Comparative Study of Placental Malaria in HIV-positive and HIV- Negative Pregnant Women in Enugu, South-Eastern Nigeria

Background: Malaria and HIV/AIDS are two of the most devastating global health problems of our time. Available evidences have shown that HIV/AIDS increases the risk of clinical malaria, which in turn leads to low birth weight, anaemia and other morbidities in pregnancy. Aim of the Study: The aim of this study was to determine if HIV infection increases placental malaria in HIV positive pregnant women compared with HIV negative pregnant women attending antenatal clinics in Poly General Hospital, South-eastern Nigeria. Material and Method: A cross-sectional descriptive study, carried out on 200 HIV positive and 200 HIV negative pregnant women attending antenatal clinics in Poly General Hospital, Enugu State. Poly General Hospital was selected using simple random sampling technique. Placenta blood samples were collected and thick blood films were examined for malaria parasite using Giemsa expert microscopy. A structured self-administered questionnaire was used for data collection. All data was collected from women who were recruited during antenatal period, entered into record form designed for this study and analysed using SPSS version 23. Results: About 164 HIV positive women had cases of malaria unlike in HIV negative women where only 151 women had cases of malaria. This brings the prevalence of malaria in HIV positive and negative pregnant women to be 82% and 75.5% respectively (P < 0.001). The HIV positive and HIV negative participants were between 16-45 years of age with majority in the age range of 31-35 years. Mean gestational age of HIV positive and HIV negative participants were 24.3±1.1 and 24.4±1.3 weeks respectively. Amongst the HIV positives, mild malaria cases were recorded in 73(36.5%) women, moderate cases in 91(45.5%) women and high cases of malaria in 3(1.5%) cases. As against 49(24.5%), 68(34%) and 82(41%) in HIV negative women with mild, moderate and high cases of malaria. The above findings show that the prevalence of mild, moderate and severe cases of malaria were higher in HIV positive than the negative pregnant women((P<0.001)) Conclusion: Malaria prevalence and cases of mild, moderate and high malaria parasitemia were higher amongst the HIV positive pregnant women when compared with their negative counterparts. Sequel to that, malaria preventive strategies, including drugs should be reviewed and up scaled in pregnancy to avert the rising complication of malaria in pregnancy.