Background: Human immunodeficiency virus (HIV)-1 infection increases the burden of malaria by increasingsusceptibility to infection and decreasing the response to malarial treatment. HIV-1 has also been found tosuppress the immune system and predispose to severe forms of malaria in adults. There is still a paucity of data onthe association between HIV-1 infection and cerebral malaria in children. The aim of this study was to determinewhether HIV-1 infection is a risk factor for cerebral malaria in children.Method: We conducted an unmatched case-control study, in which 100 children with cerebral malaria werecompared with 132 with uncomplicated malaria and 120 with no malaria. In stratified analyses we estimated oddsratios (ORs) and 95% confidence intervals (CIs) adjusted for age.Results: HIV-1 infection was present in 9% of children with cerebral malaria compared to 2.3% in uncomplicatedmalaria (age-adjusted odds ratio (aOR) 5.94 (95% confidence interval (CI) 1.36-25.94, p = 0.012); and 2.5% inchildren with no malaria (aOR 3.85 (95% CI0.99-14.93, p = 0.037). The age-adjusted odds of being HIV-positiveamong children with cerebral malaria compared to the control groups (children with uncomplicated malaria andno malaria) was 4.98 (95% CI 1.54-16.07), p-value = 0.003.Conclusions: HIV-1 infection is associated with clinical presentation of cerebral malaria in children. Cliniciansshould ensure that children diagnosed with HIV infection are initiated on cotrimoxazole prophylaxis as soon as thediagnosis is made and caretakers counselled on the importance of adherence to the cotrimoxazole towardsreducing the risk of acquiring P.falciparum malaria and associated complications such as cerebral malaria. Othermalaria preventive measures such as use of insecticide-treated mosquito nets should also be emphasized duringcounselling sessions.
