Malaria Burden in Pregnancy at Mulago National Referral Hospital in Kampala; Uganda

Pregnancy-associated malaria is a major global health concern. To assess the Plasmodium falciparum burden in pregnancy we conducted a cross-sectional study at Mulago Hospital in Kampala; Uganda. Malaria prevalence by each of three measures-peripheral smear; placental smear; and placental histology was 9(35/391); 11.3(44/389); and 13.9(53/382) respectively. Together; smear and histology data yielded an infection rate of 15.5(59/380) of active infections and 4.5(17/380) of past infections; hence 20had been or were infected when giving birth. A crude parity dependency was observed with main burden being concentrated in gravidae 1 through gravidae 3. Twenty-two percent were afflicted by anaemia and 12.2delivered low birthweight babies. Active placental infection and anaemia showed strong association (OR=2.8) whereas parity and placental infection had an interactive effect on mean birthweight (P=.036). Primigravidae with active infection and multigravidae with past infection delivered on average lighter babies. Use of bednet protected significantly against infection (OR=0.56) whilst increased haemoglobin level protected against low birthweight (OR=0.83) irrespective of infection status. Albeit a high attendance at antenatal clinics (96.8); there was a poor coverage of insecticide-treated nets (32) and intermittent preventive antimalarial treatment (41.5)

The clinical and parasitological presentation of Plasmodium falciparum malaria in Uganda is unaffected by HIV-1 infection

The relation between Plasmodium falciparum malaria and symptomatic human immunodeficiency virus 1 (HIV-1) infection was investigated in paediatric and adult patients in Kampala; Uganda; from 1987 to 1989. Both infections contributed largely to hospital morbidity. Of 1527 clinically suspicious in-patients; 61pc were positive for HIV-1 infection. 52pc of patients with positive HIV-1 serology fulfilled the World Health Organization clinical case definition for acquired immune deficiency syndrome (AIDS) in Africa. No association could be found between HIV-1 infection and malaria either in paediatrics or in adults. P. falciparum parasitaemia was present in 18pc of all patients and no differences in prevalence of malaria infection or in parasite density could be demonstrated between HIV-1 positive and HIV-1 negative patients. The comparison of clinical symptoms showed typical differences in AIDS-related morbidity but no difference in malaria-specific morbidity. Also; the response to malaria treatment was the same in HIV-1 positive and HIV-1 negative patients. P. falciparum malaria does not appear to act as an opportunistic agent in AIDS patients in Uganda