The effect of HIV-infection on the immune response to malaria infection amongst pregnant women in Kumba, South West Region of Cameroon. (Preprint)

BACKGROUND Malaria is a major cause of illness and death among pregnant HIV-positive women in Sub-Saharan Africa. In Cameroon, Malaria is a major public health issue with the entire country at risk. This study seeks to investigate the effect of HIV on the immune response to malaria infection amongst pregnant women in Kumba in the South West Region of Cameroon OBJECTIVE To determine the effect of HIV infection on the immune response to malaria infection amongst pregnant women in Kumba, South West Region of Cameroon. METHODS A mixed design comprising of a systematic review, cross sectional design and a prospective cohort will be used. The study will run from January 2022 to December 2022. The systematic review will look at HIV influence on cytokines and antibody response to malaria in Cameroon. The cross sectional aspect will recruit both HIV positive and Non-HIV infected pregnant women from three health institutions. Namely; General hospital Kumba, Presbyterian hospital Buea-road Kumba, District hospital Kumba, Mamun Ntam fiango and catholic hospital Fiango. About 3mLs of venous blood, Placenta and cord blood will be collected from each participants into an EDTA, Heparinized and Sodium citrated tube respectively. Microscopy, rapid diagnostic test (RDT) and nested PCR will be done to identify malaria parasite from all the samples, while nested PCR targeting the different genetic diversity markers for P.falciparum will be used to identify marker for genetic diversity. Furthermore, Sequencing will be done to study the nucleotide sequence of the different alleles as well as develop a phylogenetic tree showing the relationship of each alleles. A multiplex assay will be used to analyses the peripheral blood plasma and cord blood plasma for cytokine and total antibody response to malaria infection. The prospective cohort aspect will follow up the children born from these women right up to 6 week post-delivery for incidence of malaria. A well-structured questionnaire will be used for data collection. Pretesting of questionnaire will be done at the Buea regional hospital and ethical clearance will be obtained from the University of Buea and the regional delegation of public health in the South west region. Data will be analysed using SPSS and STATA. All p-value < 0.05 will be considered to be statistically significant. BioEdit 7.0.0 software will be used to align nucleotide sequences of the different genes after sequencing. Phylogenetic tree searching will be done using the maximum likelihood (ML) method in MEGA V6.0. RESULTS The prevalence of malaria amongst HIV infected pregnant women will be determined. The genetic diversity of alleles responsible for malaria infection amongst pregnant women will be assessed. Cytokine and total antibody response to malaria amongst HIV infected pregnant women will be evaluated and the incidence of malaria amongst HIV exposed children will be determined. CONCLUSIONS A successful study will show the effect of HIV on the immune response to malaria amongst pregnant women in Kumba, Meme division, South West Region of Cameroon.