Watson-Jones D, Ndokeji SD, Bulmer J, Changalucha J, Mugeye K, Kanga Z, Gumodoka B, Balira R, Weiss H; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePeC4464.

D. Watson-Jones, National Institute of Medical Research, National Institute of Medical Research, PO Box 1708, Mwanza, Tanzania, United Republic of, Tel.: +255 811 530 142, Fax: +255 685 000 19, E-mail: mema@twiga.com

Backgound: Documented risk factors for maternal malaria infection in sub-Saharan Africa include human immunodeficiency virus infection (HIV). It has been recommended that malaria prophylaxis in pregnancy would particularly benefit HIV+ pregnant women. As part of a study examining antenatal syphilis screening, data are being collected at delivery on maternal and placental malaria infection, HIV and anaemia, to measure their associations and effect on birth outcome. Methods: 1500 pregnant women, screened for syphilis at an antenatal clinic in Mwanza, are being recruited into a prospective cohort. During follow-up, mothers are given weekly chloroquine prophylaxis and treatment for any RTI identified at enrollment An HIV test, haematocrit and maternal and placental thick blood smears are performed at delivery. Placental biopsies are collected and scored using the Bulmer histological score. A placenta is considered infected if malaria parasites (active infection) and/or malaria pigment (chronic infection) are seen. Results: Data are currently available on 532 women; 155 RPR+ and 377 RPR-. HIV infection was found in 12% RPR+ and 11% RPR- women (p = 0.65). At delivery 25% of mothers had malaria parasitaemia (20% RPR+, 27% RPR-; p = 0.08). Maternal malaria infection at delivery was not associated with HIV status (28% HIV+ v.s. 25% HIV-; p = 0.55). 53% of the cohort had placental infection on histology and/or the placental smear (59% RPR+, 51% RPR-; p = 0.10). The prevalence of placental malaria infection was 62% in HIV-infected compared to 52% in HIV- uninfected mothers (p = 0.16). Although HIV+ women with malaria parasites had higher geometric mean malaria parasite densities compared to HIV-women, this was not significant, either for maternal smears at delivery (p = 0.17) or for placental smears (p = 0.14). Conclusion: Mwanza Region is an area of both high malaria and HIV transmission. Over 50% of women in this cohort had evidence of malaria infection at some stage in their pregnancy. This preliminary data has not demonstrated an association between HIV infection and placental malaria during pregnancy or malaria infection at delivery in this population. This contrasts with results from studies in Malawi and merits investigation in other populations. Further women are currently being recruited into this cohort.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Africa South of the Sahara
• Chloroquine
• Female
• HIV Infections
• HIV Seropositivity
• Humans
• Longitudinal Studies
• Malaria
• Malaria Vaccines
• Malawi
• Mothers
• Parasitemia
• Placenta
• Pregnancy
• Prevalence
• Risk Factors
• Tanzania

Other ID:

• GWAIDS0003236

UI: 102240732

From Meeting Abstracts