COMPARISON OF MALARIA PARASITAEMIA AMONG CHILDREN LESS THAN FIVE YEARS LIVING WITH HIV AND THOSE WITHOUT HIV IN HEALTH FACILITIES

(A CASE STUDY OF JOS, NIGERIA)

By

Author

Presented To

Department of Medicine

ABSTRACT
Malaria and HIV are among the two most important diseases that pose a great challenge to human health. In Nigeria malaria contributes significantly to the burden of disease especially among children less than five years. Despite all efforts aimed at prevention and control of malaria, its prevalence is still relatively high in Jos. This study was therefore conducted to determine the prevalence and circulating species of malaria parasites in under fives as well as assessing the factors associated with malaria parasitaemia among HIV positive and HIV negative under five children in selected health facilities in Jos. A comparative cross sectional study was conducted among children less than five years living with HIV and those without HIV. Blood specimen was collected and tested for malaria parasitaemia by microscopy and RDT. Haemoglobin estimation was carried out and CD4% determined for children living with HIV. Structured questionnaire was used to obtain demographic information and potential factors associated with malaria parasitaemia. A total of 528 children less than 5 years old were enrolled, 264 were living with HIV while the other half were HIV negative. The mean age (± standard deviation) of children living with HIV was 40.6 (± 13.7) months, while the mean age (± standard deviation) of children less than 5 years who are HIV negative was 28.7 (± 14.2) months. The prevalence of malaria parasitaemia among HIV positive children was 16%, while among HIV negative children was 23.1%.The most predominant species found among under five children who participated in this study was Plasmodium falciparum. A co infection of Plasmodium falciparum and Plasmodium malariae was also observed among children living with HIV. Important environmental factors significantly associated with parasitaemia in this study was the presence of grasses around the house where the child reside (OR, 3.0; 95% CI, 1.4 -11) and pools of stagnant water close to the house (OR, 9.0; 95% CI, 1.3-85). The presence of mild anaemia was significantly associated with malaria parasitaemia among HIV negative children (OR, 2; 95% CI, 1.7-3.3). Ninety five percent of caregivers of children living with HIV had good knowledge of fever, malaria infection and management, while 97.7% of caregivers of HIV negative children also had a good knowledge. The prevalence of malaria parasitaemia was low among the study population. This is probably due to the seasonal variation in malaria parasitaemia intensity and the good knowledge of caregivers on malaria infection and management. Hence there is need to sustain the current media and health facility based campaigns on malaria prevention strategy and maintenance of clean environmental condition. Key Words: Prevalence, Malaria parasitaemia, Children, HIV positive