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

No one wants an STD — sexually-transmitted disease — and state health officials encourage safe sex practices for prevention and testing for at-risk behavior.

Statewide, a total of 561 cases of early infectious syphilis were reported for the first nine months of 2010, slightly lower than the same time last year. In North Carolina, one in 268 people is infected with HIV disease, according to the North Carolina Department of Health and Human Services. this number includes those who may not be aware they are infected.

New research indicates medications that might prevent the spread of HIV with a daily pill may eventually become available, according to North Carolina State Health Director Jeff Engel.

“The research into HIV prevention is groundbreaking,” Engel said. “The medication was tested in specific high-risk populations, and it is effective when used along with regular testing, the use of condoms and other prevention methods.”

Though medical prevention may be in the future, Engel urges regular testing for HIV and other sexually transmitted diseases as the best and most effective way to stop the spread in the state.

“until more studies are done, we encourage anyone who is sexually active to learn their HIV and STD status,” Engel said. “They can then take steps to protect their own health and the health of their partner.”

North Carolina AIDS Director Jacquelyn Claymore pointed to recognizing symptoms and getting tested as important steps to take to prevent the spread of disease.

“Testing for HIV and sexually transmitted diseases is available across the state at local health departments and other health centers,” Claymore said. “Responding to possible symptoms and going to the doctor earlier, rather than later, ensures that patients will get the treatment and advice they need.”

HIV — or the human immunodeficiency virus — causes AIDS, acquired immunodeficiency syndrome. Many people who become infected with HIV develop some early symptoms two to four weeks after they were infected. The most common symptoms are fever, sore throat, swollen lymph nodes and a rash that usually consists of small raised or flat lesions scattered all over the body, Claymore said.

All STD screenings are offered by any health department in North Carolina free of charge, said Lenoir County Health Director Joey Huff.

“Testing for HIV and STDs are available at the health department by appointment, and they are free to anyone,” Huff said. “If there is any question regarding at-risk behavior or unsafe sex practices, by all means we encourage that individual to be screened for the infection.”

Joel Gerber can be reached at 252-599-1076 or jgerber@freedomenc.com.

Breakout Box:

STDs reported in 2010

Lenoir County

Jones County

Greene County

North Carolina

Source: North Carolina Department of Health and Human Services