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J Infect Dis. 2016 Jun 15;213(12):1971-8. doi: 10.1093/infdis/jiw057. Epub 2016 Feb 10.

Community-wide Prevalence of Malaria Parasitemia in HIV-Infected and Uninfected Populations in a High-Transmission Setting in Uganda.

Author information

1
Department of Medicine.
2
Vanderbilt University, Nashville, Tennessee.
3
Infectious Diseases Research Collaboration.
4
Makerere University Joint AIDS Program.
5
Malaria Elimination Initiative, Global Health Group, University of California-San Francisco.
6
School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Abstract

BACKGROUND:

Malaria control strategies depend on identifying individuals with parasitemia, who may be asymptomatic but retain the ability to transmit disease. Population-level survey data on parasitemia are limited and traditionally exclude adults and human immunodeficiency virus (HIV)-infected individuals.

METHODS:

We performed a cross-sectional survey of residents aged 18 months to 94 years in Nankoma, Uganda. Blood specimens were collected using the dried blood spot technique from 9629 residents (87.6%), and samples from a subset of 4131 were tested for malaria parasites, using loop-mediated isothermal amplification. Population-level prevalence was estimated using a weighted proportion, and predictors of parasitemia were identified using a multivariate Poisson regression model.

RESULTS:

The community prevalence of parasitemia was 83.8% (95% confidence interval [CI], 82.9%-84.6%). Parasite prevalence was highest among children aged 5-14 years (94.7%) and lowest among adults (61.9%). In analysis that controlled for age, HIV-infected individuals with an undetectable viral load had a lower risk of parasitemia, compared with HIV-uninfected individuals (adjusted relative risk, 0.16; 95% CI, .10-.27; P < .001).

CONCLUSIONS:

In a rural Ugandan community, 2 years after distribution of long-lasting insecticide-treated bed nets, the prevalence of malaria parasitemia was high across all ages, peaking in school-aged children. Persons with well-controlled HIV infection had a lower risk of parasitemia, presumably reflecting access to HIV care.

KEYWORDS:

HIV; LAMP; malaria; parasitemia

PMID:
26908725
PMCID:
PMC4878723
DOI:
10.1093/infdis/jiw057
[Indexed for MEDLINE]
Free PMC Article

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