Impact of Prophylaxis with Cotrimoxazole on Malaria Parasitaemia, PCV and CD4+ count in HIV-infected Pregnant Women in Jos, Nigeria

Abstract

The effect of prophylaxis with Cotrimoxazole (CTX) against malaria parasitaemia and other pregnancy outcomes among HIV-infected pregnant women in Jos was investigated. Peripheral blood from study women was used to prepare thin and thick blood smears for the identification and estimation of malaria parasitaemia as well as immunological and haematological investigations. Sulfadoxine pyrimethamine (SP) was used as control, being the standard used for prophylaxis against malaria in pregnant women. Result shows that Prevalence of malaria infection was reduced from 34.1-7.2% and from 25-10% among group A and B respectively. Mean parasitaemia was reduced from 1984.76 asp/µ to 1000.00 asp/µl and from 1960.38 asp/µ to 1118.18 asp/µ for CTX an SP respectively. Mean packed cell volume (PCV) was reduced from 33.09-33.02% with CTX and from 33.11-32.90% with SP. Mean CD4+ count increased from 223.55 cells/µl to 300.54 cells/µl with CTX but decreased from 570 cells/µl to 536.4 cells/µl with SP. Prophylaxis with CTX is associated with 89% reduction in parasitaemia, with immunological but no haematological benefits, while prophylaxis with standard Sp is associated with 76% reduction in malaria parasitaemia with neither immunological nor haematological benefits. There was no statistical difference between the two drugs throughout the study. The use of cotrimoxazole for antimalarial prophylaxis among HIV-infected pregnant women is strongly supported but with close monitoring of their PCV so as to detect and treat any possible anaemia.