Malaria and HIV co-infection and their effect on haemoglobin levels from three health-care institutions in Lagos, southwest Nigeria.

BACKGROUND: Malaria and human immunodeficiency virus (HIV) are two major infections with enormous public health consequence. Together, they are endemic in many developing countries with anaemia being the most frequent haematological consequence of the infections. OBJECTIVES: To determine the prevalence of malaria and HIV co-infection as well as anaemia among selected patients from three health-care institutions in Lagos, Nigeria. METHODS: A cross-sectional study of 1080 patients was carried out to determine the prevalence of malaria and HIV co-infection as well as anaemia. Blood sera from each of the patients were screened for malaria parasites, HIV-1 and HIV-2 using Giemsa stain, Cambridge Biotech Recombigen HIV-1/HIV-2 rapid device, respectively while haemoglobin estimation was performed using cyanmethemoglobin method. RESULTS: Our data showed that the total number of malaria infected patients were significantly higher in HIV sero-positive patients 47.7% (31/65) when compared with their HIV sero-negative counterparts 25.8% (262/1015) P = 0.047. The result also revealed that 25.8% (8/31) of the patients co-infected with malaria and HIV had anaemia as compared to 11.1% (29/262) infected with malaria alone. Multivariable logistic regression analysis showed that patients with dual infection of malaria and HIV were twice likely to be anaemic than those infected with malaria alone [adjusted OR 2.4, 95% CI, 1.3 to 2.7, P = 0.014]. CONCLUSIONS: Our data indicated a higher prevalence of malaria in HIV infected patients and also revealed that patients co-infected with malaria and HIV were more likely to be anaemic.

Cytokine Profiles and Antibody Responses to Plasmodium Falciparum Malaria Infection in Individuals Living in Ibadan; Southwest Nigeria

Background: The ability of the host immune system to efficiently clear Plasmodium falciparum parasites during a malaria infection depends on the type of immune response mounted by the host. Study design: In a cross-sectional study; we investigated the cellular-and antibody responses in individuals with P. falciparum infection; in an attempt to identify immunological signs indicative of the development of natural immunity against malaria in Ibadan; Nigeria. Levels of IL-10; IL-12(p70); IFN-a; and IgM; IgG and IgG1-4 subclasses in the serum of 36 symptomatic children with microscopically confirmed malaria parasitaemia and 54 asymptomatic controls were analysed by ELISA. Results: IFN-a and IL-10 were significantly higher in the symptomatic children (p=0.009; p=0.025 respectively) than in the asymptomatic controls but no differences were seen for IL-12(p70). Estimated higher ratios of IFN-a/IL-10 and IFN-a/IL-12 were also observed in the symptomatic children while the asymptomatic controls had higher IL-12/IL-10 ratio. The mean concentration levels of anti-P. falciparum IgG1; IgG2; IgG3 antibodies were statistically significantly higher in the individuals 5 years of age than 5 years while anti-P. falciparum IgG3 antibodies were notably low in 5 years category. Children 5 years had higher IgM antibodies than IgG and the expression of IgG subclasses increased with age. Conclusion: Taken together; malaria infection is on a delicate balance of pro- and anti-inflammatory cytokines. The higher levels of IFN-a seen in the symptomatic children (6months) may be instrumental in immune-protection against malaria by limiting parasite replication. The observed variations in immunoglobulin subclass levels were age- dependent and exposure-related