Effect of HIV Infection on anti-malarial treatment outcome among in patients at the Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

HIV/AIDS and malaria are both major public health and socio-economic problems in sub-Saharan Africa. HIV infection may, in particular, complicate the clinical picture of malaria or its management. In this paper, malaria parasitaemia and outcome of anti-malarial treatment is examined in relation to HIV infection in patients based on a study conducted at the Moi Teaching and Referral Hospital (MTRH) located in Eldoret, Kenya. One hundred consenting patients with malaria were recruited into the study, malaria parasitaemia levels, HIV status and CD4 counts were determined for each patient, and the outcome of anti-malarial drug treatment with quinine or artemisinin derivative drugs observed. Malaria parasitaemia was monitored for each patient after antimalarial drug administration, for up to 7 days. Regardless of patient age, malaria parasitaemia clearance in anti-malarial drug treated, HIV negative patients was 2-3 days, whereas in the HIV positive patients, parasitaemia did not clear even 7 days after initiating treatment. The delay in parasitaemia clearance was more evident in patients whose CD4 counts were below 200 cells /μL. Overall, nearly 88% of the HIV negative patients with malaria had cleared malaria parasitaemia by the end of the observation period, compared with only about 12% in the HIV negative patients, P=0.012, OR=5.33 (1.53-18.56). It was thus concluded that HIV infection may delay clearance of malaria parasitaemia in anti-malarial drug treated patients.