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dc.contributor.authorBerg, Åseeng
dc.contributor.authorPatel, Sameng
dc.contributor.authorAukrust, Påleng
dc.contributor.authorDavid, Catarinaeng
dc.contributor.authorGonca, Migueleng
dc.contributor.authorBerg, Einar Sverreeng
dc.contributor.authorDalen, Ingvildeng
dc.contributor.authorLangeland, Ninaeng
dc.date.accessioned2015-02-25T12:12:30Z
dc.date.available2015-02-25T12:12:30Z
dc.date.issued2014-02-05eng
dc.identifier.issn1932-6203eng
dc.identifier.urihttp://hdl.handle.net/1956/9435
dc.description.abstract<p>Background: Co-infection with falciparum malaria and HIV-1 increases the severity and mortality of both infections in unstable malaria-transmission areas. In contrast, in stable transmission areas, HIV co-infection increases the severity of both infections but has not been found to influence malaria mortality.</p> <p>Methods: In a prospective cross-sectional study, clinical and laboratory data were consecutively collected for all adults admitted with fever and/or suspected malaria to the medical department of the Central Hospital of Maputo, Mozambique, during two malaria seasons from January 2011. Malaria and HIV PCRs were performed, and risk factors for fatal outcomes were analysed. The impact of HIV on the clinical presentation and mortality of malaria was assessed.</p> <p>Findings: A total of 212 non-pregnant adults with fever and/or suspected malaria and 56 healthy controls were included in the study. Of the 131 patients with confirmed falciparum malaria, 70 were co-infected with HIV-1. The in-hospital mortality of the co-infected patients was 13.0% (9/69) compared with 1.7% (1/59) in the patients without HIV (p = 0.018). Malaria severity (p = 0.016) and co-infection with HIV (p = 0.064) were independent risk factors for death although the association with HIV did not reach statistical significance. The co-infected patients had significantly more frequent respiratory distress, bleeding disturbances, hypoglycaemia, liver and renal failure and high malaria parasitemia compared with the patients with malaria alone.</p> <p>Interpretations: HIV co-infection is associated with increased disease severity in and mortality from malaria in an area of stable malaria transmission. This finding was not observed earlier and should motivate doctors working in malaria-endemic areas to consider early HIV testing and a closer follow-up of patients with malaria and HIV co-infection.</p>en_US
dc.language.isoengeng
dc.publisherPLoSeng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.titleIncreased severity and mortality in adults co-infected with malaria and HIV in Maputo, Mozambique: a prospective cross-sectional studyeng
dc.typeJournal articleeng
dc.date.updated2015-02-25T12:08:41Z
dc.rights.holderCopyright 2014 Berg et al.
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
bora.journalTitlePLoS ONEeng
bibo.volume9eng
bibo.issue2eng
bibo.numbere88257eng
bibo.doihttp://dx.doi.org/10.1371/journal.pone.0088257eng
bora.accessRightsinfo:eu-repo/semantics/openAccesseng
dc.identifier.cristinID1147050eng
dc.identifier.doi10.1371/journal.pone.0088257


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