Learning Objectives

Emerg Infect Dis

EID

Emerging Infectious Diseases

1080-60401080-6059

Centers for Disease Control and Prevention

2687015

08-1008

10.3201/eid1505.081008

Research

CME ACTIVITY: Increased Risk for Severe Malaria in HIV-1–infected Adults, Zambia

52009

155749749

Increased Risk for Severe Malaria in HIV-1-infected Adults, Zambia

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Medscape, LLC designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at http://www.medscape.com/cme/eid; (4) view/print certificate.

Learning Objectives

Upon completion of this activity, participants will be able to:

Describe the impact of HIV infection on malaria infection

Identify different levels of severity of malaria infection

Describe the presentation of severe malaria in patients infected with HIV-1 in one region in Zambia

Compare the risk for severe malaria in relation to CD4 count in patients infected with HIV-1

EDITOR

Karen L. Foster, Writer-Editor, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA; copyeditor, Emerging Infectious Diseases. Disclosure: Karen L. Foster has disclosed no relevant financial relationships.

CME AUTHOR

Désirée Lie, MD, MSEd, Clinical Professor, Family Medicine, University of California, Orange, California, USA; Director, Division of Faculty Development, UCI Medical Center, Orange. Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.

AUTHORS

Disclosures: Victor Chalwe, MD, MSc; Jean-Pierre Van geertruyden, MD, PhD; Doreen Mukwamataba, RN; Joris Menten, MSc; John Kamalamba, MD; Modest Mulenga, MD, PhD; and Umberto D’Alessandro, MD, PhD, have disclosed no relevant financial relationships.

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions and earn continuing medical education (CME) credit, please go to http://www.medscape.com/cme/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.com. If you are not registered on Medscape.com, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit is acceptable as evidence of participation in CME activities. If you are not licensed in the US and want to obtain an AMA PRA CME credit, please complete the questions online, print the certificate and present it to your national medical association.

Article Title: Increased Risk for Severe Malaria in HIV-1–infected Adults, ZambiaCME Questions

Which of the following best explains the large scale of the HIV-1–malaria interaction that has emerged in the last decade?

A. Longer survival of patients infected with HIV

B. Effects of increased antiretroviral drug use

C. Poor immune function and higher susceptibility

D. Poor control of malaria worldwide

A 28-year-old Zambian patient presents with a fever of 38.5°C, Plasmodiumfalciparum on thick smear with 120 parasites per 200 white blood cells, and jaundice. Which of the following best describes the likely diagnosis?

A. Uncomplicated malaria

B. Moderately severe malaria

C. Severe malaria

D. HIV and malaria

The study noted the importance of fever as an indicator of severe malaria in patients infected with HIV-1. Which of the following features were most commonly encountered in addition to fever?

A. Impaired consciousness and jaundice

B. Impaired consciousness and hypoglycemia

C. Multiple convulsions and jaundice

D. Hypoglycemia and jaundice

Which of the following best describes the association between HIV-1 infection and risk for severe malaria in the population studied?

A. HIV-1 infection is a risk factor for uncomplicated and severe malaria

B. Risk for severe malaria is only increased in patients with HIV-1 with a CD4 count <250 cells/µL

C. HIV-1 infection increases the risk for severe malaria

D. Risk for severe malaria is increased only in patients with AIDS

Activity Evaluation

1. The activity supported the learning objectives.
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2. The material was organized clearly for learning to occur.
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3. The content learned from this activity will impact my practice.
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4. The activity was presented objectively and free of commercial bias.
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