Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children

Israel Kalyesubula, Philippa Musoke-Mudido, Lawrence Marum, Danstan Bagenda, Esther Aceng, Christopher Ndugwa, Karen Olness

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background. Malaria causes severe morbidity and mortality in many areas of Africa where HIV-1 infection is also prevalent. Immunosuppression is associated with both diseases but most reports do not find significant interactions between them. Methods. A collaborative study of HIV-1 infection in Ugandan women and their infants was established between the Ministry of Health, Makerere University, Kampala, and Case Western Reserve University in 1988. Four hundred fifty-eight infants, including 77 HIV-1-infected, 232 seroreverter and 125 control children born to HIV-1-negative mothers and 24 of indeterminate status were followed closely from birth for 4 years. Data on these infants were reviewed with respect to episodes of general illness and infections, suspected and confirmed episodes of malaria, onset and frequency of malaria, use of chloroquine and occurrence of selected illnesses after episodes of febrile illnesses. Thick and thin blood smears for malaria were obtained from children with fever. Results. There was no association between occurrence of febrile illnesses and childrens' HIV-1 category. The relative rates of occurrence were 1.0 (95% confidence interval (CI), 0.8 to 1.2) and 1.1 (95% CI 0.9 to 1.4) for the HIV seroreverter and control children compared with the HIV-infected children. Although there was no association (P = 0.83) between HIV-1 status and a smear being taken during a febrile episode, there was an increase in smears positive for malaria parasitemia among seroreverter (risk ratio, 1.5; 95% CI 1.1 to 1.9) and control infants (risk ratio, 1.6; 95% CI 1.2 to 2.2) compared with HIV-1-infected infants. The level of parasitemia was similar in each group. A greater proportion of malaria episodes among the HIV-infected group than among the control groups resulted in hospitalizations (P = 0.001) and blood transfusions (P = 0.02). There was a positive association between time to clinical AIDS and absence of malaria (adjusted for follow-up age) in infected children (P = 0.02). Use of chloroquine was similarly high in each HIV-1 category (80%). Conclusions. In this group of HIV-infected children there was no significant increase in malarial episodes as compared with their HIV-negative controls. The results suggest a possibility that malaria may offer some protection against HIV-1 progression or that chloroquine used to treat malaria may have a direct effect against the HIV-1 virus.

Original languageEnglish (US)
Pages (from-to)876-881
Number of pages6
JournalPediatric Infectious Disease Journal
Volume16
Issue number9
DOIs
StatePublished - Sep 1997

Fingerprint

Malaria
HIV-1
Infection
HIV
Chloroquine
Fever
Confidence Intervals
Parasitemia
HIV Infections
Odds Ratio
Blood Transfusion
Immunosuppression
Acquired Immunodeficiency Syndrome
Hospitalization
Mothers
Parturition
Viruses
Morbidity
Control Groups
Mortality

Keywords

  • Human immunodeficiency virus type 1 infection
  • Malaria
  • Ugandan children

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Kalyesubula, I., Musoke-Mudido, P., Marum, L., Bagenda, D., Aceng, E., Ndugwa, C., & Olness, K. (1997). Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children. Pediatric Infectious Disease Journal, 16(9), 876-881. https://doi.org/10.1097/00006454-199709000-00011

Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children. / Kalyesubula, Israel; Musoke-Mudido, Philippa; Marum, Lawrence; Bagenda, Danstan; Aceng, Esther; Ndugwa, Christopher; Olness, Karen.

In: Pediatric Infectious Disease Journal, Vol. 16, No. 9, 09.1997, p. 876-881.

