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|Title: ||Human immunodeficiency virus infection and cerebral malaria in children in Uganda: a case-control study|
|Authors: ||Imani, Peace D.|
Tumwine, James K
|Issue Date: ||2010 |
|Publisher: ||BioMed Central|
|Citation: ||Immani, P.D., Musoke, P., Byarugaba, J., Tumwine, J.K. (2010). Human immunodeficiency virus infection and cerebral malaria in children in Uganda: a case-control study. BMC Pediatrics, 11(5)|
|Abstract: ||Background: Human immunodeficiency virus (HIV)-1 infection increases the burden of malaria by increasing
susceptibility to infection and decreasing the response to malarial treatment. HIV-1 has also been found to
suppress the immune system and predispose to severe forms of malaria in adults. There is still a paucity of data on
the association between HIV-1 infection and cerebral malaria in children. The aim of this study was to determine
whether HIV-1 infection is a risk factor for cerebral malaria in children.
Method: We conducted an unmatched case-control study, in which 100 children with cerebral malaria were
compared with 132 with uncomplicated malaria and 120 with no malaria. In stratified analyses we estimated odds
ratios (ORs) and 95% confidence intervals (CIs) adjusted for age.
Results: HIV-1 infection was present in 9% of children with cerebral malaria compared to 2.3% in uncomplicated
malaria (age-adjusted odds ratio (aOR) 5.94 (95% confidence interval (CI) 1.36-25.94, p = 0.012); and 2.5% in
children with no malaria (aOR 3.85 (95% CI0.99-14.93, p = 0.037). The age-adjusted odds of being HIV-positive
among children with cerebral malaria compared to the control groups (children with uncomplicated malaria and
no malaria) was 4.98 (95% CI 1.54-16.07), p-value = 0.003.
Conclusions: HIV-1 infection is associated with clinical presentation of cerebral malaria in children. Clinicians
should ensure that children diagnosed with HIV infection are initiated on cotrimoxazole prophylaxis as soon as the
diagnosis is made and caretakers counselled on the importance of adherence to the cotrimoxazole towards
reducing the risk of acquiring P.falciparum malaria and associated complications such as cerebral malaria. Other
malaria preventive measures such as use of insecticide-treated mosquito nets should also be emphasized during
|Appears in Collections:||Research Articles (Health-Sciences)|
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