Pascual 1

Rhena Pascual
Evelyn Galvez
Biology 1615
July 14, 2014
Malaria Parasitemia and CD4 T Cell Count, Adverse HIV, and Viral Load in HIV-Infected
Women in Tanzania, Africa
A cross-sectional study was completed to show if there was a relationship between malar-
ia parasitemia, viral load, and CD4 cell count with pregnant women that are infected with HIV in
Tanzania, Africa. There are millions of individual worldwide with HIV that live in sun-Saharan
Africa where malaria is increasingly growing, in which ranks first in causing morbidity in indi-
viduals that are infected with HIV. There is growing evidence that suggests a detrimental rela-
tionship between these diseases. It seems that individuals with HIV-related immune suppression
that reside in malaria-endemic areas are more vulnerable to clinical malaria or malaria parasitem-
ia. Previous studies in HIV-infected individuals have reported a relationship between clinical
malaria and viral load.
The main point of the study was to determine whether malaria parasitemia was related
with CD4 cell count, or viral load in the cross-sectional analysis that was done. The population
that was being studied consisted of 1,078 pregnant women with HIV, in which the women were
enrolled in a double-blind study and a placebo-controlled randomized trial that was done in Dar
Pascual 2


es Salaam, Tanzania, Africa to examine the effects daily micronutrient supplements had on mor-
tality and HIV.
In order to diagnose malaria, thick and thin blood films had to be stained and air-dried
with 5% Giemsa at a pH of 7.2 for 20 minutes. A microscopic examination of the stained slides
was used in order to determine if malaria was present. The first drug used for treatment of un-
complicated malaria until August of 2011 was chloroquine, but then the drug was changed to sul-
fadoxine-pyrimethamine because the use of choloroquine results in high levels of treatment fail-
ures. In accordance with Tanzania Ministry of Health treatment guidelines, pregnant women
with malaria parasites and other infections were able to receive treatment free-of-charge.
In result, 12 out of 1,078 that as enrolled in the study were then excluded from the study
and the remaining 1,066, 199 women had parasitemia confirmed by the slides during the time of
study. It was found that there was no relationship between progression to HIV stage 3 and 4 and
baseline parasitemia, but there was a significant relationship between ARD and parasitemia. In
the study, statistically significant heterogeneity was observed and it seems that parasitemia was
most detrimental in pregnant women with with T cell counts > 500 cells/ML.
This study was done during an era when HIV-infected pregnant women were not able to
get access to ART in Tanzania, Africa, therefore these results were not able to be generalized to
individuals that were receiving ART. In conclusion, the observation had cross-sectional done to
show a relationship between parasitemia and viral load with pregnant women with HIV had a
positive outcome.
References


Molly F. Franke, Donna Spiegelman, Amara Ezeamama, Said Aboud, Gernard I. Msamanga,
Saurabh Mehta, and Wafaie W Fawzi, Malaria Parasitemia and CD4 Cell Count, Viral Load, and
Adverse HIV Outcomes Among HIV-Infected Pregnant Women in Tanzania, The American So-
ciety of tropical Medicine and Hygiene, Pages 556-562, 2010.