Research output: Contribution to journalArticle

Kalyesubula, I, Musoke-Mudido, P, Marum, L, Bagenda, D, Aceng, E, Ndugwa, C & Olness, K 1997, 'Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children', Pediatric Infectious Disease Journal, vol. 16, no. 9, pp. 876-881. https://doi.org/10.1097/00006454-199709000-00011
Kalyesubula, Israel ; Musoke-Mudido, Philippa ; Marum, Lawrence ; Bagenda, Danstan ; Aceng, Esther ; Ndugwa, Christopher ; Olness, Karen. / Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children. In: Pediatric Infectious Disease Journal. 1997 ; Vol. 16, No. 9. pp. 876-881.
@article{226414380ed243378082095e20e7dd3d,
title = "Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children",
abstract = "Background. Malaria causes severe morbidity and mortality in many areas of Africa where HIV-1 infection is also prevalent. Immunosuppression is associated with both diseases but most reports do not find significant interactions between them. Methods. A collaborative study of HIV-1 infection in Ugandan women and their infants was established between the Ministry of Health, Makerere University, Kampala, and Case Western Reserve University in 1988. Four hundred fifty-eight infants, including 77 HIV-1-infected, 232 seroreverter and 125 control children born to HIV-1-negative mothers and 24 of indeterminate status were followed closely from birth for 4 years. Data on these infants were reviewed with respect to episodes of general illness and infections, suspected and confirmed episodes of malaria, onset and frequency of malaria, use of chloroquine and occurrence of selected illnesses after episodes of febrile illnesses. Thick and thin blood smears for malaria were obtained from children with fever. Results. There was no association between occurrence of febrile illnesses and childrens' HIV-1 category. The relative rates of occurrence were 1.0 (95{\%} confidence interval (CI), 0.8 to 1.2) and 1.1 (95{\%} CI 0.9 to 1.4) for the HIV seroreverter and control children compared with the HIV-infected children. Although there was no association (P = 0.83) between HIV-1 status and a smear being taken during a febrile episode, there was an increase in smears positive for malaria parasitemia among seroreverter (risk ratio, 1.5; 95{\%} CI 1.1 to 1.9) and control infants (risk ratio, 1.6; 95{\%} CI 1.2 to 2.2) compared with HIV-1-infected infants. The level of parasitemia was similar in each group. A greater proportion of malaria episodes among the HIV-infected group than among the control groups resulted in hospitalizations (P = 0.001) and blood transfusions (P = 0.02). There was a positive association between time to clinical AIDS and absence of malaria (adjusted for follow-up age) in infected children (P = 0.02). Use of chloroquine was similarly high in each HIV-1 category (80{\%}). Conclusions. In this group of HIV-infected children there was no significant increase in malarial episodes as compared with their HIV-negative controls. The results suggest a possibility that malaria may offer some protection against HIV-1 progression or that chloroquine used to treat malaria may have a direct effect against the HIV-1 virus.",
keywords = "Human immunodeficiency virus type 1 infection, Malaria, Ugandan children",
author = "Israel Kalyesubula and Philippa Musoke-Mudido and Lawrence Marum and Danstan Bagenda and Esther Aceng and Christopher Ndugwa and Karen Olness",
year = "1997",
month = "9",
doi = "10.1097/00006454-199709000-00011",
language = "English (US)",
volume = "16",
pages = "876--881",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Effects of malaria infection in human immunodeficiency virus type 1- infected Ugandan children

