The effect of dual infection with HIV and malaria on pregnancy outcome in western Kenya

AIDS. 2003 Mar 7;17(4):585-94. doi: 10.1097/00002030-200303070-00014.


Objective: To determine the effect of dual infection with HIV and malaria on birth outcomes and maternal anaemia among women delivering at a large public hospital in Kisumu, western Kenya.

Subjects and methods: Data on obstetric and neonatal characteristics, maternal and placental parasitaemia, and postpartum haemoglobin levels were collected from women enrolled in a cohort study of the interaction between malaria and HIV during pregnancy.

Results: Between 1996 and 1999, data were available from 2466 singleton deliveries. The maternal HIV seroprevalence was 24.3%, and at delivery 22.0% of the women had evidence of malaria. Low birthweight, preterm delivery (PTD), intrauterine growth retardation (IUGR) and maternal anaemia (haemoglobin < 8 g/dl) occurred in 4.6, 6.7, 9.8 and 13.8% of deliveries, respectively. Maternal HIV, in the absence of malaria, was associated with a 99 g (95% CI 52-145) reduction in mean birthweight among all gravidae. Malaria was associated with both IUGR and PTD, resulting in a reduction in mean birthweight of 145 g (95% CI 82-209) among HIV-seronegative and 206 g (95% CI 115-298) among HIV-seropositive primigravidae, but not among multigravidae. Both HIV and malaria were significant risk factors for postpartum maternal anaemia, and HIV-seropositive women with malaria were twice as likely to have anaemia than HIV-seronegative women with or without malaria.

Conclusion: Women with dual infection are at particular risk of adverse birth outcomes. In areas with a moderate or high prevalence of HIV and malaria, all pregnant women should be the focus of malaria and anaemia control efforts to improve birth outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Anemia / parasitology
  • Anemia / virology
  • Female
  • Fetal Growth Retardation / parasitology
  • Fetal Growth Retardation / virology
  • HIV Seropositivity / complications*
  • HIV-1*
  • Hospitals, Public
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Kenya
  • Malaria, Falciparum / complications*
  • Obstetric Labor, Premature / microbiology
  • Obstetric Labor, Premature / parasitology
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Pregnancy Complications, Parasitic*