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The Association Between Malaria, Blood Transfusions, and HIV Seropositivity in a Pediatric Population in Kinshasa, Zaire
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
JAMA. 1988;259(4):545-549.
Abstract
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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)
Author Affiliations
From the Malaria Branch (Drs Greenberg, Nguyen-Dinh, and Campbell), the Division of Parasitic Diseases (Ms Roberts), and AIDS Program (Drs Mann and Curran), Center for Infectious Diseases, Centers for Disease Control, Atlanta; Project SIDA (Drs Mann, Colebunders, and Francis), the Ministry of Public Health and Social Affairs (Dr Kabeya), and the Department of Pediatrics, Mama Yemo Hospital (Drs Kabote, Baudoux, Lyamba, and Davachi), Kinshasa, Zaire; the Institute of Tropical Medicine, Antwerp, Belgium, Belgian Zairian Medical Cooperative (Dr Colebunders); and the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md (Drs Francis and Quinn).
Footnotes
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).
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