Effect of malaria on hematological profiles of people living With human immunodeficiency virus attending gambella Hospital, southwest ethiopia

Abstract

Background: Malaria and human immunodeficiency virus are the two most devastating global health problems of our time, causing more than two million deaths each year. Hematological abnormalities such as anemia, thrombocytopenia and leucopenia are the common complications in malaria and HIV co-infected individuals. Objective: To determine the effect of malaria on hematological profiles of people living with HIV attended Gambella Hospital ART clinic, Southwestern Ethiopia. Methods: A facility based comparative cross-sectional study was conducted from May 25 to November11, 2014 in Gambella Hospital. A total of 172 adult people living with HIV, 86 malaria infected and 86 malaria non-infected participants were included in the study. Demographic and data were collected by using questionnaire, anthropometric data were collected by measuring height and weight and clinical data were collected carefully from the existing ART logbook. Venous blood sample was collected for blood film preparation, complete blood count (CBC) and CD4+ lymphocyte count. Stool specimen was collected for intestinal parasite examination. The blood films were examined using light microscope for malaria detection. The whole blood sample was analyzed using CELL DYN 1800 for CBC and BD FACS counter for CD4+ lymphocyte count. The data were analyzed using SPSS, Version-20. All variables with p-value <0.05 were considered as statistically significant. Results: The prevalence of anemia, thrombocytopenia and leucopenia in malaria and HIV coinfected participants were 60.5%, 59.3%, and 43.0%, respectively. A significant difference was observed in prevalence of anemia (P=0.022) and thrombocytopenia (P<0.001) between the two groups. The comparison in mean value of hemoglobin, hematocrit, platelet, lymphocyte and neutrophil count between the two groups were statistically significant (P<0.05). Resident (AOR= 4.67 95% CI: 1.44 - 15.14), malaria infection (AOR=2.42 95% CI: 1.16 - 5.04) and CD4+ count were predictors for anemia. Predictor for thrombocytopenia was malaria infection (AOR= 9.79 95% CI: 4.33-22.17). Malaria parasitic density (AOR= 0.13 95% CI: 0.03 - 0.57) and CD4+ count (AOR= 4.77 95% CI: 1.23-18.45) were predictors of leucopenia. Conclusion: Prevalence of anemia and thrombocytopenia were higher in malaria and HIV coinfected study participants than HIV mono-infected study participants. Mean value of hemoglobin, hematocrit, lymphocyte, neutrophils and platelet counts were significantly different in two groups. Malaria infection increases the rate of being anemic and thrombocytopenic. Further longitudinal researches are required by including additional associated factors that elaborate the research.