Anemia and Its Associated Risk Factors at the Time of Antiretroviral Therapy Initiation in Public Health Facilities of Arba Minch Town, Southern Ethiopia

Abstract

Background: Anemia is the most common hematologic abnormality in HIV patients and is associated with disease progression and decreased survival. This study aims to describe the prevalence and predictors of anemia in HIV positive patients at the time of ART initiation at public health facilities of Arba Minch town, Southern Ethiopia. Methods: A total of 411 adults (≥15 years) HIV positive patients with complete information on hemoglobin levels and CD4 count and clinical characteristics registered from 2006 to 2013 were assessed for anemia prevalence and risk factors at the ART clinic of the Arba Minch hospital and health center. The measurements of Hemoglobin and CD4 + T cell count were performed using standard methodology at baseline of ART initiation. Results: A total of 411 HIV positive patients (195 males and 216 females) with a mean ± SD age of 33.9 ± 9.0 years were assessed. Hemoglobin levels were between 6.0 and 16.5 mg/dL. The overall prevalence of anemia at the time of ART initiation was 52.3%; with 28.1%, 22.9% and 1.3% mild, moderate and severe anemia respectively. The overall prevalence of anemia was 62.4% A. G. Alamdo et al. 1658 among males and 46.7% among females (P < 0.001). An increased risk of anemia was seen in males (adjusted OR = 2.78, 95% CI = 1.77 -4.35); low CD4 cell counts (adjusted OR = 3.48, 95% CI = 2.09 -5.79); and history of TB (adjusted OR = 2.89, 95% CI = 1.28 -6.54). Conclusions: Anemia in HIV-positive patients was highly prevalent at the time of ART initiation. Male gender, low CD4 count and history of TB were associated with higher risk of baseline anemia.

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).…”

“…Anemia is also common hematologic disorder among HIV infected individuals [2] with impact on quality of life and clinical outcomes among these individuals [3]. …”

“…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]. …”

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

“…According to theory, anemia in HIV is affected by the side effects of HIV treatment. 40,41 Use of AZT can cause hematology toxicity which is started with decreasing ATP concentration and depletion of glutathione before the damage of mtDNA. The decrease in glutatione levels can cause an increase in reactive oxygen species (ROS) production, which will cause a disturbance in DNA, protein, and lipid functions.…”