Prevalence of Anemia and Associated Factors among PHIVs Attendants Antiretroviral Therapy Clinics in Public Health Institutions in Dire Dawa Town, East Ethiopia

Abstract

Background: Anemia is one of the most commonly observed hematological abnormalities and an independent prognostic marker of Human Immunodeficiency virus (HIV) disease progression in people living with HIV. However, there is limited evidence on the magnitude and its correlates among attendants of Antiretroviral Therapy (ART) in low-income countries including Ethiopia. Objective: The aim this study was to determine Prevalence of anemia and associated factors among PHIVs attendants Antiretroviral Therapy clinics in public health institutions in Dire Dawa Town, East Ethiopia Methods: An institution based cross - sectional study design was used from mid January to mid February 2014.The study participants were selected by using simple random sampling technique. A pre- tested structured questionnaire was used to collect data. Both bivariate and multivariable logistic regressions were used to identify associated factors. Hematological and immunological data were collected by using blood samples. Odds ratio along with 95% confidence interval was estimated to identify factors associated with anemia among the study population using a multivariable logistic regression. Results: The prevalence of anemia was 41.2%, 95% CI (36.7%, 45.9%). In multivariable logistic regression analysis, being female[AOR=1.95, 95% CI (1.22, 3.11)], use of different types of  zidovudine (AZT) based Highly Active Antiretroviral Therapy (HAART) : 1c:AZT+3TC+ neverapine [ AOR=2.56 , 95% CI (1.28,5.12) ] , and 1d: AZT+3TC + Evaferenz [ AOR=2.99 , 95% CI(1.27,7.03)] , overall ART category: zidovudine - based HAART  [ AOR=2.98, 95% CI (1.27,6.99)] ,  WHO’s HIV  clinical  stage III [AOR=2.49, 95% CI: (1.24, 5.01)] and stage IV [AOR= 5.92, 95% CI (1.26, 27.8)] , and lower CD4 count [AOR=2.34, 95% CI (1.10,4.98)]  were  independently associated with anemia .Conclusion: Macrocytic anemia was common among patients taking Antiretroviral Therapy. The likelihood of developing anemia increases with disease progression associated decreased immunological state and use of zidovudin-based HAART. Therefore, those factors associated with anemia among PHIVs would be emphatically considered comprehensive care and treatment for PHIVs by including anemia treatment and prevention strategies by police makers in collaboration with others responsible bodies.

Keywords: Anemia, Antiretroviral Therapy, Ethiopia, Dire Dawa , Macrocytosis, Zidovudin.