Correlates and incidence of Plasmodium falciparum among HIV infected and HIV non- infected children below 5 years in Kisumu County, Kenya

Abstract

Globally over 3 billion people are at risk of malaria infection every year. This burden is compounded by the fact that approximately 2-3 million children live with human immunodeficiency virus (HIV) in low and middle income coutries. Malaria and HIV account for a significant amount of morbidity and mortality. Cotrimoxazole prevents opportunistic infections in HIV-infected persons, but its effectiveness in preventing malaria varies especially in children. This cohort study determined the correlates and incidence of P. falciparum among HIV positive and negative children < 5 years in Kisumu County. A sample size of 132 was estimated based on methods in Observational Epidemiology. Data analysis was done using Stata version 14. Relative Risk with corresponding 95% CI was used to estimate the strength of association between the independent predictors of malaria. There was a significant difference in the incidence of P. falciparum among HIV infected compared to HIV non-infected children (p-value = 0.0030). Symptoms presented such as; Fever RR 0.69 (95%CI: 0.22-2.16), headache RR 1.53 (95%CI: 0.12-19.08),Inability to retain oral medication RR 0.12 (95%C: 0.01-1.92), the number of persons per bed net use where two, RR 5.46 (95%CI: 0.46-64.58), three 2.14 (95%CI: 0.27-17.25) and > three 2.58 (95%CI: 0.27-24.87) were indication to malaria infection. The study concluded that risk factors such as inability to retain oral antimalarial medication, presence of fever and headache were indicative of malaria infection; similarly, caretaker level risk factors such as the individual taking care of the child was also a source of risk to P.falciparum infection.The study realized an overall three-month cumulative incidence rate of 17.42%, with a higher proportion (27.27%) of the subject who suffered malaria being HIV negative indicative that Cotrimoxazole offers protection to malaria infection in children below five years. We recommended for policies to emphasise the direct observe therapy at the facility level for malaria treatments with continuous medical education to enhance drug absorption and bioavailability.