MALARIA AND HIV CO- INFECTION IN HADYA ZONE, SOUTHERN ETHIOPIA

Background: Malaria and human immunodeficiency virus (HIV) are the major priority medical challenges currently facing sub-Saharan Africa, and yet little has been known on the clinical and public health implications of their co-infections. Objectives: To determine the prevalence of malaria and HIV co-infections and to describe the clinical manifestations of malaria in HIV-positive and negative malaria patients. Methods: A cross-sectional study was conducted from October 2003 through January 2004 in three health facilities located in Hadya Zone, Southern Ethiopia. A total of 337 microscopically confirmed Plasmodium falciparum malaria patients in the age group of 15-34 years were included in the study. Anonymous HIV testing was done on the blood samples of the patients using a single enzyme linked immunosorbent assay (ELISA) technique. Results: The HIV serostatus assessment revealed that 14 (4.2%) of the P. falciparum patients were seropositive for a single ELISA HIV test. No socio-demographic difference was observed between HIV positive and HIV negative malaria patients. The proportion of HIV-positives (71.4%) among patients who reported two or more malaria attacks during the last year was higher than those who only reported the current attack (28.6%). However, all patients with signs of cerebral malaria and prostration were negative for HIV test. The frequently reported symptoms of severe malaria included cerebral manifestation (76.7%), persistent vomiting (35.3%), dark urine (21.6%), inability to eat or drink (18.0%), and prostration (16.8%). Pallor (44.8%) and splenomegally (19.9%) were the most frequently detected physical findings. Conclusions: The HIV prevalence among malaria patients was not different from HIV prevalence in the general population. Further studies with carefully designed methodologies are recommended.