Prevalence of anemia before and after initiation of antiretroviral therapy among HIV infected patients at Black Lion Specialized Hospital, Addis Ababa, Ethiopia: a cross sectional study

Abstract

BackgroundAnemia is the most common hematological abnormality in Human immunodeficiency virus (HIV) positive patients and a significant predictor of its progression to AIDS or death. This study was aimed to assess the prevalence of anemia before and after initiation of antiretroviral therapy (ART) among HIV positive patients attending Black Lion Specialized Hospital, Addis Ababa, Ethiopia.MethodsA cross sectional study was conducted from January to April, 2017 in Black Lion Specialized Hospital, Addis Ababa, Ethiopia. A total of 255 patients on ART were selected using simple random sampling techniques. Socio-demographic and clinical characteristics of the study subjects were collected using structured questionnaire. Measurements of complete blood cell counts and CD4 + T cell counts were made using Sysmex XT 2000i hematology analyzer and BD FACS Count CD4 analyzer, respectively. Statistical analysis of the data (Chi-square, paired T-test, logistic regression) was done using SPSS version 20. A p-value < 0.05 was considered as significant.ResultsPrevalence of anemia before and after ART initiation was 41.9 and 11.4% respectively. There are a significance differences in CD4 + T cell count, RBC count, hemoglobin values and RBC indices in HIV patients before and after ART initiation (p-value < 0.05). WHO clinical stages and CD4+ T cell counts were found to be associated with the prevalence of anemia before ART initiation. Among the total number of anemic cases, normocytic normochromic anemia was present in 71% of the cases before ART and in 58.6% of the cases after ART. The prevalence of macrocytic normochromic anemia before and after ART initiation was 4.7 and 27.6% respectively.ConclusionsIt is evident from this study that there is a remarkable reduction in the prevalence of anemia after ART initiation. However, a significant proportion of HIV patients remained anemic after 6 months of ART initiation suggesting the need for routine screening and proper treatment of anemia to mitigate its adverse effects.

Prevalence of anemia and its associated factors in human immuno deficiency virus infected adult individuals in Ethiopia. A systematic review and meta-analysis

“…Of the total 20 articles, more than one third of studies were conducted in Amhara regional state health institutions [2, 14, 18, 20, 23, 24, 26, 28]; four studies in Addis Ababa health institutions [13, 16, 21, 22]; four studies at South Nations Nationalities and peoples of Ethiopia national regional state (SNNP) [3, 15, 17, 34]; one study at Oromia national regional state [19], one study at Gambella national regional state [27], one study at Tigray regional national state [35] and one study at Dire Dawa town administration of Ethiopia [25]. …”

“…Regarding the study designs, 13 studies [3, 13, 15, 17–20, 25–28, 34, 35] and the remaining seven were cross sectional and cohort studies respectively. After critical appraisal of each articles based on JBI-MAStARI, both in peer and independently, they scored in the range of 5-up to 8 out of 9 values (see Table 1).…”

“…This systematic review and meta-analysis was established out to estimate the pooled prevalence of anemia and its associated factors among HIV infected adult individuals in Ethiopia from 2005 [15] up 2017 [13]. …”

“…Based on this recommendation, a number of researches were done and reported that the prevalence of anemia among HIV infected adult individuals was:11.2% at northwest parts of Ethiopia in 2014 [3], 11.4% at Addis Ababa in 2018 [13],11.5% at northwest parts of Ethiopia in 2014 [14], 12% at southern parts of Ethiopia in 2005–2010 [15],14.3% at Addis Ababa in 2011/2012 [16], 22.6 at southern parts of Ethiopia in 2016 [17], 23%at northwest parts of Ethiopia in 2015 [18], 23.1% at Southwest parts of Ethiopia in 2012 [19], 25% at Northwest parts of Ethiopia in 2016 [20], 32.48% at Addis Ababa in 2011/2012 [21], 33% at Addis Ababa in 2008–2012 [22], 34.4% at northeast parts of Ethiopia in 2010–2013 [23], 35% at northwest Ethiopia in 2011/2012 [24], 41.2% at Eastern parts of Ethiopia in 2014 [25], 43% at northwest parts of Ethiopia in 2012/2013 [26], 51.74% at Gambella region in Southwest parts of Ethiopia in 2014 [27], 53.3% in Southern parts of Ethiopia in 2016–2013 [3] and 70.1% at northwest parts of Ethiopia in 2011/2012 [28]. …”

HIV and haematopoiesis

“…There are no published reports available from Frenchspeaking countries in the eastern and southern sub-Saharan African region. These countries include: Ethiopia (10 reports); [6][7][8][9][10][11][12][13][14][15] Malawi (1 report); [16] SA (6 reports); [17][18][19][20][21] Rwanda (1 report); [22] Tanzania (1 report); [23] Uganda (4 reports); [24][25][26][27] and Zimbabwe (1 report). [19] The size of the cohorts ranged from 30 -15 030 patients.…”