Placental malaria in human immunodeficiency virus positive and negative parturient at term: A comparative cross -sectional study

Background: The burden of malaria is severe in Africa, affecting mainly pregnant women and their unborn children. Malaria and Human Immunodeficiency Virus (HIV) combined account for 9% of the total burden of diseases in sub-Saharan Africa, with more than 80% of the related global deaths occurring in tropical Africa. Objective: We compared the proportion of placenta malaria in HIV positive and negative parturients at term and evaluated for possible associated factors. Methods: This was a prospective comparative cross-sectional study in which 90 HIV positive and 90 HIV negative pregnant women who at term had a full-thickness placenta biopsy, following delivery, for assessment of placenta malaria parasitemia. Their peripheral venous blood was also tested malaria parasite. Demographic and baseline variables were summarized using descriptive statistics. Comparison of continuous variables was done using student’s t-test and categorical variables were compared using the Ch square or Fisher ‘exact test as appropriate. 95% confidence interval and significant at reported at p<0.05. Findings: Placenta malaria was present in 11.1% of HIV positive women and in 21.1% of HIV negative women although all women in both groups were negative for malaria parasite on peripheral venous blood microscopy. Most of the positive pregnant women (80%) who had placenta malaria had previously been treated for malaria in pregnancy and this was about 10 times more (8.8%) than in women without placenta malaria (<0.001), thus was similar in HIV negative women. Conclusion: HIV positive pregnant women on HAART had about 2 -fold less prevalence of placenta malaria compare to HIV negative women. Both HIV positive and negative women who had been previously treated for malaria were significantly more likely to have placenta malaria compare to women who were not treated for malaria in pregnancy.