Hematological predictors of increased severe anemia in Kenyan children coinfected with Plasmodium falciparum and HIV‐1

Abstract

Malaria and HIV-1 are coendemic in many developing countries, with anemia being the most common pediatric hematological manifestation of each disease. Anemia is also one of the primary causes of mortality in children monoinfected with either malaria or HIV-1. Although our previous results showed HIV-1 (+) children with acute Plasmodium falciparum malaria [Pf (+)] have more profound anemia, potential causes of severe anemia in coinfected children remain unknown. As such, children with P. falciparum malaria (aged 3–36 months, n= 542) from a holoendemic malaria transmission area of western Kenya were stratified into three groups: HIV-1 negative [HIV-1 (−)/Pf (+)]; HIV-1 exposed [HIV-1 (exp)/Pf (+)]; and HIV-1 infected [HIV-1 (+)/Pf (+)]. Comprehensive clinical, parasitological, and hematological measures were determined upon enrollment. Univariate, correlational, and hierarchical …