|HIV–malaria co-infection: effects of malaria on the prevalence of HIV in East sub-Saharan Africa|
||Diego F Cuadros, Adam J Branscum and Philip H Crowley
||International Journal of Epidemiology, 2011;1–9 doi:10.1093/ije/dyq256
Multiple African Countries
||Objective To examine the association between malaria and HIV prevalence
in East sub-Saharan Africa.
Methods Using large nationally representative samples of 19 735 sexually
active adults from the 2003–04 HIV/AIDS indicator surveys
conducted in Kenya, Malawi and Tanzania, and the atlas malaria
project, we analysed the relationship between malaria and HIV
prevalence adjusting for important socioeconomic and biological
Results In adjusted models, individuals who live in areas with high
Plasmodium falciparum parasite rate (PfPR40.42) had increased estimated
odds of being HIV positive than individuals who live in areas
with low P. falciparum parasite rate (PfPR40.10) [men: estimated
odds ratio (OR) 2.24, 95% confidence interval (CI) 1.62–3.12;
women: estimated OR 2.44, 95% CI 1.85–3.21].
Conclusion This is the first study to report malaria as a risk factor of concurrent
HIV infection at the population level. According to our results, individuals
who live in areas with high P. falciparum parasite rate
have about twice the risk of being HIV positive compared with
individuals who live in areas with low P. falciparum parasite rate.
Our work emphasizes the need for field studies focused on quantifying
the interaction among parasitic infections and risk of HIV
infection, and studies to explore the impact of control interventions.
Programmes focused on reducing malaria transmission will be important
to address, especially in HIV-infected individuals.
Keywords HIV, malaria, Plasmodium falciparum, Africa, Eastern