AU - Kalyesubula, Israel

AU - Musoke-Mudido, Philippa

AU - Marum, Lawrence

AU - Bagenda, Danstan

AU - Aceng, Esther

AU - Ndugwa, Christopher

AU - Olness, Karen

PY - 1997/9

Y1 - 1997/9

N2 - Background. Malaria causes severe morbidity and mortality in many areas of Africa where HIV-1 infection is also prevalent. Immunosuppression is associated with both diseases but most reports do not find significant interactions between them. Methods. A collaborative study of HIV-1 infection in Ugandan women and their infants was established between the Ministry of Health, Makerere University, Kampala, and Case Western Reserve University in 1988. Four hundred fifty-eight infants, including 77 HIV-1-infected, 232 seroreverter and 125 control children born to HIV-1-negative mothers and 24 of indeterminate status were followed closely from birth for 4 years. Data on these infants were reviewed with respect to episodes of general illness and infections, suspected and confirmed episodes of malaria, onset and frequency of malaria, use of chloroquine and occurrence of selected illnesses after episodes of febrile illnesses. Thick and thin blood smears for malaria were obtained from children with fever. Results. There was no association between occurrence of febrile illnesses and childrens' HIV-1 category. The relative rates of occurrence were 1.0 (95% confidence interval (CI), 0.8 to 1.2) and 1.1 (95% CI 0.9 to 1.4) for the HIV seroreverter and control children compared with the HIV-infected children. Although there was no association (P = 0.83) between HIV-1 status and a smear being taken during a febrile episode, there was an increase in smears positive for malaria parasitemia among seroreverter (risk ratio, 1.5; 95% CI 1.1 to 1.9) and control infants (risk ratio, 1.6; 95% CI 1.2 to 2.2) compared with HIV-1-infected infants. The level of parasitemia was similar in each group. A greater proportion of malaria episodes among the HIV-infected group than among the control groups resulted in hospitalizations (P = 0.001) and blood transfusions (P = 0.02). There was a positive association between time to clinical AIDS and absence of malaria (adjusted for follow-up age) in infected children (P = 0.02). Use of chloroquine was similarly high in each HIV-1 category (80%). Conclusions. In this group of HIV-infected children there was no significant increase in malarial episodes as compared with their HIV-negative controls. The results suggest a possibility that malaria may offer some protection against HIV-1 progression or that chloroquine used to treat malaria may have a direct effect against the HIV-1 virus.

AB - Background. Malaria causes severe morbidity and mortality in many areas of Africa where HIV-1 infection is also prevalent. Immunosuppression is associated with both diseases but most reports do not find significant interactions between them. Methods. A collaborative study of HIV-1 infection in Ugandan women and their infants was established between the Ministry of Health, Makerere University, Kampala, and Case Western Reserve University in 1988. Four hundred fifty-eight infants, including 77 HIV-1-infected, 232 seroreverter and 125 control children born to HIV-1-negative mothers and 24 of indeterminate status were followed closely from birth for 4 years. Data on these infants were reviewed with respect to episodes of general illness and infections, suspected and confirmed episodes of malaria, onset and frequency of malaria, use of chloroquine and occurrence of selected illnesses after episodes of febrile illnesses. Thick and thin blood smears for malaria were obtained from children with fever. Results. There was no association between occurrence of febrile illnesses and childrens' HIV-1 category. The relative rates of occurrence were 1.0 (95% confidence interval (CI), 0.8 to 1.2) and 1.1 (95% CI 0.9 to 1.4) for the HIV seroreverter and control children compared with the HIV-infected children. Although there was no association (P = 0.83) between HIV-1 status and a smear being taken during a febrile episode, there was an increase in smears positive for malaria parasitemia among seroreverter (risk ratio, 1.5; 95% CI 1.1 to 1.9) and control infants (risk ratio, 1.6; 95% CI 1.2 to 2.2) compared with HIV-1-infected infants. The level of parasitemia was similar in each group. A greater proportion of malaria episodes among the HIV-infected group than among the control groups resulted in hospitalizations (P = 0.001) and blood transfusions (P = 0.02). There was a positive association between time to clinical AIDS and absence of malaria (adjusted for follow-up age) in infected children (P = 0.02). Use of chloroquine was similarly high in each HIV-1 category (80%). Conclusions. In this group of HIV-infected children there was no significant increase in malarial episodes as compared with their HIV-negative controls. The results suggest a possibility that malaria may offer some protection against HIV-1 progression or that chloroquine used to treat malaria may have a direct effect against the HIV-1 virus.

KW - Human immunodeficiency virus type 1 infection

KW - Malaria

KW - Ugandan children

UR - http://www.scopus.com/inward/record.url?scp=0030779099&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030779099&partnerID=8YFLogxK

U2 - 10.1097/00006454-199709000-00011

DO - 10.1097/00006454-199709000-00011

M3 - Article

C2 - 9306483

AN - SCOPUS:0030779099

VL - 16

SP - 876

EP - 881

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 9

ER -