HIV-Malaria co-infection and its determinants among patients attending antiretroviral treatment clinic in Zaria, Kaduna state, Nigeria

Abstract

Introduction: Malaria and HIV are two important global public health problems. Together, they cause more than two million deaths each year. In sub-Saharan Africa alone, more than 29 million people are living with HIV/AIDS and about 70% of population is at risk to malaria infection. Nigeria accounts for about a quarter of the global malaria cases and tenth of the global HIV cases. Recent theories suggested possibilities of high occurrence of HIV-malaria co-infection wherever there is geographical overlap of the two diseases. We therefore conducted this study to determine the prevalence of HIV-malaria co-infection and its determinants in a malaria endemic setting. Methods: We conducted a cross-sectional study. Two hundred and sixty-two clients attending antiretroviral treatment (ART) clinic in Zaria, Kaduna State were enrolled between February and April 2018 using systematic sampling technique. Questionnaires were administered to collect information on respondents’ personal characteristics and to assess their knowledge, perception and practices on malaria prevention. Venous blood samples were collected and analyzed for malaria parasite, viral load, CD4, and FBC using Giemsa stained light microscopy, COBAS TaqMan equipment, BD FACSTM flow cytometer, and Sysmex haematology analyser respectively. Descriptive and inferential statistics were performed, predictors of HIV-malaria co-infection were ascertained at multivariate analysis. Results: Median age of the respondents was 33 years, 52% were females, 65% were married, 65% were employed, 57% lived in urban residence, and 34% had tertiary education. The prevalence of malaria co-infection among HIV patients was found to be 22.9%. Significant risk factors for the co-infection were high HIV viral load (aOR= 3.30, C.I = 1.15-9.45), being co-infected with TB (aOR= 5.60, C.I = 1.34-23.33), poor knowledge of malaria infection (aOR= 3.12, C.I = 1.27-7.72) and poor practice of malaria prevention (aOR= 13.30, C.I = 4.88-36.23). Conclusion: The level of occurrence of malaria among HIV infected patients in this setting calls for attention. We recommended that health education on malaria should be a priority in malaria control programme; the programmes for control of HIV, malaria and TB should collaborate to ensure integrated service delivery and that people living with HIV/AIDS should be given special consideration for malaria prevention.