Plasmodium falciparum Biomass and Haematological Changes during Treatment of HIV/AIDS Patients in Western Kenya

Background: Monitoring and evaluation (M & E) of anti-malarial treatment among people living with HIV/AIDS (PLWHA) is very important to assess the response and change in malaria parasite biomass in an endemic area. Published data have shown that HIV-related immunosuppression correlates with increased malaria biomass, treatment failure and complicated outcome despite an individual's immune status. We evaluated blood samples from PLWHA based on malaria parasite biomass and haematological changes during anti-malarial treatment

Aim: To evaluate Plasmodium falciparum biomass and haematological changes during antimalarial treatment of PLWHA.

Settings and Designs: Cross-sectional and descriptive study design

Subjects and Methods: A randomized antimalarial treatment involving 126 subjects was carried out in a hospital setup in Western Kenya. Blood samples were collected and analysed to determine malaria parasitaemia, changes in parasite biomass and haemoglobin levels in 28 days among PLWHA following treatment with Quinine and Coartem® antimalarial drugs. Descriptive and chi-square tests were used to determine the association of parasitaemia with gender and relevant haematological changes during treatment.

Results: A significant difference between females and males of those with parasitaemia on day-3 was noticed (p - 0.031). Quinine and Coartem® arms recorded a 100% parasite deletion/clearance by day-14 but showed recurrence on day-21 of 6.3% and 3.1% of day-14 respectively. On day-28 the Quinine arm had higher parasitaemia (306.3%). Mean Hb improved from 11.0 gm/dL to 11.6 gm/dL by day-28.

Conclusion: Recurrence of malaria parasite biomass was noticeable from day-21 to day-28 with Quinine arm of recipients and by day-28 haematological parameters had improved indicating recovery. Routine M &E of malaria cases and haematinic agent dosages to correct anaemia among PLWHA are recommended.