At seven government rural health clinics in Uganda from December 2006 to January 2007, it was estimated that between one and three percent of all adults who came to the clinics with suspected malaria were also diagnosed with acute or early HIV infection.

Recent evidence shows that testing for HIV in people who are suspected of having malaria could help discover people who recently got HIV in countries with a high HIV burden. This scientific claim allows for a new approach of testing both diseases; they can integrate HIV and malaria control activities at the primary care level, particularly if there are better developed and implemented care tests for diagnosing acute HIV infection. Providing regular primary care and a focus on the diagnosis and treatment of malaria in sub-Saharan Africa will be a unique prospect to discover a great number of people with acute HIV infection by offering point-of-care HIV testing and counseling.

Acute HIV has symptoms that mimic the ones of malaria.  In sub-Saharan Africa, where the burden of HIV is the greatest, more than 300 million people are diagnosed with malaria. Between 30 to 50 percent of the health clinic visits are due to flu-like symptoms for which patients are instantaneously diagnosed with malaria disregarding another cause for the flu-like symptoms (acute HIV aids). therefore, many people miss the opportunity to get treated and prevent the HIV transmission.

The author conducted a cross-sectional study to examine the percentage of people diagnosed with malaria who instead have acute HIV aids.  The study results   show that a great number of people with suspected malaria were actually suffering from acute HIV aids. The detailed statistics of this study can be viewed at the end of this summary.

People with flu-like symptoms in the sub-Saharan African region might have acute HIV aids. The authors believe that by examining patients who experience flu-like symptoms at general health clinics many people with acute or early infection can be classified. By adhering the test and acquiring a faster diagnosis of HIV aids when it is acute, the prevention of transmission can be successfully implemented.

Limitations of the study:

1. Cross-sectional analysis might have led to misclassification.
2. The method used for the study, which involved dried blood spots and pooling estimates,  could have miscalculated those with acute infection.
3. The resource-intensive nature of the testing used in this study is not sensible in most resource-poor settings.

The author’s findings create the potential for discovering a great number of Africans with acute or early HIV infection by synchronizing HIV and malaria control strategies. Being more careful with diagnosing malaria . Acute HIV aids in union with the appropriate counseling and continuum of treatment and care can be a significant step for global HIV prevention.

Results from the study:

1. 2893 (41%) who were included in the study had blood smears positive for malaria varying from 3.4%-30% by site.

2. 11.2%)  (324) were HIV-infected with site prevalence ranging from 1.4%-16.9%.

3. 26.5% of all HIV-positive adults were recognized as having acute (30 or 9.3%) or early (56 or 17.3%) HIV infection.

4. of the total population patients with acute, early and established infection represented 1.0%, 1.8% and 8% respectively.

5. Site prevalence for acute and early HIV infection varied ranging from 0.5% to 6% of all adult patients.

6. Site-level predictors for acute HIV infection, among all patients, included high HIV prevalence (greater than 10 percent) (OR 4.5, P=0.006) and low levels of endemic malaria (OR 2.8, P=0.015).

7. 4-6% of all adults suspected of having malaria and who met the criteria for acute HIV infection were from the three study sites with the highest HIV prevalence, ranging from 10.6% to 16.9%.

Tags: AIDS, diagnosis, HIV, Malaria, Sub-Saharan Africa, symptoms