Preprint: Please note that this article has not completed peer review.
Research article

Determinants of anemia among HIV positive children on Highly Active Antiretroviral Therapy (HAART) attending hospitals of North Wollo Zone, Amhara Region, Ethiopia, 2019: A case-control study

Biruk Abate Beletew, Ayelign Mengesha, Mohammed Ahmed
DOI: 10.21203/rs.2.12765/v1

Abstract

Background:  Anemia is one of the most commonly observed hematological abnormalities and an independent poor prognostic marker of HIV disease. The rate of progression and mortality in this subgroup of patients is high compared to non-anemic patients. WHO estimates that over 2 billion people are anemic worldwide and young children bear the world's highest prevalence rate of anemia. In Ethiopia, there is limited information about the determinant factors associated with anemia among HIV positive children. Thus, the main purpose of this study was to assess the determinants of anemia among children on highly active anti-retroviral therapy attending hospitals of North Wollo Zone, Amhara Region, Ethiopia.  Methods: A case-control study was conducted on 350 HIV infected children on HAART attending Hospitals of North Wollo Zone, from February 1 to March 30, 2019. The study participants were selected with consecutive sampling technique. An adapted, interviewer-administered, and pre-tested questionnaire and chart review were employed to collect the data. Besides, blood and stool sample was investigated to determine hematologic indices and to investigate intestinal parasites respectively. Data were analyzed by using the SPSS version 24 statistical software and bivariate and multivariate logistic regression was used to identify predictors. Results: A total of 350 HIV positive children (117 cases and 234 controls) were included in this study with an overall response rate of 100%.On multivariate analysis, variables which have spastically significance association with anemia were; had Amebiasis (AOR = 7.29, 1.22 - 43.56), had history of opportunistic infections (AOR = 9.63, 1.94 - 47.85), had malaria infection (malaria pf) (AOR = 4.37, 1.16 - 16.42),eating non-diversified (AOR = 10.39, 2.25 - 48.0), WGT –Age  Z score value between -2_-3 (AOR = 9.80, 2.46 - 39.14),level of adherence (AOR = 2.31, 1.92, 7.77) and being from rural area(AOR = 8.8, 2.07 - 37.79). Conclusion: In this study having parasitic infections, history of opportunistic infections, being malnourished, poor adherence to ART, caregivers living in the rural area and eating non-diversified foods were significantly associated with anemia among HIV positive children on HAART.This indicates the need of an integrated package of interventions to design anemia prevention program.

Keywords
Children, Anemia, HAART, North Wollo Zone, Ethiopia

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Preprint: Please note that this article has not completed peer review.
Research article

Determinants of anemia among HIV positive children on Highly Active Antiretroviral Therapy (HAART) attending hospitals of North Wollo Zone, Amhara Region, Ethiopia, 2019: A case-control study

Biruk Abate Beletew, Ayelign Mengesha, Mohammed Ahmed

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Abstract

Background:  Anemia is one of the most commonly observed hematological abnormalities and an independent poor prognostic marker of HIV disease. The rate of progression and mortality in this subgroup of patients is high compared to non-anemic patients. WHO estimates that over 2 billion people are anemic worldwide and young children bear the world's highest prevalence rate of anemia. In Ethiopia, there is limited information about the determinant factors associated with anemia among HIV positive children. Thus, the main purpose of this study was to assess the determinants of anemia among children on highly active anti-retroviral therapy attending hospitals of North Wollo Zone, Amhara Region, Ethiopia.  Methods: A case-control study was conducted on 350 HIV infected children on HAART attending Hospitals of North Wollo Zone, from February 1 to March 30, 2019. The study participants were selected with consecutive sampling technique. An adapted, interviewer-administered, and pre-tested questionnaire and chart review were employed to collect the data. Besides, blood and stool sample was investigated to determine hematologic indices and to investigate intestinal parasites respectively. Data were analyzed by using the SPSS version 24 statistical software and bivariate and multivariate logistic regression was used to identify predictors. Results: A total of 350 HIV positive children (117 cases and 234 controls) were included in this study with an overall response rate of 100%.On multivariate analysis, variables which have spastically significance association with anemia were; had Amebiasis (AOR = 7.29, 1.22 - 43.56), had history of opportunistic infections (AOR = 9.63, 1.94 - 47.85), had malaria infection (malaria pf) (AOR = 4.37, 1.16 - 16.42),eating non-diversified (AOR = 10.39, 2.25 - 48.0), WGT –Age  Z score value between -2_-3 (AOR = 9.80, 2.46 - 39.14),level of adherence (AOR = 2.31, 1.92, 7.77) and being from rural area(AOR = 8.8, 2.07 - 37.79). Conclusion: In this study having parasitic infections, history of opportunistic infections, being malnourished, poor adherence to ART, caregivers living in the rural area and eating non-diversified foods were significantly associated with anemia among HIV positive children on HAART.This indicates the need of an integrated package of interventions to design anemia prevention program.

Background

Methods

Results

Discussion

Conclusions

Recommendations

Abbreviations

Declarations

References

Tables

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