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Table 2 Overview of African studies on geometric mean parasite densities during uncomplicated symptomatic malaria, by HIV-1 status of the patient

From: The impact of HIV-1 on the malaria parasite biomass in adults in sub-Saharan Africa contributes to the emergence of antimalarial drug resistance

Study Setting Median age (range) # patients (or malaria episodes, if indicated) Parasite density, HIV-positive vs. HIV negative patients Parasite density in HIV-infected: immune-suppressed vs. not immune-suppressed*
CHILDREN HIGH ENDEMICITY    Values % change P-value Values % change P-value
Shaffer [45] Zaire, 1988 3.3 y 166 (6 HIV+) 93 325 vs 8 913/μL 947% 0.04 ---   
Mermin, 2004 [46] Uganda, 2001–3 0–5 y NR 154 vs 61/200 WBC 152% 0.03 ---   
Kamya, 2006 [47] Uganda, 2002–4 3 y 1802 28 186 vs 20 076/μL 40% NS ---   
Otieno, 2006 [19] Kenya, 2003–4 11 m 317 48 356 vs 47 245/μL 2% NS ---   
Greenberg, 2001 [17] DRC, 1986–8 5–21 m 271 episodes 4 173 vs 3 854/μL 8% NS AIDS vs. HIV positive: 11256 vs 2394/μL 370% 0.068
Taha, 1994 [48] Malawi, 1989 0–18 m 564 episodes ---   NS ---   
Colebunders, 1990 [49] Zaire, 1986–7 7 y 59 3 210 vs 4 170/μL -23% NS ---   
Muller, 1990 [50] Uganda, 1989 11 m 75 ---   NS ---   
ADULTS HIGH ENDEMICITY         
Mermin, 2004 [46] Uganda, 2001–3 34 y 90 episodes ---   NS <200 vs. ≥ 200 CD4/μL: 60 vs. 24/200 WBC 185% 0.02
French [21] Uganda, 1995–98 31 y 153 episodes ---    Association low CD4 ↔ high parasite density   0.0001
Kamya, 2006 [47] Uganda, 2002–4 28 y 163 20 537 vs 15 174/μL 35% NS ---   
Laufer, 2006 [22] Malawi, 2002–3 31.7 y 203 ---    Association low CD4 ↔ high parasite density   0.005
Van geertruyden, 2006 [37] Zambia, 2003–5 27 y (15–50) 971 8 715 vs 8 538/μL 2% NS <300 vs. ≥ 300 CD4/μL: 10 093 vs. 7328/μL 37% 0.03
Shah, 2006 [38] Kenya, 2002–4 Adults 619 11 732 vs 9 516/μL 22% NS <200 vs ≥ 200CD4/μL: 22 515 vs. 8232/μL 173%, <0.005
Francesconi, 2001 [18] Uganda, 2000 25 y 170 ---   NS ---   
Whitworth, 2000 [1] Uganda, 1990–98 35 y 559 episodes ---   NS Association low CD4 ↔ high parasite density   0.02
Simooya [51] Zambia, 1988 >12 y 170 ---   0.10 ---   
Muller, 1990 [50] Uganda, 1989 26 y 200 ---   NS ---   
CHILDREN LOW ENDEMICITY         
Kalyesubula, 1997 [18] Uganda, 1988 0–4 y 635 episodes ---   NS ---   
Grimwade, 2003 [52] South Africa, 2000 7 y 663 ---   NS ---   
ADULTS LOW ENDEMICITY         
Atzori, 1993 [2] Tanzania, 1991 18–41 y 300 ---   NS ---   
Grimwade, 2004 [16] South Africa, 2000 30 y 613 16.7% vs 12.5%* 34% 036 ---   
Birku, 2002 [36] Ethiopia, 2000 31 y 19 27 486 vs 32 892/μL -16% NS ---   
  1. Abbreviations: NS = non-significant; --- = Not reported; m = months; y = years; RR = relative risk; WBC = white blood cells. *All studies except for [23] measured CD4 count during malaria episodes, which, due to the temporary decrease in CD4 caused by symptomatic malaria [24], probably inflated the CD4 threshold below which HIV-related immune-suppression starts to increase malaria incidence.