Background
Malaria is well established as a major global health problem worldwide. Malaria, Human Immunodeficiency Virus (HIV) and tuberculosis are among the three most important global health problems of developing countries. Both of them together, cause more than four million deaths per year. The co-infection exists in many parts of the world. This is particularly true in sub-Saharan Africa, where an estimated 40 million people are living with HIV and more than 350 million episodes of malaria occur yearly. Malaria and HIV infections are also the most deleterious conditions in sub-Saharan African pregnant women, in terms of the morbidity and mortality they cause in mothers and their newborns.
In the DRC, malaria is reported to be the principal cause of morbidity and mortality, especially among vulnerable population like pregnant women and children less than five years of age. Close to 70% of all outpatient health care visits and an average of 30% of hospital admissions are malaria-related. A recent study in the DRC based on Demographic and Health Survey (DHS) in 2007 showed an increase risk for malaria in certain populations and regions of the DRC with higher prevalence in rural area than urban. In 2003, UNAIDS estimated that the prevalence of HIV in adult in DRC was 4.2% and 1.1 million people were living with HIV/AIDS. However, this prevalence among pregnant women was ranged from 2.7 to 5.4% in 1999 in urban area and 8.5% in rural area.
Understanding the epidemiology of malaria and HIV during pregnancy is important for deciding the best control strategies. Unfortunately, vital registration systems in sub-Saharan African countries have low coverage and do not produce accurate estimation of this co-infection. Health workers in the Congolese Army are unable to identify high or risk factors for both malaria and HIV infections so as to tailor interventions and do effective health monitoring. Moreover, pregnant women married to soldiers and single soldiers are habitually facing war-related poverty and human movements. Therefore, the study aims were to determine the magnitude, predictive factors, clinical, biologic and anthropometric consequences of malaria infection, HIV infection, and interactions between malaria and HIV infections in pregnant women.