Anemia and its associated factors among adult people living with human immunodeficiency virus at Wolaita Sodo University teaching referral hospital

Autoři: Temesgen Anjulo Ageru aff001;  Mengistu Meskele Koyra aff002;  Kassa Daka Gidebo aff002;  Temesgen Lera Abiso aff002
Působiště autorů: Wolaita Sodo University Teaching Referral Hospital, Wolaita Sodo, South Ethiopia aff001;  School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, South Ethiopia aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0221853



In Sub-Saharan Africa, both HIV/AIDS and anemia have considerable public health problems. Anemia has an adverse effect on treatment outcome and it decreases the quality of life among adult HIV patients. This study was aimed to assess the prevalence of anemia and its associated factors among adult HIV positive patients in Wolaita Sodo University Teaching Referral Hospital.


Institution based cross-sectional study was conducted at Wolaita Sodo University Teaching Referral Hospital from 01 October to December 30, 2016. A randomly selected 411 adult people living with the human immunodeficiency virus were included in the study. A pre-tested questionnaire was used to collect data. Variables with P-value ≤0.25 in the bivariable logistic regression model were taken into multivariable logistic regression analysis along with 95% confidence interval and Odds Ratio was used to examine the association between anemia and independent variables. P˗value ≤ 0.05 was taken as statistically significant.


Prevalence of anemia in this study was 36.5% with 95% CI (32%-41%). Factors associated with anemia among adult people living with HIV/AIDS were individuals who lived with HIV ≥9years (AOR = 2.6, 95% CI:-1.03–6.59),years lived with HIV 5–8 years (AOR = 2.59, 95% CI:-1.02–6.57),CD4 count <200cells/ul (AOR = 4.2, 95%CI:-2.03–8.67), CD4 count200-350cells/ul(AOR = 1.82,95%CI:-1.01–3.26),infection with intestinal parasites (AOR = 2.04, 95% CI:-1.06–3.95), Participants with BMI <18.5kg/m2 (AOR = 2.96, 95%CI:-1.37–6.390),BMI 18.5-25kg/m2(AOR = 1.98, 95%CI:-1.11–3.56) and being HAART naïve (AOR = 2.23, 95% CI:- 1.16–4.28).


Prevalence of anemia among this study participant was high. This may affect the treatment outcome, increases morbidity and mortality of the participants. So periodic screening of anemia, a routine checkup of nutritional status, CD4 count and examination for intestinal parasite are essential.

Klíčová slova:

Anemia – Ethiopia – HIV – Intestinal parasites – Malarial parasites – Parasitic diseases – Parasitic intestinal diseases – Highly-active antiretroviral therapy


1. World Health Organization. Iron Deficiency Anaemia Assessment, Prevention, and Control a guide for programme managers. Document, 2001: URL:

2. World Health Organization.Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Document, 2011: URL:

3. George Pray God, Lackson Kasonka, Woodd Susannah, Rehman Andrea M, Molly Chisenga, Filteau et al.Effects on mortality of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy:. BMC Medicine, 2015: p. 13. doi: 10.1186/s12916-015-0267-x

4. Woodd Susannah, George Pray God, Molly Chisenga, Siame Joshua, Koethe John R.,Rehman et al. Effects on Anthropometry and Appetite of Vitamins and Minerals Given in Lipid Nutritional Supplements for Malnourished HIV-Infected Adults Referred for Antiretroviral Therapy: Results From the NUSTART Randomized Controlled Trial. J Acquir Immune Defic Syndr, 2015. 68(4).

5. Opie J. Haematological complications of HIV infection. SAMJ, 2012. Vol. 102, No. 6 p. 4.

6. Paul-aryee. Interaction between anaemia and human immuno-deficiency virus infection in an asymptomatic population. SEPTEMBER 2009: p. 256.

