Inter Press Service Examines HIV/Malaria CoinfectionInter Press Service on Tuesday examined issues surrounding HIV/malaria coinfection, particularly in Mozambique. Research during the past five years has suggested that severe malaria can further suppress the immune system of an HIV-positive person, according to Albert Kilian, a senior technical adviser for Malaria Consortium. "Patients suffer more often and more severely from malaria once their immune system starts to decline, and they will respond less quickly to treatment," he said. A pregnant HIV-positive woman who also has malaria is "likely to have more severe malaria symptoms and runs the risk of developing life-threatening anemia," Kilian said, adding that malaria adds to the risk of having a low-birthweight infant. Although there is "no solid evidence yet," some researchers believe that malaria also might increase HIV viral loads and the risk of mother-to-child HIV transmission, Kilian said. He added that anemia, which is common among children who have malaria more than once, also has been associated with increased mortality among HIV-positive children. It is possible for people living with HIV to minimize their vulnerability to malaria, Kilian said, adding that they should take prophylactic treatment using co-trimoxazol and antiretroviral drugs, if appropriate.
There are significant challenges to controlling the spread of HIV and malaria in Mozambique. According to Inter Press Service, Mozambique has an adult HIV prevalence of 16.6%, and malaria is endemic and transmitted throughout the year. Cases of the disease peak toward the end of the rainy season, which usually starts in September and ends by May. Addressing HIV/malaria coinfection is an additional challenge, primarily because of widespread poverty and a lack of access to basic health service. "Many people living with HIV/AIDS die of malaria, especially in the rural areas," Cesar Mufanequico, national director of the Mozambican Treatment Access Movement, said. Although the government distributes no-cost insecticde-treated nets to pregnant women and children younger than age five, Mufanequico said he wants the distribution of no-cost ITNs to HIV-positive people increased as well. "Many people living with HIV/AIDS die of malaria, especially in the rural areas," he said, adding, "Most do not have nets. We talk about fighting HIV/AIDS together with malaria and tuberculosis, but in practice, we often treat them separately" (Ayisi, Inter Press Service, 7/17). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.