Hypoglycemia and Anemia Associated with Malaria among Pregnant Mothers living with HIV attending Aminu Kano Teaching Hospital, Kano State-Nigeria

Abstract

Human Immunodeficiency Virus (HIV) and Malaria each interact with the host immune system, resulting in complex activation of immune cells. Human Immunodeficiency Virus (HIV) positive patients are predisposed to severe malaria with marked reduction of CD4 cells count and increase in plasma viral load. An assessment was carried out to examine the relationship between hypoglycemia, HIV infection and malaria prevalence in pregnant mothers as well as parasitemia in relation to severity of infection. A hospital based case-control study was carried out. Screening was done at the antenatal and ART clinics, Aminu Kano Teaching Hospital through routine voluntary and confidential HIV testing. After obtaining ethical approval, a total of 200 HIV positive and equivalent numbers of HIV negative pregnant mothers were selected from whom socio-demographic and biomedical data was collected using structured Questionnaire. Blood samples were aseptically collected in an EDTA container. Blood smears (Thick and thin) for malaria screening, Packed Cell Volume (PCV) and Blood Glucose Level were systematically performed using standard procedure. The results were analyzed using Microsoft excel and OpenEpi statistical software version 2.3 and p-value of ≤ 0.05 was considered significant. Malaria prevalence was 141(70.5%) in HIV positive and 110(55.0%) in HIV negative clients. The severity of infection was 41(29.1%) and 5(4.5%) in HIV positive and HIV negative respectively with significant difference (p <0.05).Cases of hypoglycemia ( Blood glucose level ≤ 2.2mmol/L) were observed to be higher among the malaria positive in both the HIV positive and HIV negative clients (100%). There was no significant difference with the severity of infection (p>0.05).The higher prevalence of severe malaria infection among HIV positive clients obtained in this study reveals that HIV positive pregnant mothers had clear evidence of greater exposure to severe malaria in this study area. Therefore strategies to reduce the severity of malaria during pregnancy should be reinforced especially in area of high HIV prevalence by both governmental and non-governmental agencies.