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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Malaria Journal 1/2012

Factors associated with malaria parasitaemia, malnutrition, and anaemia among HIV-exposed and unexposed Ugandan infants: a cross-sectional survey

Zeitschrift:
Malaria Journal > Ausgabe 1/2012
Autoren:
Beth Osterbauer, James Kapisi, Victor Bigira, Florence Mwangwa, Stephen Kinara, Moses R Kamya, Grant Dorsey
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2875-11-432) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

BO participated in the coordination of the study, data analysis and manuscript preparation. JK participated in coordination of the study, data collection and manuscript preparation. VB, FM and SK participated in the coordination of the study and data collection. MRK participated in the study design and manuscript preparation. GD conceived of the study, participated in its design, coordination, data analysis and manuscript preparation. All authors read and approved the final manuscript.

Abstract

Background

Malaria, malnutrition and anaemia are major causes of morbidity and mortality in African children. The interplay between these conditions is complex and limited data exist on factors associated with these conditions among infants born to HIV-uninfected and infected women.

Methods

Two hundred HIV-exposed (HIV-uninfected infants born to HIV-infected mothers) and 400 HIV-unexposed infants were recruited from an area of high malaria transmission in rural Uganda. A cross-sectional survey was performed at enrolment to measure the prevalence of malaria parasitaemia, measures of malnutrition (z-scores <2 standard deviations below mean) and anaemia (haemoglobin <8 gm/dL). Multivariate logistic regression was used to measure associations between these conditions and risk factors of interest including household demographics, malaria prevention practices, breastfeeding practices, household structure and wealth index.

Results

The prevalence of malaria parasitaemia was 20%. Factors protective against parasitaemia included female gender (OR = 0.66, p = 0.047), mother’s age (OR = 0.81 per five-year increase, p = 0.01), reported bed net use (OR = 0.63, p = 0.03) and living in a well-constructed house (OR = 0.25, p = 0.01). Although HIV-unexposed infants had a higher risk of parasitaemia compared to HIV-exposed infants (24% vs 14%, p = 0.004), there was no significant association between HIV-exposure status and parasitaemia after controlling for the use of malaria preventative measures including bed net use and trimethoprim-sulphamethoxazole prophylaxis. The prevalence of stunting, underweight, and wasting were 10%, 7%, and 3%, respectively. HIV-exposed infants had a higher odds of stunting (OR = 2.23, p = 0.005), underweight (OR = 1.73, p = 0.09) and wasting (OR = 3.29, p = 0.02). The prevalence of anaemia was 12%. Risk factors for anaemia included older infant age (OR = 2.05 per one month increase, p = 0.003) and having malaria parasitaemia (OR = 5.74, p < 0.001).

Conclusions

Compared to HIV-unexposed infants, HIV-exposed infants had a higher use of malaria preventative measures and lower odds of malaria parasitaemia. Having a better constructed house was also protective against malaria parasitaemia. HIV-exposure was the primary risk factor for measures of malnutrition. The primary risk factor for anaemia was malaria parasitaemia. These findings suggest the need to better target existing interventions for malaria, malnutrition and anaemia as well as the need to explore further the mechanisms behind the observed associations.
Zusatzmaterial
Additional file 1: Comparison of characteristics between HIV exposed and unexposed infants.(DOCX 13 KB)
12936_2012_2585_MOESM1_ESM.docx
Additional file 2: Associations between variables of interest and malarial parasitaemia.(DOCX 13 KB)
12936_2012_2585_MOESM2_ESM.docx
Additional file 3: Associations between variables of interest and measures of malnutrition.(DOCX 13 KB)
12936_2012_2585_MOESM3_ESM.docx
Additional file 4: Associations between variables of interest and moderate-severe anaemia.(DOCX 13 KB)
12936_2012_2585_MOESM4_ESM.docx
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