Prevalence of malaria and anaemia among HIV infected pregnant women using co-trimoxazole prophylaxis in Kinondoni municipality

Abstract

Background: HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. The Ministry of Health introduced a daily co-trimoxazole prophylaxis among HIV infected pregnant women to prevent opportunistic infections and malaria in 2011. Objective: To determine the prevalence and the associated factors of malaria infection and anaemia among HIV infected pregnant women using co-trimoxazole prophylaxis. Methodology: This was a cross sectional study conducted among HIV-infected pregnant women in eight health facilities in Kinondoni Municipality from February to April 2013. Results: A total of 420 subjects with the mean±SD age of 28.2 ±5.2 years were recruited and analyzed. The prevalence of malaria infection was 4.5% (19/420). The proportion of subjects with poor adherence to co-trimoxazole was 50.5% (208/320). Factors that were significantly associated with malaria infection were poor adherence to co-trimoxazole prophylaxis [Adjusted Odds Ratio (AOR) = 6.81, 95%CI=1.35-34.43, P=0.02] and severe anaemia (AOR=10.77, 95%CI=1.38-84.05, P=0.022). The prevalence of anaemia was 54 % (227/420). Factors associated with anaemia were WHO clinical stage II (AOR=3.08, 95%CI=1.46-6.49, P=0.003), WHO clinical stage III or IV (AOR=2.65, 95%CI=1.18-5.95, P=0.018), poor adherence to co-trimoxazole prophylaxis (AOR=1.75, 95%CI=1.03-2.98, P=0.039), malaria infection (AOR=10.36, 95%CI=1.33-80.8, P=0.026) and history of episodes of malaria illness during current pregnancy (AOR=1.75, 95%CI=1.00-3.03 and P=0.048). Conclusion: The study showed a low prevalence of malaria; however, a significant proportion of subjects had anaemia. Efforts for monitoring of adherence to co-trimoxazole prophylaxis and mitigation of advanced HIV/AIDS are needed in order to reduce the burden of malaria and anaemia among HIV infected pregnant women.