A Study to investigate an association between the human immunodeficiency virus (HIV) and plasmodium falciparum infections in an adult population aged 18-60 years living in a malaria meso-endemic region in Western Uganda

Abstract

This study was carried out between January and May 1990 inclusive, based at Mbarara Hospital in the malaria Meso - endemic region in the West off Uganda, ,The study aimed at initially confirming reports of the high incidence of severe p falciparum malaria infection in adults in the area and then investigating the possibility and nature of its association with HIV infection. Sixty- nine adult patients aged 18-5 7 years with severe P.falciparum malaria infection were studied. They included patients admitted directly to the medical wards at the hospital or from the medical out patient clinics and those referred to us by other practicing Doctors in the Districts of Mbarara and Bushenyi. This number however, did not reflect the actual rate of adult patients with severe P.falciparum malaria seen and or admitted to the hospital. A number of such other cases could not be recruited into the study for one reason or another. This group of patients was matched for age and sex with two other groups of patients viz., non-severe P.falciparum malaria cases and non-malaria controls, thus a total of 207 patients altogether were-studied. Infection with P.falciparum was ascertained on clinical signs and symptoms together with the microscopic demonstration of the asexual forms of P.falciparum parasites on a peripheral blood smear stained, with Giemsa " stain. HIV serostatus was determined by/ ELISA. All confirmed cases of P.falciparum infection received appropriate antimalarial chemotherapy.One group received chloroquine.T-onlyanother received- a combination of chloroquine, and Fansidaf and another received quinine therapy only. Each patient's response to treatment was assessed over a Y'tey period ana this was then related to his/her HIV serostatus