title: Effects of HIV-1 infection on malaria parasitemia in milo sub-location, western Kenya.
abstract: BACKGROUND
  Malaria and HIV infections are both highly prevalent in sub-Saharan Africa, with HIV-infected patients being at higher risk of acquiring malaria. HIV-1 infection is known to impair the immune response and may increase the incidence of clinical malaria. However, a positive association between HIV-1 and malaria parasitaemia is still evolving. Equally, the effect of malaria on HIV-1 disease stage has not been well established, but when fever and parasitemia are high, malaria may be associated with transient increases in HIV-1 viral load, and progression of HIV-1 asymptomatic disease phase to AIDS.
  
  
  OBJECTIVE
  To determine the effects of HIV-1 infection on malaria parasitaemia among consented residents of Milo sub-location, Bungoma County in western Kenya.
  
  
  METHODS
  Census study evaluating malaria parasitaemia in asymptomatic individuals with unknown HIV-1 status.
  
  
  METHODS
  After ethical approvals from both Moi University and MTRH research ethics committees, data of 3,258 participants were retrieved from both Webuye health demographic surveillance system (WHDSS), and Academic Model Providing Access to Healthcare (AMPATH) in the year 2010. The current study was identifying only un-diagnosed HIV-1 individuals at the time the primary data was collected. The data was then analysed for significant statistical association for malaria parasitemia and HIV-1 infection, using SPSS version 19. Demographic characteristics such as age and sex were summarized as means and percentages, while relationship between malaria parasitaemia and HIV-1 (serostatus) was analyzed using Chi square.
  
  
  RESULTS
  Age distribution for the 3,258 individuals ranged between 2 and 94 years, with a mean age of 26 years old. Females constituted 54.3%, while males were 45.8%. In terms of age distribution, 2-4 years old formed 15.1% of the study population, 5-9 years old were 8.8%, 10-14 years old were 8.6% while 15 years old and above were 67.5%. Of the 3,258 individuals whose data was eligible for analysis, 1.4% was newly diagnosed HIV-1 positive. Our findings showed a higher prevalence of malaria in children aged 2-10 years (73.4%), against the one reported in children in lake Victoria endemic region by the Kenya malaria indicator survey in the year 2010 (38.1%). There was no significant associations between the prevalence of asymptomatic malaria and HIV-1 status (p = 0.327). However, HIV-1/malaria co-infected individuals showed elevated mean malaria parasite density, compared to HIV-1 negative individuals, p = 0.002.
  
  
  CONCLUSIONS
  HIV-1 status was not found to have effect on malaria infection, but the mean malaria parasite density was significantly higher in HIV-1 positive than the HIV-1 negative population.
authors.affiliation: Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya. rutodr@mu.ac.ke.|Department of Medical Microbiology and Parasitology, Moi University, Eldoret, Kenya. rutodr@mu.ac.ke.
authors.forename: Erick Kipkoech
authors.initials: EK
authors.lastname: Rutto
authors.affiliation: Department of Human Pathology, College of Health Sciences, University of Nairobi, Nairobi, Kenya. joshua.nyagol@uonbi.ac.ke.
authors.forename: Joshua
authors.initials: J
authors.lastname: Nyagol
authors.affiliation: Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya. julias_oyugi@hotmail.com.|Department of Medical Microbiology College of Health Sciences, University of Nairobi, Nairobi, Kenya. julias_oyugi@hotmail.com.
authors.forename: Julius
authors.initials: J
authors.lastname: Oyugi
authors.affiliation: Department of Medical Microbiology and Parasitology, Moi University, Eldoret, Kenya. ndegekip@yahoo.com.
authors.forename: Samson
authors.initials: S
authors.lastname: Ndege
authors.affiliation: Department of of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, Nairobi, Kenya. noelksm@gmail.com.
authors.forename: Noel
authors.initials: N
authors.lastname: Onyango
authors.affiliation: Department of Medical Microbiology and Parasitology, Moi University, Eldoret, Kenya. andrew.obala@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Obala
authors.affiliation: Department of Medical Microbiology and Parasitology, Moi University, Eldoret, Kenya. chris.simiyu@gmail.com.
authors.forename: Chrispinus J
authors.initials: CJ
authors.lastname: Simiyu
authors.affiliation: Department of Medical Microbiology and Parasitology, Moi University, Eldoret, Kenya. gboor@mu.ac.ke.
authors.forename: Gye
authors.initials: G
authors.lastname: Boor
authors.affiliation: Department of Surgery and Anaethesiology, Moi University, Eldoret, Kenya. Wcheriro@gmail.com.
authors.forename: Winfrida Chelangat
authors.initials: WC
authors.lastname: Cheriro
authors.affiliation: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. barasaotsyula@yahoo.com.
authors.forename: Barasa
authors.initials: B
authors.lastname: Otsyula
authors.affiliation: Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya. bestambale@gmail.com.|Department of Medical Microbiology College of Health Sciences, University of Nairobi, Nairobi, Kenya. bestambale@gmail.com.
authors.forename: Ben
authors.initials: B
authors.lastname: Estambale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005334:Fever / Q000209:etiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D007107:Immune System; D015994:Incidence; D007223:Infant; D007630:Kenya; D008288:Malaria / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000150:complications; D015995:Prevalence; D055815:Young Adult