%) of participants were on malaria chemoprophylaxis at the time of the study. Female sex (adjusted Odds Ratio [aOR]=1.54, 95% confidence interval (CI): 1.32-2.73), immunosuppression (CD4+ cell count <350/μL vs. 600/μL, aOR=2.41, 95% CI 1.23-3.74) and non-use of ITN (aOR=1.97, 95% CI 1.17-2.85) predicted the occurrence of clinical malaria in patients. We report a high burden of malaria in HIV-infected patients attending a tertiary facility in urban Kano, Nigeria. Health communication, standardized protocols and ITN distribution should be integrated into comprehensive HIV programs in this setting.
Department of Community Medicine, Bayero University Kano, Nigeria; School of Health and Related Research, University of Sheffield, UK. Electronic address: ziliyasu@yahoo.com.
Zubairu
Z
Iliyasu
Musa
M
Babashani
Isa S
IS
Abubakar
Abdulfatah A
AA
Salahudeen
Muktar H
MH
Aliyu
D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
Co-infection; HIV/AIDS; Malaria; Nigeria; Prevention