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Malaria and HIV co-infection in Hadya Zone, southern Ethiopia.

BACKGROUND
Malaria and human immunodeficiency virus (HIV) are the major priority medical challenges currently facing sub-Saharan Africa, and yet little has been known on the clinical and public health implications of their co-infections.


OBJECTIVES
To determine the prevalence of malaria and HIV co-infections and to describe the clinical manifestations of malaria in HIV-positive and negative malaria patients.


METHODS
A cross-sectional study was conducted from October 2003 through January 2004 in three health facilities located in Hadya Zone, Southern Ethiopia. A total of 337 microscopically confirmed Plasmodium falciparum malaria patients in the age group of 15-34 years were included in the study. Anonymous HIV testing was done on the blood samples of the patients using a single enzyme linked immunosorbent assay (ELISA) technique.


RESULTS
The HIV serostatus assessment revealed that 14 (4.2%) of the P. falciparum patients were seropositive for a single ELISA HIV test. No socio-demographic difference was observed between HIV positive and HIV negative malaria patients. The proportion of HIV-positives (71.4%) among patients who reported two or more malaria attacks during the last year was higher than those who only reported the current attack (28.6%). However, all patients with signs of cerebral malaria and prostration were negative for HIV test. The frequently reported symptoms of severe malaria included cerebral manifestation (76.7%), persistent vomniting (35.3%), dark urine (21.6%), inability to eat or drink (18.0%), and prostration (16.8%). Pallor (44.8%) and splenomegally (19.9%) were the most frequently detected physicalfindings.


CONCLUSIONS
The HIV prevalence among malaria patients was not different from HIV prevalence in the general population. Further studies with carefully designed methodologies are recommended