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Background: The seroprevalence of Brucella infection in sub-Saharan regions is high, and no recent data are available for Malawi, a country in which >60% of the population is involved in agropastoral activity. Aim: To evaluated the seroprevalence of Brucella in a cohort of HIV-positive pregnant women, living in an urban setting in Malawi. Methods: Sera of 201 pregnant women were tested for Brucella IgG. The Rose Bengal Plate Test and Serum Agglutination Tube test were used to determine antibody titer. Results: Five out of 201 (2.48%) women show positivity to Brucella, consistent with a past exposition to the infection. All five women delivered healthy infants, but two of them reported previous abortion/stillbirths, with a higher rate than those of the rest of the cohort (40% vs. 21.5%). Conclusions: This is one of the first reports of exposure of pregnant women to Brucella infection in Malawi, providing evidence of Brucella occurrence in an urban setting. Control programs should be introduced to reduce its impact on animal and human health. [ABSTRACT FROM AUTHOR]

HIV-infected patients have increased risk of noncommunicable diseases (NCDs). HIV+ patients in Africa are experiencing growing comorbidities due to increase in life expectancy and long-time antiretroviral therapy (ART). HIV prevalence in Malawi is one of highest in the world (10.8% in women and 6.4% in men); few data are available about NCDs epidemiology in HIV+ elderly patients in Malawi. A retrospective analysis of routine medical records in 14 health centers run by Disease Relief through Excellent and Advanced Means (DREAM) program in Malawi was carried out. All HIV+ patients aged >40 years in care in the period January 01, 2017–December 31, 2018 were included. Clinical and laboratory features were collected in the last visit of the study period. Files from 7,071 patients (62.1% women) in ART were analyzed, 362 (5.1%) were aged >65 years. Median time on ART was 98.9 (64.8–118.0) months; median body mass index, haemoglobin (HB), and CD4 count were, respectively, 21.63 kg/m2 (19.5–24.5), 13 mg/dL (12–14), and 457 cell/mm3 (328–613). Elderly patients >65 years were more likely to be malnourished (odds ratio [OR] = 2.0, confidence interval [CI]: 1.54–2.59), diagnosed with arterial hypertension (OR = 2.5, CI: 1.94–3.43), affected with diabetes (OR = 2.7, CI: 1.25–6.22), have macrocytic anemia (OR = 2.5, CI: 2.00–3.35), and increased serum creatinine (OR = 1.5, CI: 1.03–2.43]). Other factors were associated with NCD burden, but age remained always independently related. Two concomitant chronic conditions in addition to HIV were present in 19.2% (66/343) of elderly people and 5.2% (338/6.454) of patients aged <65 years (OR = 4.3, CI: 3.22–5.76). Some associations were observed: nevirapine (NVP) was associated with kidney disease (OR = 1.5, CI: 1.22–2.06), NVP and protease inhibitor (PI) with hypertension (OR = 2.79, CI: 2.16–3.35 and OR = 2.15, CI: 1.52–3.02), azidothymidine (AZT) with macrocytic anemia (OR = 15.6, CI: 13.18–18.68). NVP, AZT, and duration of any ART >3 years were associated with the presence of two or more comorbidities (OR = 2.1 1.54–2.96, OR = 2.6 1.87–3.71, and OR = 1.7 1.12–2.84). Our data show the burden of NCDs in aging HIV+ patients in Malawi. The expansion of HIV treatment programs will require special attention to such comorbidities in elderly patients. [ABSTRACT FROM AUTHOR]