7. UNAIDS. Nutrition assessment, counselling and support for adolescents and adults living with HIV. A PROGRAMMING GUIDE, 2014: URL:

8. Kayode O. Osungbade, A.O.O. Anaemia in Developing Countries: Burden and Prospects of Prevention and Control. 2012: URL:

9. World Health Organization.Worldwide prevalence of anaemia 1993–2005. WHO Global Database on Anaemia, 2008: URL:

10. Jasrasaria Rashmi, Naghavi Mohsen, Wulf Sarah K., Johns Nicole, Lozano Rafael, Kassebaum et al. A systematic analysis of global anemia burden from 1990 to 2010. The American Society of Hematology, 2014. 123: p. 11.

11. Walson JL, S.B., Sangare L, Mbogo LW, Otieno PA, et al. (2010), Prevalence and Correlates of Helminth Co-infection in Kenyan HIV-1 Infected Adults. PLOS, 2010: p. 10.

12. Omoregie R., Omokaro E.U., Palmer O., Ogefere H.O., Egbeobauwaye A., Adeghe J.E., Osakue S.I. and V. Ihemej Prevalence of anemia among HIV-infected patients in Benin City, Nigeria. Tanzania Journal of Health Research, Vol. 11, No. 1, January 2009.

13. Gedefaw L, Yemane T, Salehmariam Z, Yilma D. Anemia and Risk Factors in HAART Naı¨ve and HAART Experienced HIV Positive Persons in South West Ethiopia: A Comparative Study PLOS, 2013: p. 5.

14. Watkins Crystal C and Treisman G.J. Cognitive impairment in patients with AIDS–prevalence and severity. Dove medical press, 2015: p. 13.

15. Central Statistical Agency Addis Ababa. An Ethiopia Demographic and Health Survey 2011. SURVEY, 2012: p. 450.

16. Central Statistical Agency Addis Ababa. Ethiopia Mini Demographic and Health Survey REPORT, 2014: p. 108.

17. Assefa Muluken, W.E.A., Shewamare Aster, Medhin Girmay and Belay Mulugeta.Prevalence and correlates of anemia among HIV infected patients on highly active anti-retroviral therapy at Zewditu Memorial Hospital, Ethiopia. BMC Hematology, 2015.

18. Wondimeneh Y.7& Ferede G. Prevalence and related factors of anemia in HAART-naive HIV positive patients at Gondar University Hospital, Northwest Ethiopia. BMC HEMATOLGY,2013: p. 5.

19. Phe T, T.S., Veng C, Sok S, Lynen L, et al. Risk Factors of Treatment-Limiting Anemia after Substitution of Zidovudine for Stavudine in HIV-Infected Adult Patients on Antiretroviral Treatment. PLoS ONE 2013: p. 7.

20. Zhou Jialun, A.J., Bissagnene Emmanuel, Musick Beverly, Wools-Kaloustian Kara, Maxwell Nicola, Andrew Boulle F.W., Masys Daniel, Iriondo-Perez Jeniffer, Hemingway-Foday Jay and Law Matthew. Short-term risk of anaemia following initiation of combination antiretroviral treatment in HIV- infected patients in countries in sub-Saharan Africa, Asia-Pacific, and central and South America. Journal of the International AIDS Society, 2012.

21. REUST C.E. Common Adverse Effects of Antiretroviral Therapy for HIV Disease. American Academy of Family Physician, 2011: p. 9.


23. Milkiyas Wolde Habtamu et al. Incidence and Risk Factors of Anemia among HIV/AIDS Patients Taking Anti-Retroviral Terapy at Tertiary Hospitals in Addis Ababa, Ethiopia: A Retrospective Cohort Study. Journal of HIV/AIDS & Infectious Diseases, 2014: p. 8.

24. Enawgaw al. Determination of hematological and immunological parameters among HIV positive patients taking highly active antiretroviral treatment and treatment naïve in the antiretroviral therapy clinic of Gondar University Hospital, Gondar, Northwest Ethiopia: a comparative cross-sectional study. BMC HEMATOLGY, 2014: p. 7.

