喀麦隆杜阿拉 Bonasssama 卫生区小于 15 岁的 HIV 感染儿童中的疟疾寄生虫血症及其与 CD4 细胞、病毒载量和血液学参数的关系：发病率和风险因素

IF 2 Q3 INFECTIOUS DISEASES

Parasite Epidemiology and Control Pub Date : 2024-11-01 DOI:10.1016/j.parepi.2024.e00390

Ambe Fabrice Ngwa , Ekwi Damian Nsongmayi , Tanyi Pride Bobga , Bih Vanessa Tita , Judith Ngong Nyeme , Nyanjoh Eugine Mbuh

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引用次数: 0

摘要

背景疟疾是导致儿童发病和死亡的主要原因之一，而艾滋病病毒感染和其他因素可能会使情况变得更糟。本研究旨在评估喀麦隆杜阿拉 Bonassama 卫生区 15 岁以下感染艾滋病毒的儿童中疟疾寄生虫血症的流行率，并调查其与 CD4 细胞计数、病毒载量和血液学参数的关系。方法：本研究是一项横断面研究，涉及 287 名感染艾滋病毒的 15 岁儿童，采用方便抽样法进行登记。研究采用半结构式问卷，从护理人员处了解参与者的特征。采集静脉血；制作血片并使用革兰氏染色法检测寄生虫。全血细胞计数、CD4 水平和病毒载量分别使用血液自动分析仪、皮马计数器和 genexpert 进行测量。数据使用 SPSS 进行分析，并使用卡方检验来评估相关性。采用多变量逻辑回归法评估疟疾的诱发因素，以 p < 0.05 为显著性。5岁儿童（42.68%，p <0.001）、发烧儿童（40.70%，p = 0.047）、未接受抗逆转录病毒疗法（ART）（28.6%，p = 0.02）和复方新诺明（28.6%，p = 0.02）的疟疾发病率明显更高。5岁儿童（AOR = 1.81，95 % 1.19-2.75）、5-9岁儿童（AOR = 1.61，95 % CI 1.11-2.48）、未接受抗逆转录病毒疗法的儿童（AOR = 2.2，95 % 1.03-4.74）和复方新诺明（AOR = 9.08，95 % 2.33-43.46）、发热儿童（AOR = 1.72，95 % 1.01-2.11）、病毒载量>3000拷贝/μL（AOR = 2.933，95 % 1.36-6.49）和CD4计数<200个细胞/μL（AOR = 3.09，95 % 2.08-4.6）是艾滋病毒感染儿童疟疾寄生虫血症的相关因素。与艾滋病毒感染儿童相比，疟疾/艾滋病毒感染儿童的血红蛋白水平（P = 0.0016）、白细胞（P = 0.002）、红细胞（P < 0.001）、中性粒细胞计数（P < 0.001）和血小板计数（P = 0.0164）显著降低。结论该研究得出结论，感染艾滋病毒的 5 岁以下儿童，尤其是未接受抗逆转录病毒疗法或复方新诺明治疗的儿童，患疟疾和相关血液病的风险明显更高。这突出表明，有必要对这一弱势群体进行有针对性的疟疾筛查和治疗。公共卫生战略应优先考虑提高抗逆转录病毒疗法和复方新诺明的可及性，以降低这些风险并改善总体健康状况。

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Malaria parasitemia and its association with CD4 cells, viral load and haematological parameters among HIV-infected children < 15 years in the Bonasssama Health District, Douala, Cameroon: Prevalence and risk factors

Background

One of the major causes of morbidity and death in children is malaria, and HIV infection and other factors may make the situation worse. This study aimed to assess the prevalence of malaria parasitemia among HIV-infected children under 15 years in the Bonassama Health District, Douala, Cameroon, and investigate its association with CD4 cell counts, viral load, and haematological parameters.

Methods

The study was a cross-sectional study involving 287 HIV-infected children <15 years and convenient sampling was used to enrol participants. A semi-structured questionnaire was used to obtain the characteristics of the participants from the caregivers. Venous blood was collected; blood films were made and stained using Giemsa for parasite detection. Full blood count, CD4 level and viral load were measured using a haematology auto-analyzer, pima counter and genexpert, respectively. Data were analysed using SPSS, and the chi-square test was used to assess the association. Predisposing factors to malaria were evaluated using multivariable logistic regression, and a p < 0.05 was considered significant.

Results

The overall prevalence of malaria and anaemia was 31.01 % and 25.44 %, respectively. Malaria prevalence was significantly higher in children <5 years (42.68 %, p < 0.001), those presented with fever (40.70 %, p = 0.047), children not on antiretroviral therapy (ART) (28.6 %, p = 0.02) and cotrimoxazole (28.6 %, p = 0.02). Children <5 years (AOR = 1.81, 95 % 1.19–2.75), those between 5 and 9 years (AOR = 1.61, 95 % CI 1.11–2.48), children not on ART(AOR = 2.2, 95 % 1.03–4.74) and Cotrimoxazole (AOR = 9.08, 95 % 2.33–43.46), febrile children (AOR = 1.72, 95 % 1.01–2.11), children with viral load >3000 copies/μL(AOR = 2.933, 95 % 1.36–6.49), and CD4 count <200cells/ μL (AOR = 3.09, 95 % 2.08–4.6) were factors associated with malaria parasitemia among HIV-infected children. Haemoglobin levels (p = 0.0016), White Blood Cells (p = 0.002), Red Blood Cells (P < 0.001), neutrophils count (p < 0.001), and platelet counts (p = 0.0164) were significantly lowered among malaria/HIV children compared to HIV-infected children.

Conclusion

The study concludes that HIV-infected children under 5 years, especially those not on ART or cotrimoxazole, are at a significantly higher risk for malaria and related haematological issues. This underscores the necessity for targeted malaria screening and treatment in this vulnerable group. Public health strategies should prioritize enhancing access to ART and cotrimoxazole to mitigate these risks and improve overall health outcomes.

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.