Parasito-haematological features of acute Plasmodium falciparum and P. vivax malaria patients with and without HIV co-infection at Wonji Sugar Estate, Ethiopia

Abstract

Abstract
Background: Investigation to identify factors that determine the clinical outcome of malaria are essential for the
improvement of patient care in severe malaria cases.
Objectives: To assess the parasitologic and haemato-immunological characteristics of malaria patients with and
without HIV co-infection.
Methods: Immune cells were enumerated using the Flow cytometer method. Haematological values were determined
using the Coulter Counter system. Malaria parasite detection was conducted using standard microscopy; and HIV
testing was conducted using Determine, ELISA and Western blot methods.
Results: A total of 253 study participants, out of which 87 were control cases, and 166 were acute malaria patients
(49.4% due to P. falciparum, 48.8 % due to P. vivax, 1.8% due to mixed infection) were included. Eight out of 166
(4.8%) of the malaria patients were found to be HIV positive. Asexual stage parasitemia was increased in HIV positive
falciparum patients (P=0.031). However, the increase in parasitemia in HIV positive vivax malaria patients was not
significant. HIV infection is seen to aggravate the decrease in Haemoglobin (Hgb), Haematocrit (Hct) and Platelet (Plt)
levels. Lymphopenia, CD4+ lymphocytopenia, eosinopenia, monocytosis and thrombocytopenia were found to be
higher in both malaria infections compared to the control ones (P<0.05).
Conclusion: Care should be taken when using immune cell counts for research or diagnostic purposes in malaria
patients. The effects of HIV on parasitologic and haematologic values should be taken into account during the
provision of care to HIV positive malaria patients. [Ethiop.J.Health Dev. 2005;19(2):132-139]