25. Mihiretie Hylemariam, B.T., Tsegaye Aster. Intestinal Parasitosis in Relation to CD4+T Cells Levels and Anemia among HAART Initiated and HAART Naive Pediatric HIV Patients in a Model ART Center in Addis Ababa, Ethiopia. PLOS, 2015.

26. Egata G., Dereje B., Dessalegn G., Birhanu S. Prevalence of Anemia and Associated Factors among PHIVs Attendants Antiretroviral Therapy Clinics in Public Health Institutions in Dire Dawa Town, East Ethiopia. Journal of Medicine, Physiology and Biophysics, 2016. 22.

27. WHO STEPS Surveillance Manual: The WHO STEP wise Approach to Chronic Disease Risk Factor Surveillance. Geneva, Switzerland: World Health Organization; 2008:URL:

28. Owiredu WKBA, Quaye L., Amidu N., Addai M.O. Prevalence of anaemia and immunological markers among Ghanaian HAART-naïve HIV-patients and those on HAART. African Health Sciences, 2011: p. 14.

29. Kulkarni Dr. Mukund B., D.M.M.B., Mungal Dr. S.U., Dube Dr. S. P.Anemia in People Living With HIV/AIDS: A Cross Sectional Study from India. IOSR Journal of Dental and Medical Sciences, 2015. 14.

30. Meidani M, Rezaei F, Maracy MR, Avigan M, Tayeri K. Prevalence, severity, and related factors of anemia in HIV/AIDS patients. Anemia in HIV/AIDS patients, 2012: p. 6.

31. Abubakar, Grace P. Prevalence of Anemia among Human Immunodeficiency Virus Infected Patients Accessing Healthcare in Federal Medical Center Keffi, Nigeria. International Journal of TROPICAL DISEASE & Health, 2015.

32. Gil Cunha De Santis a, Denise Menezes Brunetta a, Fernando Crivelenti Vilar b, Renata Amorim Branda, G.M.N.d.L. Renata Zomer de Albernaz Munizb, and D.T.C.a. Manuela Emiliana Amorelli-Chacel b, c, Alcyone Artioli Machadob.Hematological abnormalities in HIV-infected patients. International Journal of Infectious Diseases 15 (2011) e808–e811, 2011: p. 4.

33. Takuva Simbarashe, et al., Anemia among HIV-Infected Patients Initiating Antiretroviral Therapy in South Africa: Improvement in Hemoglobin regardless of Degree of Immunosuppression and the Initiating ART Regimen. Journal of TropicalMedicine, 2013: p. 7.

34. Habtamu Fufa, M.U., Samson Taffesse, Najat Mokhtar, and Hassan Aguenaou. Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa, Ethiopia. Food and Nutrition Bulletin, vol., 2009. 30(3).

35. Belaynew Wasie Y.K., Anwar Yibrie, nutritional status of adults living with HIV/AIDS At The University Of Gondar Referral Hospital, Northwest Ethiopia. Ethiop. J. Health Biomed Sci., 2010. 3(1): p. 12.

36. Kawai K., E.V.M.M., Saathoff E. Urassa W., Bosch R. J., Spiegelman D., Fawzi W. W. Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania. INT J TUBERC LUNG Disease 2011: p. 11.

37. Sicotte Maryline, Bemeur Chantal, Diouf Assane, Maria Victoria Zunzunegui and Vinh-Kim Nguyen and f.t.A. initiative. Nutritional status of HIV-infected patients during the first year HAART in two West African cohorts. Journal of Health, Population and Nutrition 2015: p. 10.

38. Daka D, Lelissa D, Amsalu A. Prevalence of anemia before and after the initiation of antiretroviral therapy at ART center of Hawassa University Referral Hospital, Hawassa, South Ethiopia. Sch J Med. 2013; 3(1): 1–6.

