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

Abstract

Background Anemia has up to 87% prevalence in high Tuberculosis (TB) and HIV burden settings of the Sub-Saharan Africa (SSA) including Ethiopia. It increases Lost to follow up (LTFU) rate, reduces quality of life and shortens the life expectancy of TB-HIV patients. Despite these facts, there is limited information on anemia and its determinants among TB-HIV adults of ART naïve in Ethiopia in general. Hence, the current study will partly fill the gap in the setting particularily.Methods A facility based cross-sectional study was conducted among 305 TB-HIV co-infected patients of ART naïve who have been started treatment from January, 2009 to December, 2017 in two public hospital of Mekelle, Ethiopia by reviewing an ART register and patient medical charts. A Generalized Linear Model (GLM) of binomial family with link function logit (logit model) was fitted to identify the statistically significant determinants of anemia. Finally, the decision was made based on the 95% Confidence Interval (95% CI) and the magnitude of association was measured based on the Adjusted Odds ratio (Adj. OR).Results At baseline, the cumulative prevalence of anemia was 59.0% (95% CI: 53.3% – 64.6%) where the prevalence of mild, moderate and severe anemia’s 24.6%, 28.2% and 6.2%, respectively. Female sex ((Adj.OR = 0.379; 95% CI: 0.226 – 0.635) and Body Mass Index (Adj. OR = 0.897, 95% CI: 0.823 - 0.977) reduces the odds of developing anemia whereas baseline ambulatory functional status (Adj. OR = 2.302; 95% CI: 1.293 - 4.097), Bedridden functional status (Adj. OR = 2.352; 95% CI: 1.074 - 5.149), HIV Clinical stage III (Adj. OR = 2.987; 95% CI: 1.226-7.279) and HIV Clinical stage IV (Adj. OR = 3.056; 95% CI: 1.219 - 7.657) increases the odds of anemia in TB-HIV co-infected adults of ART naïve in the current study.Conclusion Six in every ten TB-HIV co-infected adults of ART naïve developed anemia at baseline. Therefore, curious attention has to be given to undernourished, advanced clinical stage (III and IV) and non-working functional status TB-HIV adults to reducing anemia associated bad consequences.