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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The effect of HIV on morbidity and mortality in children with severe malarial anaemia
Malaria Journal, Volume 6, Article 143, Year 2007
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Description
Background. Malaria and HIV are common causes of mortality in sub-Saharan Africa. The effect of HIV infection on morbidity and mortality in children with severe malarial anaemia was assessed. Methods. Children <5 years old were followed as part of a prospective cohort study to assess the transfusion-associated transmission of blood-borne pathogens at Mulago Hospital, Kampala, Uganda. All children were hospitalized with a diagnosis of severe malarial anaemia requiring blood transfusion. Survival to different time points post-transfusion was compared between HIV-infected and uninfected children. Generalized estimating equations were used to analyse repeated measurement outcomes of morbidity, adjusting for confounders. Findings. Of 847 children, 78 (9.2%) were HIV-infected. Median follow-up time was 162 days (inter-quartile range: 111, 169). HIV-infected children were more likely to die within 7 days (Hazard ratio [HR] = 2.86, 95% Confidence interval [CI] 1.30-6.29, P = 0.009) and within 28 days (HR = 3.70, 95% CI 1.91-7.17, P < 0.001) of an episode of severe malarial anaemia, and were more likely to die in the 6 months post-transfusion (HR = 5.70, 95% CI 3.54-9.16, P < 0.001) compared to HIV-uninfected children. HIV-infected children had more frequent re-admissions due to malaria within 28 days (Incidence rate ratio (IRR) = 3.74, 95% CI 1.41-9.90, P = 0.008) and within 6 months (IRR = 2.66, 95% CI 1.17 - 6.07, P = 0.02) post-transfusion than HIV-uninfected children. Conclusion. HIV-infected children with severe malarial anaemia suffered higher all-cause mortality and malaria-related mortality than HIV-uninfected children. Children with HIV and malaria should receive aggressive treatment and further evaluation of their HIV disease, particularly with regard to cotrimoxazole prophylaxis and antiretroviral therapy. © 2007 Malamba et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Malamba, Samuel Sewava
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
United States, Berkeley
University of California, Berkeley
Hladik, Wolfgang
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Reingold, Arthur Lawrence
United States, Berkeley
University of California, Berkeley
Banage, Flora
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
McFarland, Willi C.
United States, San Francisco
University of California, San Francisco
Rutherford, George Williams
United States, San Francisco
University of California, San Francisco
Mimbe, Derrick E.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Nzaro, Esau
Uganda, Kampala
Mulago Hospital
Downing, Robert G.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Mermin, Jonathan H.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Statistics
Citations: 37
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1186/1475-2875-6-143
e-ISSN:
14752875
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda