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January 22, 1988, Vol 259, No. 4 >
ARTICLE | January 22, 1988

The Association Between Malaria, Blood Transfusions, and HIV Seropositivity in a Pediatric Population in Kinshasa, Zaire FREE

Alan E. Greenberg, MD; Phuc Nguyen-Dinh, MD, MPH; Jonathan M. Mann, MD, MPH; Ndoko Kabote, MD; Robert L. Colebunders, MD; Henry Francis, MD; Thomas C. Quinn, MD; Paola Baudoux, MD; Bongo Lyamba, MD; Farzin Davachi, MD; Jacquelin M. Roberts, MS; Ngandu Kabeya; James W. Curran, MD, MPH; Carlos C. Campbell, MD, MPH
[+] Author Affiliations

Use of trade names is for identification only and does not constitute endorsement by the Department of Health and Human Services or its agencies.

Reprint requests to Malaria Branch C-22, Division of Parasitic Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Greenberg).


JAMA. 1988;259(4):545-549. doi:10.1001/jama.1988.03720040037023
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Since Plasmodium falciparum malaria is a frequent cause of anemia among African children, and blood transfusions, unscreened for human immunodeficiency virus (HIV) antibody, are used frequently in the treatment of children with severe malaria, the relationships between malaria, transfusions, and HIV seropositivity were investigated in a pediatric population in Kinshasa, Zaire. In a cross-sectional survey of 167 hospitalized children, 112 (67%) had malaria, 78 (47%) had received transfusions during the current hospitalization, and 21 (13%) were HIV seropositive. Ten of the 11 seropositive malaria patients had received transfusions during the current hospitalization; pretransfusion specimens were available for four of these children and were seronegative. Of all blood transfusions, 87% were administered to malaria patients, and there was a strong dose-response association between transfusions and HIV seropositivity. A review of 1000 emergency ward records demonstrated that 69% of transfusions were administered to malaria patients, and 97% of children who received transfusions had pretransfusion hematocrits of 0.25 or less (≤25%). The treatment of malaria with blood transfusions is an important factor in the exposure of Kinshasa children to HIV infection.

(JAMA 1988;259:545-549)

REFERENCES

1 +
Clumeck N, Sonnet J, Taelman H, et al:  Acquired immunodeficiency syndrome in African patients. N Engl J Med 1984;;310:492-497.
2 +
Piot P, Quinn TC, Taelman H, et al:  Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lancet 1984;;2:65-69.
3 +
Van de Perre P, Rouvroy D, Lepage P, et al:  Acquired immunodeficiency syndrome in Rwanda. Lancet 1984;;2:62-65.
4 +
Van de Perre P, Clumeck N, Carael M, et al:  Female prostitutes: A risk group for infection with human T-cell lymphotropic virus type III. Lancet 1985;;2:524-526.
5 +
Clumeck N, Robert-Guroff M, Van de Perre P, et al:  Seroepidemiologic studies of HTLV-III antibody among selected groups of heterosexual Africans. JAMA 1985;;254:2599-2602.
6 +
Kreiss JK, Koech D, Plummer FA, et al:  AIDS virus infection in Nairobi prostitutes: Spread of the epidemic to East Africa. N Engl J Med 1986;;314:414-418.
7 +
Serwadda D, Mugerwa RD, Sewankambo NK, et al:  Slim disease: A new disease in Uganda and its association with HTLV-III infection. Lancet 1985;;2:849-852.
8 +
Mann JM, Francis H, Quinn T, et al:  Surveillance for AIDS in a Central African city: Kinshasa, Zaire. JAMA 1986;;255:3255-3259.
9 +
Biggar RJ, Gigase PL, Melbye M, et al:  ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complexes in healthy Africans. Lancet 1985;;2:520-523.
10 +
Volsky DJ, Yin Tang Wu, Stevenson M, et al:  Antibodies to HTLV-III/LAV in Venezuelan patients with acute malarial infections. N Engl J Med 1986;;314:647-648.
11 +
Greenberg AE, Schable CA, Sulzer AJ, et al:  Evaluation of serological cross-reactivity between antibodies to Plasmodium and HTLV-III/LAV Lancet 1986;;2:247-249.
12 +
Miller LH:  Malaria , in Warren KS, Mahmoud AAF (eds): Tropical and Geographic Medicine . New York, McGraw-Hill International Book Co, 1984;, pp 223-239.
13 +
Mann JM, Francis H, Davachi F, et al:  HTLV-III/LAV seroprevalence in pediatric in-patients 2-14 years old in Kinshasa, Zaire. Pediatrics 1986;;78:673-677.
14 +
Mann JM, Francis H, Davachi F, et al:  Risk factors for human immunodeficiency virus seropositivity among children 1-24 months old in Kinshasa, Zaire. Lancet 1986;;2:654-657.
15 +
Tsang VCW, Peralta JM, Simons AR:  Enzyme-linked immunoelectrophoresis transfer blot techniques (EITB) for studying the specificities of antigens and antibodies separated by gel electrophoresis , in Landgone JJ, Vunakie HV (eds): Methods in Enzymology Immunochemical Techniques , part E. Orlando, Fla, Academic Press Inc, 1983;, pp 377-391.
16 +
Curran JW, Lawrence DN, Jaffe H, et al:  Acquired immunodeficiency syndrome (AIDS) associated with transfusions. N Engl J Med 1984;; 310:69-75.
17 +
Menitove JE:  Status of recipients of blood from donors subsequently found to have antibody to HIV N Engl J Med 1986;;315:1095-1096.
18 +
Ward JW, Deppe DA, Samson S, et al:  Risk of human immunodeficiency virus infection from blood donors who later developed the acquired immunodeficiency syndrome. Ann Intern Med 1987;;106:61-62.
19 +
Ngimbi NP, Wery M, Henry MC, et al:  Response in vivo a la chloroquine au cours du traitement du paludisme a Plasmodium falciparum en region suburbaine de Kinshasa, Zaire. Ann Soc Belg Med Trop 1985;;65:123-125.
20 +
Nguyen-Dinh P, Greenberg AE, Kabote N, et al:  Plasmodium falciparum in Kinshasa, Zaire: In vitro drug susceptibility studies. Am J Trop Med Hyg 1987;;37:217-219.

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1 +
Clumeck N, Sonnet J, Taelman H, et al:  Acquired immunodeficiency syndrome in African patients. N Engl J Med 1984;;310:492-497.
2 +
Piot P, Quinn TC, Taelman H, et al:  Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lancet 1984;;2:65-69.
3 +
Van de Perre P, Rouvroy D, Lepage P, et al:  Acquired immunodeficiency syndrome in Rwanda. Lancet 1984;;2:62-65.
4 +
Van de Perre P, Clumeck N, Carael M, et al:  Female prostitutes: A risk group for infection with human T-cell lymphotropic virus type III. Lancet 1985;;2:524-526.
5 +
Clumeck N, Robert-Guroff M, Van de Perre P, et al:  Seroepidemiologic studies of HTLV-III antibody among selected groups of heterosexual Africans. JAMA 1985;;254:2599-2602.
6 +
Kreiss JK, Koech D, Plummer FA, et al:  AIDS virus infection in Nairobi prostitutes: Spread of the epidemic to East Africa. N Engl J Med 1986;;314:414-418.
7 +
Serwadda D, Mugerwa RD, Sewankambo NK, et al:  Slim disease: A new disease in Uganda and its association with HTLV-III infection. Lancet 1985;;2:849-852.
8 +
Mann JM, Francis H, Quinn T, et al:  Surveillance for AIDS in a Central African city: Kinshasa, Zaire. JAMA 1986;;255:3255-3259.
9 +
Biggar RJ, Gigase PL, Melbye M, et al:  ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complexes in healthy Africans. Lancet 1985;;2:520-523.
10 +
Volsky DJ, Yin Tang Wu, Stevenson M, et al:  Antibodies to HTLV-III/LAV in Venezuelan patients with acute malarial infections. N Engl J Med 1986;;314:647-648.
11 +
Greenberg AE, Schable CA, Sulzer AJ, et al:  Evaluation of serological cross-reactivity between antibodies to Plasmodium and HTLV-III/LAV Lancet 1986;;2:247-249.
12 +
Miller LH:  Malaria , in Warren KS, Mahmoud AAF (eds): Tropical and Geographic Medicine . New York, McGraw-Hill International Book Co, 1984;, pp 223-239.
13 +
Mann JM, Francis H, Davachi F, et al:  HTLV-III/LAV seroprevalence in pediatric in-patients 2-14 years old in Kinshasa, Zaire. Pediatrics 1986;;78:673-677.
14 +
Mann JM, Francis H, Davachi F, et al:  Risk factors for human immunodeficiency virus seropositivity among children 1-24 months old in Kinshasa, Zaire. Lancet 1986;;2:654-657.
15 +
Tsang VCW, Peralta JM, Simons AR:  Enzyme-linked immunoelectrophoresis transfer blot techniques (EITB) for studying the specificities of antigens and antibodies separated by gel electrophoresis , in Landgone JJ, Vunakie HV (eds): Methods in Enzymology Immunochemical Techniques , part E. Orlando, Fla, Academic Press Inc, 1983;, pp 377-391.
16 +
Curran JW, Lawrence DN, Jaffe H, et al:  Acquired immunodeficiency syndrome (AIDS) associated with transfusions. N Engl J Med 1984;; 310:69-75.
17 +
Menitove JE:  Status of recipients of blood from donors subsequently found to have antibody to HIV N Engl J Med 1986;;315:1095-1096.
18 +
Ward JW, Deppe DA, Samson S, et al:  Risk of human immunodeficiency virus infection from blood donors who later developed the acquired immunodeficiency syndrome. Ann Intern Med 1987;;106:61-62.
19 +
Ngimbi NP, Wery M, Henry MC, et al:  Response in vivo a la chloroquine au cours du traitement du paludisme a Plasmodium falciparum en region suburbaine de Kinshasa, Zaire. Ann Soc Belg Med Trop 1985;;65:123-125.
20 +
Nguyen-Dinh P, Greenberg AE, Kabote N, et al:  Plasmodium falciparum in Kinshasa, Zaire: In vitro drug susceptibility studies. Am J Trop Med Hyg 1987;;37:217-219.

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