Community-wide Prevalence of Malaria Parasitemia in HIV-Infected and Uninfected Populations in a High-Transmission Setting in Uganda. (10th February 2016)

• Record Type: Journal Article
• Authors: Katrak, Shereen; Day, Nathan; Ssemmondo, Emmanuel; Kwarisiima, Dalsone; Midekisa, Alemayehu; Greenhouse, Bryan; Kamya, Moses; Havlir, Diane; Dorsey, Grant
• Is Part Of: Journal of infectious diseases. Volume 213:Number 12(2016:Jun. 15)
• Page Start: 1971
• Page End: 1978
• Publication Date: 2016-02-10
• Subjects: malaria -- parasitemia -- HIV -- LAMP; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw057
• Languages: English
• ISSNs: 0022-1899

Abstract

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.