Anemia among adult HIV patients in Ethiopia: a hospital-based cross-sectional study

Abstract

BackgroundAnemia is a major public health problem in HIV patients around the world. It has a negative effect on the quality of life of HIV patients and progression of the HIV disease. In the sub-Saharan African setting, including Ethiopia where both HIV infection and under-nutrition are expected to be high, there is a paucity of data on the matter. This study was aimed to reveal the magnitude and factors associated with anemia among adult HIV patients in Debre-Tabor Hospital, northwest Ethiopia.MethodsA hospital-based cross-sectional study was used among adult HIV patients in Debre-Tabor Hospital from April 1 to May 30, 2015. The diagnosis of anemia was made following the 2011 World Health Organization recommendation on hemoglobin cut-off points. Univariable and multivariable logistic regression was carried out to assess factors associated with anemia.ResultsA total of 377 patients’ charts were reviewed. Most of the participants (n=237, 62.9%) were taking antiretroviral treatment (ART). The overall prevalence of anemia was 23% (95% CI: 19.1, 27.6). Being ART-naïve (adjusted odds ratio [AOR]: 3.37; 95% CI: 1.59, 7.14), having treatment history with anti-tuberculosis (TB) drug (AOR: 3.2; 95% CI: 1.19, 8.67), taking zidovudine (ZDV)-containing ART regimen (AOR: 2.14; 95% CI: 1.03, 4.57), and having recent CD4+ T-lymphocytes count of <200 cells/μL (AOR: 2.13; 95% CI: 1.04, 4.36) were associated with occurrence of anemia among adult HIV patients.Conclusion and recommendationAnemia continues to be a major co-morbidity among adult HIV patients in Ethiopia. Adult HIV patients who are taking ZDV-containing ART, with a history of TB treatment, have a low CD4+T-lymphocytes count and are ART-naïve should be carefully screened and treated for anemia.

Anemia and its determinants among TB-HIV co-infected adults of ART naïve in two public hospitals of Mekelle, Ethiopia: a facility based cross-sectional study

“…In this study, the overall prevalence of anemia at baseline was found to be 59.0% (24.6% mild, 28.2% moderate and 6.2% severe anemia) which almost exactly in line to a study conducted across Europe where the target groups HIV patients of HAART naïve [29]. The overall prevalence of anemia in the current study was higher than other different studies that ranges from 18.9% in Uganda to 49.6% in Indonesia [25][26][27][28][30][31][32][33][34]. To the contrary, the baseline prevalence was lower than other studies conducted among ART Naïve HIV or TB patients in Ghana, Nigeria and Gambia that had been reported 63.0%, 69.2% and 67%, respectively [11,35,36].…”

“…In the current study, participants were ascertained their active TB and HIV co-infection status by reviewing ART logbook and patient medical charts. We used the single population proportion formula to estimate the minimum sample size considering the following underlining assumptions -95% confidence level, 5% acceptable level of precision (margin of error), and overall prevalence of anemia (23%) among HIV patients irrespective their ART conducted in Debre-tabor, Ethiopia which is [28].…”

“…These studies revealed the overall prevalence of anemia was varying from 23.0% -42.9% with the highest proportion among patients of ART naive than on HAART. Male sex, rural place of residence, WHO clinical stage III/IV, presence of TB co-infection and low baseline CD4 cell count were reported as positive predictors of anemia at baseline in one or more of the studies [25][26][27][28]. However, none of the studies were assessed the magnitude of anemia in TB-HIV co-infected adults.…”

The length of AZT consumption and homocysteine levels are protective factors of macrocytic anemia among adult HIV-infected patients: A case-control study in Central Java Province, Indonesia

“…3 Globally, anemia prevalence in HIV patients who received ART treatment is 23-50%. 32 This study found anemia prevalence of 29,4% in HIV patients who were treated with AZT. This prevalence is consistent with a research result in South West Ethiopia, which was 23,1%.…”

“…Anemia can happen each year due to HIV infection, and the degree of anemia is related to the progressivity of the disease. 32 The pathophysiology of anemia in HIV infection is an important factor in disease management, as well as prevention in morbidity and mortality. 7 Prevalence of anemia is around 11,7-92,0%, depending on HIV stadium, sex, age, pregnancy status, and whether or not an opportunistic infection is present.…”