HIV and malaria co-infection in pregnancy in a teaching hospital in sub-Saharan Africa

Background: The high prevalence of Human immunodeficiency virus (HIV) and malaria infection in sub Saharan Africa, makes co-infection a burden in this region, as together, they are responsible for 4 million deathsannually. A study of the health implications of this interaction in our pregnant women is important.Objective: To determine the incidence and recurrence, incidence of febrile malaria infection in different stages of HIV infection among pregnant women, at Aminu Kano Teaching Hospital, Kano, Nigeria.Method: A retrospective analysis of 95 HIV-infected and 95 HIV-uninfected pregnant women, who met the recruitment criteria between January 2005 and December 2007. The study variables of interest were age and parity; occurrence and recurrence of febrile malaria infection in both groups; the incidence of febrile malaria infection in different stages of HIV-infection. The data was prospectively obtained and retrospectively analysed using Z and Chi-square tests. Odds ratio (OR) and confidence interval (CI) were determined where appropriate.Results: The incidence of febrile malaria co-infection among HIV-infected women was 22.1%. The occurrence of febrile malaria infection was three times higher (OR = 3.09, CI=1.21 – 8.11, P < 0.05), and recurrence was nine times higher (OR = 9.33, CI=0.83 – 241.31, P < 0.05) among HIV-infected pregnant women. Febrile malaria coinfection was significantly higher among those in the symptomatic stages compared to asymptomatic stage.Conclusion: There is increased frequency of febrile malaria parasitaemia among HIV-infected pregnant women. Effective Highly Active Antiretroviral Therapy (HAART) and antimalarial interventions through structured antenatal programs are needed.Keywords: HIV/AIDS, malaria fever, incidence, clinical cours