39. Measy et al. Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia. AIDS Research and Therapy 2013, 10:7, 2013: p. 9.

40. Dereje Gedle B.G., Dagnachew Muluye and Molla Mesele.Prevalence of malnutrition and its associated factors among adult people living with HIV/AIDS receiving anti-retroviral therapy at Butajira Hospital,southern Ethiopia. BMC Nutrition, 2015: p. 11.

41. Sara Adarvishi, M.A., Mohamad Ghasemi Deh Cheshmeh, Mahdi Tavalla, and Fatemeh Hardani. Prevalence of Intestinal Parasites in HIV-Positive Patients Attending Ahvaz Health Centers in 2012: A Cross-Sectional Study in South of Iran. Jundishapur J Chronic Dis Care. 2016, 2016: p. 6.

42. Mugisha JO, B.K., Asiki G, Seeley J, Kuper H. Prevalence, Types, Risk Factors and Clinical Correlates of Anaemia in Older People in a Rural Ugandan Population. PLOS, 2013: p. 10.

43. Johannessen A., et al. Antiretroviral treatment reverses HIV-associated anemia in rural Tanzania. BMC Infectious Diseases, 2011.

44. AGARAWAL et al. High incidence of zidovudine induced anaemia in HIV infected patients in eastern India. Indian J Med Res 132, 2010: p. 4. 20693582

45. Thong Phe, S.T., Chhunheng Veng, Sopheak Sok, Lutgarde Lynen, Johan van, Griensven.Risk Factors of Treatment-Limiting Anemia after Substitution of Zidovudine for Stavudine in HIV-Infected Adult Patients on Antiretroviral Treatment. PLOS, 2013.

46. Kateera et al. Malaria, anaemia and under-nutrition: three frequently co-existing conditions among preschool children in rural Rwanda. MALAEIA JOURNAL, 2015: p. 11.

47. Tay et al. The prevalence of malaria among HIV seropositive individuals and the impact of the co- infection on their hemoglobin levels. Annals of Clinical Microbiology and Antimicrobials (10, 2015: p. 8. doi: 10.1186/1476-0711-10-8

48. Kerkhoff et al. Predictive Value of Anemia for Tuberculosis in HIV-Infected Patients in Sub-Saharan Africa: An Indication for Routine Microbiological Investigation Using New Rapid Assays. J Acquir Immune Defic Syndr, 2014. 66: p. 6.

49. Nagu Tumaini J., D.S.E.H., Makani Said Abo Julie, Matee Wafaie Fawzi Mecky I., Mugusi Nagu Ferdinand et al.Anemia at the Initiation of Tuberculosis Therapy Is Associated with Delayed Sputum Conversion among Pulmonary Tuberculosis Patients in Dar-es-Salaam, Tanzania. PLOS, 2014: p. 8.

50. Aishwarya R. et al. Assessment of Nutritional Status of people living with HIV/AIDS (PLWHA) in the age group of 18–55 years. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 2015: p. 12.

Článek vyšel v časopise


2019 Číslo 10

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Zvyšte si kvalifikaci online z pohodlí domova

Léčba bolesti v ordinaci praktického lékaře
nový kurz
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Jistoty a nástrahy antikoagulační léčby aneb kardiolog - neurolog - farmakolog - nefrolog - právník diskutují
Autoři: doc. MUDr. Štěpán Havránek, Ph.D., prof. MUDr. Roman Herzig, Ph.D., doc. MUDr. Karel Urbánek, Ph.D., prim. MUDr. Jan Vachek, MUDr. et Mgr. Jolana Těšínová, Ph.D.

Léčba akutní pooperační bolesti
Autoři: doc. MUDr. Jiří Málek, CSc.

Nové antipsychotikum kariprazin v léčbě schizofrenie
Autoři: prof. MUDr. Cyril Höschl, DrSc., FRCPsych.

Všechny kurzy
Kurzy Doporučená témata Časopisy
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.


Nemáte účet?  Registrujte se