It is malaria, not AIDS, that remains Africa鈥檚 most serious disease.
The World health Organization estimates that more that 107 million people
contract malaria each year around the world. Researchers are now trying
to establish whether HIV affects the course of this disease and others,
such as tuberculosis, that are endemic in Africa.
Most of the small studies conducted so far have not found any significant
differences in the way that HIV-positive and HIV-negative people respond
to malaria. But one study presented in Kinshasa suggests that infection
with HIV may reduce that partial immunity that people acquire to malarial
parasites.
Sister Davnet O鈥橩ane works at the Kitovu Hospital in Masaka in southern
Uganda 鈥� one of Africa鈥檚 worst-hit regions for AIDS. Almost a quarter of
the blood donors for the region are HIV-positive. Malaria causes severe
anaemia, which raises the demand for blood transfusions. 鈥楳alaria is as
big a problem as AIDS for us,鈥� says O鈥橩ane.
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O鈥橩ane and her colleagues studied 108 patients who were admitted with
severe malaria. Forty-eight were HIV-positive. The HIV-positive people had
significantly larger amounts of the malarial parasite, Plasmodium falciparum,
in their blood than the HIV-negative group. They responded less well to
treatment with the antimalarial drug chloroquine 鈥� 56 per cent responded
compared with 93 per cent of the HIV-negative group 鈥� and they spend almost
twice as long in hospital.
Those in the HIV-positive group who failed to respond to chloroquine
had to have alternative medication. Seven of the 48 were so anaemic that
they needed transfusions. More of the HIV-positive group suffered reduced
consciousness and seven died.
O鈥橩ane stresses that this case study needs to be followed by a psospective,
long-term study on a larger scale.
Several groups confirmed that infection with HIV appears to increase
greatly the risk of tuberculosis. For example, a team at Project SIDA in
Kinshasa found that 19 out of 249 HIV-positive women developed TB over 32
months compared with only one woman out of 310 HIV-negative women. And a
study from Kigali, Rwanda, found that HIV-positive women were 42 times as
likely as uninfected women to develop active TB. Michael Merson, director
of the WHO鈥檚 Global Programme on AIDS said Africa faced 鈥榓 parallel epidemic鈥�
of TB asd HIV spreads.
