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Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study

BACKGROUND: Malaria and HIV/AIDS constitute major public health problems in Ethiopia, but the burden associated with malaria-HIV co-infection has not been well documented. In this study, the burden of malaria among HIV positive and HIV negative adult outpatients attending health facilities in Oromia...

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Autores principales: Alemayehu, Guda, Melaku, Zenebe, Abreha, Tesfay, Alemayehu, Bereket, Girma, Samuel, Tadesse, Yehualashet, Gadisa, Tsigereda, Lulseged, Sileshi, Balcha, Taye Tolera, Hoos, David, Teka, Hiwot, Reithinger, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681039/
https://www.ncbi.nlm.nih.gov/pubmed/26671012
http://dx.doi.org/10.1186/s12936-015-1029-0
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author Alemayehu, Guda
Melaku, Zenebe
Abreha, Tesfay
Alemayehu, Bereket
Girma, Samuel
Tadesse, Yehualashet
Gadisa, Tsigereda
Lulseged, Sileshi
Balcha, Taye Tolera
Hoos, David
Teka, Hiwot
Reithinger, Richard
author_facet Alemayehu, Guda
Melaku, Zenebe
Abreha, Tesfay
Alemayehu, Bereket
Girma, Samuel
Tadesse, Yehualashet
Gadisa, Tsigereda
Lulseged, Sileshi
Balcha, Taye Tolera
Hoos, David
Teka, Hiwot
Reithinger, Richard
author_sort Alemayehu, Guda
collection PubMed
description BACKGROUND: Malaria and HIV/AIDS constitute major public health problems in Ethiopia, but the burden associated with malaria-HIV co-infection has not been well documented. In this study, the burden of malaria among HIV positive and HIV negative adult outpatients attending health facilities in Oromia National Regional State, Ethiopia was investigated. METHODS: A comparative cross-sectional study among HIV-positive patients having routine follow-up visits at HIV care and treatment clinics and HIV-seronegative patients attending the general medical outpatient departments in 12 health facilities during the peak malaria transmission season was conducted from September to November, 2011. A total of 3638 patients (1819 from each group) were enrolled in the study. Provider initiated testing and counseling of HIV was performed for 1831 medical outpatients out of whom 1819 were negative and enrolled into the study. Malaria blood microscopy and hemoglobin testing were performed for all 3638 patients. Data was analyzed using descriptive statistics, Chi square test and multivariate logistic regression. RESULTS: Of the 3638 patients enrolled in the study, malaria parasitaemia was detected in 156 (4.3 %); malaria parasitaemia prevalence was 0.7 % (13/1819) among HIV-seropositive patients and 7.9 % (143/1819) among HIV-seronegative patients. Among HIV-seropositive individuals 65.4 % slept under a mosquito bed net the night before data collection, compared to 59.4 % of HIV-seronegative individuals. A significantly higher proportion of HIV-seropositive malaria-negative patients were on co-trimoxazole (CTX) prophylaxis as compared to HIV-malaria co-infected patients: 82 % (1481/1806) versus 46 % (6/13) (P = 0.001). HIV and malaria co-infected patients were less likely to have the classical symptoms of malaria (fever, chills and headache) compared to the HIV-seronegative and malaria positive counterparts. Multivariate logistic regression showed that HIV-seropositive patients who come for routine follow up were less likely to be infected by malaria (OR = 0.23, 95 % CI = 0.09–0.74). CONCLUSION: The study documented lower malaria prevalence among the HIV-seropositive attendants who come for routine follow up. Clinical symptoms of malaria were more pronounced among HIV-seronegative than HIV-seropositive patients. This study also re-affirmed the importance of co-trimoxazole in preventing malaria symptoms and parasitaemia among HIV- positive patients.
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spelling pubmed-46810392015-12-17 Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study Alemayehu, Guda Melaku, Zenebe Abreha, Tesfay Alemayehu, Bereket Girma, Samuel Tadesse, Yehualashet Gadisa, Tsigereda Lulseged, Sileshi Balcha, Taye Tolera Hoos, David Teka, Hiwot Reithinger, Richard Malar J Research BACKGROUND: Malaria and HIV/AIDS constitute major public health problems in Ethiopia, but the burden associated with malaria-HIV co-infection has not been well documented. In this study, the burden of malaria among HIV positive and HIV negative adult outpatients attending health facilities in Oromia National Regional State, Ethiopia was investigated. METHODS: A comparative cross-sectional study among HIV-positive patients having routine follow-up visits at HIV care and treatment clinics and HIV-seronegative patients attending the general medical outpatient departments in 12 health facilities during the peak malaria transmission season was conducted from September to November, 2011. A total of 3638 patients (1819 from each group) were enrolled in the study. Provider initiated testing and counseling of HIV was performed for 1831 medical outpatients out of whom 1819 were negative and enrolled into the study. Malaria blood microscopy and hemoglobin testing were performed for all 3638 patients. Data was analyzed using descriptive statistics, Chi square test and multivariate logistic regression. RESULTS: Of the 3638 patients enrolled in the study, malaria parasitaemia was detected in 156 (4.3 %); malaria parasitaemia prevalence was 0.7 % (13/1819) among HIV-seropositive patients and 7.9 % (143/1819) among HIV-seronegative patients. Among HIV-seropositive individuals 65.4 % slept under a mosquito bed net the night before data collection, compared to 59.4 % of HIV-seronegative individuals. A significantly higher proportion of HIV-seropositive malaria-negative patients were on co-trimoxazole (CTX) prophylaxis as compared to HIV-malaria co-infected patients: 82 % (1481/1806) versus 46 % (6/13) (P = 0.001). HIV and malaria co-infected patients were less likely to have the classical symptoms of malaria (fever, chills and headache) compared to the HIV-seronegative and malaria positive counterparts. Multivariate logistic regression showed that HIV-seropositive patients who come for routine follow up were less likely to be infected by malaria (OR = 0.23, 95 % CI = 0.09–0.74). CONCLUSION: The study documented lower malaria prevalence among the HIV-seropositive attendants who come for routine follow up. Clinical symptoms of malaria were more pronounced among HIV-seronegative than HIV-seropositive patients. This study also re-affirmed the importance of co-trimoxazole in preventing malaria symptoms and parasitaemia among HIV- positive patients. BioMed Central 2015-12-15 /pmc/articles/PMC4681039/ /pubmed/26671012 http://dx.doi.org/10.1186/s12936-015-1029-0 Text en © Alemayehu et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Alemayehu, Guda
Melaku, Zenebe
Abreha, Tesfay
Alemayehu, Bereket
Girma, Samuel
Tadesse, Yehualashet
Gadisa, Tsigereda
Lulseged, Sileshi
Balcha, Taye Tolera
Hoos, David
Teka, Hiwot
Reithinger, Richard
Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study
title Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study
title_full Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study
title_fullStr Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study
title_full_unstemmed Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study
title_short Burden of malaria among adult patients attending general medical outpatient department and HIV care and treatment clinics in Oromia, Ethiopia: a comparative cross-sectional study
title_sort burden of malaria among adult patients attending general medical outpatient department and hiv care and treatment clinics in oromia, ethiopia: a comparative cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681039/
https://www.ncbi.nlm.nih.gov/pubmed/26671012
http://dx.doi.org/10.1186/s12936-015-1029-0
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