The Incidence of Asymptomatic and Symptomatic Malaria Infection in HIV Positive and Negative Individuals in Osun State, Nigeria

Abstract

Malaria infection remains a public health problem in the sub-Saharan African region, including Nigeria. Clinical symptomatic malaria cases are treated when diagnosed. However, asymptomatic malaria cases are most often undetected and, therefore, untreated, resulting in a significant source of gametocytes that serve as carriers of malaria transmission. This study was conducted to determine the prevalence of malaria cases in both asymptomatic and symptomatic individuals who are HIV positive and negative in Osun State, Nigeria, as a call for effective diagnosis and treatment awareness. One hundred and twenty-two participants were enrolled in the study. Primary clinical biodata was examined to determine the fitness of the participants. Blood samples were collected for malaria parasite (Plasmodium falciparum) analysis using microscopy and polymerase chain reaction. Gametocytes were detected using nested PCR targeting gametocyte-specific marker, Pf377g. Malaria was detected in 31 (25.4%) HIV-positive individuals and 91 (74.6%) HIV-negative individuals. The prevalence of symptomatic malaria was 8.2% in HIV-positive individuals. The prevalence of symptomatic malaria was 31.2% in HIV-negative patients. However, it was 43.4% in the same group of people (HIV-negative patients) that are asymptomatic. CD4 cell count (p˂0.0001) and parasite density (p=0.005) were significantly lower in symptomatic malaria individuals than their asymptomatic malaria counterparts. The higher prevalence of asymptomatic malaria individuals recorded in this study with the presence of gametocytes, a significant carrier of the disease, may contribute to the spread of the infection. Therefore, to reduce the fatality of malaria infection and limit its transmission, accurate and improved diagnostic strategies are essential for the treatment and management of asymptomatic malaria carriers.