EPIDEMIOLOGY OF HUMAN MALARIA AND CO-INFECTIONS WITH HIV AMONG PREGNANT WOMEN IN AKURE, ONDO STATE, NIGERIA

Abstract

Studies on the epidemiology of human malaria and co-infections with HIV in pregnant women were carried out in the State Specialist Hospital, Akure. Malaria and HIV in pregnancy are the major factors contributing to adverse maternal and perinatal outcome. HIV increases pregnant women’s chances of contracting malaria their risk of developing anaemia, delivering of low birth weight infants, and premature deliveries. With an average annual number of pregnancies of about 4015 pregnant women reporting at the State Specialist Hospital Akure, data on malaria and HIV infection among these categories of women is scanty. This present study was therefore designed to investigate the seroprevalence of malaria parasite, HIV and co-infections by both pathogens in pregnant mothers in Akure, Ondo State Nigeria. Venous blood was collected from a total of 616 pregnant women aged 15-46 years that attended the major referral health facility (State Hospital) in Akure for routine ante-natal purposes were randomly selected for this study. ‘Determine’ and Uni-Gold rapid diagnostic tests kits were used to screen the participants for presence of HIV antibodies while Giemsa stained thick blood smears of patients were examined for presence of the asexual stages of Plasmodium parasite. Packed Cell Volume (PCV), genotype and blood group of mothers were determined using the haematocrit, electrophoresis and agglutination methods respectively. Results indicate very high malaria infection rate of 96.92% among the 616 pregnant women examined which is indicative of the endemicity of the disease in Akure metropolis. The study also showed that pregnant women aged 15-19 (100%), and 40 (100%) years above were all infected with malaria. The difference in the mean PCV of malaria infected and non-infected mothers coupled with the high rate of malaria infection suggests the involvement of malaria in maternal anaemia. Results of HIV screening showed that 28(4.55%) of the women were positive and that pregnant mothers aged 15-19 years had the highest percentage of infection (7.69%), followed by those aged 30-34 years (4.96%) and all the women aged 40 years and above did not show evidence of the retroviral infection. This finding is probably due to the fact that most of the women in this age group had formal education about the infection and took extra care by keeping to one sex partner. 28 (4.55%) of the pregnant women were co-infected with HIV and malaria parasite, and all the women positive for HIV appear to also harbor malaria parasites. There was moderate association or correlation between HIV and malaria parasite p< 0.05. The scanty existing data on the prevalence rate of malaria and HIV infection have been largely speculative or discordant. The present study therefore provided a more reliable picture of the diseases in a State Specialist Hospital in Akure metropolis