Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.
Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America.
PLoS One. 2021 Jan 22;16(1):e0245743. doi: 10.1371/journal.pone.0245743. eCollection 2021.
Both malaria and intestinal parasites are endemic in Cameroon, and their co-infection can be of great impact on anaemia among people living with HIV (PLWH). This community-based retrospective cohort study determined the prevalence and association of infections with anaemia in PLWH and HIV-negative individuals in Buea, Cameroon from March to August 2019.
The study population comprised of 190 PLWH and 216 consenting HIV-negative individuals from the Buea community. Participants were examined clinically, the collected blood sample was used for malaria parasite (MP) detection, HIV diagnosis and haemoglobin (Hb) measurement while stool samples were examined for the detection of intestinal parasites (IPs). Proportions were compared using Pearson's Chi-square test and association of anaemia with independent variables was evaluated using logistic regression analysis.
Out of the 406 participants, MP, IPs and MP/IP co-infection prevalences were 15.5%, 13.0% and 3.0% respectively. PLWH had a higher prevalence of MP (16.3%, P = 0.17), IPs (23.7%, P ˂ 0.001) and MP/IPs co-infection (3.7%, P = 0.04) when compared with HIV-negative participants. Similarly, PLWH had significantly lower mean haemoglobin value (11.10 ± 1.54 g/dL) than their HIV-negative counterparts (12.45 ± 2.06 g/dL). Also, PLWH co-infected with MP and IPs were observed to have a significantly lower mean haemoglobin value (10.6 ± 1.21 g/dL). PLWH had a significantly (P ˂ 0.001) higher prevalence of mild (56.8%), moderate (18.4%) and severe (1.6%) anaemia when compared with HIV-negative counterparts. The significant risk factors associated with anaemia included being febrile (P = 0.03), MP-infected only (P = 0.001), HIV-infected only (P < 0.001), having dual (P < 0.001) or triple-infections (P = 0.03).
Malaria and intestinal parasites remain public health concerns among PLWH and anaemia as a serious haematological abnormality gets exacerbated even with the viral load suppression. Hence, routine medical check-ups among PLWH are recommended.
疟疾和肠道寄生虫在喀麦隆均为地方性疾病，它们的合并感染可能会对艾滋病毒感染者（PLWH）的贫血状况产生重大影响。本项基于社区的回顾性队列研究于 2019 年 3 月至 8 月在喀麦隆布埃亚社区确定了 PLWH 和 HIV 阴性个体中感染疟疾寄生虫（MP）和肠道寄生虫（IP）合并感染与贫血之间的关联。
研究人群包括 190 名 PLWH 和 216 名同意的 HIV 阴性个体。对参与者进行临床检查，采集的血液样本用于检测疟原虫（MP）、HIV 诊断和血红蛋白（Hb）测量，而粪便样本则用于检测肠道寄生虫（IPs）。使用 Pearson 卡方检验比较比例，使用逻辑回归分析评估贫血与独立变量之间的关联。
在 406 名参与者中，MP、IP 和 MP/IP 合并感染的患病率分别为 15.5%、13.0%和 3.0%。与 HIV 阴性参与者相比，PLWH 更易感染 MP（16.3%，P=0.17）、IP（23.7%，P<0.001）和 MP/IP 合并感染（3.7%，P=0.04）。同样，PLWH 的平均血红蛋白值（11.10±1.54 g/dL）明显低于 HIV 阴性对照者（12.45±2.06 g/dL）。此外，观察到同时感染 MP 和 IP 的 PLWH 的平均血红蛋白值明显降低（10.6±1.21 g/dL）。PLWH 中，轻度（56.8%）、中度（18.4%）和重度（1.6%）贫血的患病率明显更高（P<0.001）。与 HIV 阴性对照者相比，PLWH 发热（P=0.03）、仅感染 MP（P=0.001）、仅感染 HIV（P<0.001）、双重感染（P<0.001）或三重感染（P=0.03）是贫血的显著危险因素。
疟疾和肠道寄生虫仍然是 PLWH 的公共卫生问题，即使病毒载量得到抑制，贫血这一严重的血液学异常也会恶化。因此，建议对 PLWH 进行常规医疗检查。
