Francine H. Verhoeff|Bernard Brabin|C. A. Hart|L. Chimsuku|Peter N. Kazembe|Robin L. Broadhead
Increased prevalence of malaria in HIV?infected pregnant women and its implications for malaria control
Liverpool School of Tropical Medicine|University of Amsterdam|Liverpool School of Tropical Medicine|University of Liverpool|Blantyre Institute for Community Ophthalmology|Liverpool School of Tropical Medicine|Kamuzu Central Hospital|Blantyre Institute for Community Ophthalmology
examine pregnant women relationship hiv infection malaria prevalence determine relation hiv infection effectiveness sulphadoxinepyrimethamine clearing p falciparum infectiondescriptive crosssectional analysis p falciparum prevalence pregnant women first antenatal visit women delivery received two sulphadoxinepyrimethamine treatments malaria hiv status assessed 621 women attended antenatal care delivery two rural hospitals southern malawi 199394 information collected maternal age parity gestational age prevalence p falciparum measured first antenatal visit delivery women given two routine treatment doses sulphadoxinepyrimethamine sp first antenatal visit 28 34 weeks gestation conforming malawi government policy antimalarial control pregnancyprevalence hiv infection 256 infections hiv type1 primigravidae malaria prevalence recruitment 563 hivinfected 365 hivuninfected women p004 corresponding figures multigravidae 238 110 respectively p001 hivinfected primigravidae increased malaria prevalence gestational ages peak parasite prevalence occurred earlier gestation hivinfected primigravidae 1619 weeks hivinfected 2023 weeks hivuninfected relative risk parasitaemia hivinfected compared hivuninfected women significantly increased three five parity groups including two highest ones parity3 indicating parityspecific immunity malaria impaired malaria prevalence delivery remained high hivinfected women despite prior routine treatment sulphadoxinepyrimethamine pregnancy significant difference parasite prevalence delivery women use sulphadoxinepyrimethaminehiv infection associated significant increase malaria prevalence pregnant women parities effect apparent early gestation two treatment doses sulphadoxinepyrimethamine inadequate clear parasitaemia many women time delivery occurred independently hiv status despite high sensitivity sp area need undertake longitudinal studies determine incidence p falciparum infection hivinfected uninfected pregnant women reassess frequency timing sulphadoxinepyrimethamine treatment doses women late pregnancy reinfections p falciparum probably explain high parasite prevalence delivery following sulphadoxinepyrimethamine treatment 2834 weeks gestation