Fentaw Mulaw Getahun, Ahmed Yesuf Fatima, Temesgen Abebe Haftom
Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Afar, Ethiopia.
Afar Regional Health Bureau, Samara, Afar, Ethiopia.
Adv Hematol. 2020 Sep 30;2020:9643901. doi: 10.1155/2020/9643901. eCollection 2020.
The two major comrbidities (anemia and poor nutrition) are common manifestations of HIV-infected children, which threaten their lives. In Ethiopia, there is limited information on the magnitude and factors associated with anemia among HIV-infected children. Thus, this study was aimed to determine the magnitude and factors associated with anemia among HIV-infected children receiving antiretroviral therapy in the Afar region, Ethiopia.
A cross-sectional retrospective record review was conducted on a sample size of 102 HIV-infected children aged 6 months to < 15 years in selected ART sites of the Afar region from May 1 to 25, 2018. Patient cards from 2009 to 2017 with the required information were considered. A paired sample -test was used to assess whether there is a significant difference in the hemoglobin level before and after the HAART regimen. Multivariable logistic regression was used to determine predictors of anemia. Statistical significance was determined at value < 0.05.
At baseline, 53.9% of study participants were anemic, from which 8.7%, 36.3%, and 9.8% were mild, moderate, and severe, respectively. There was a statistically significant improvement of hemoglobin level following the one-year course of ART treatment from 10.67 ± 1.82 to 11.5 ± 1.5 ( value ≤ 0.001): an improvement of 0.83 ± 1.74. Children who were moderately and severely stunted were more than five (AOR = 5.16, 95% CI (1.71, 15.56)) and more than twelve (AOR = 12.45, 95% CI (2.62, 59.21)) times more likely to be anemic than children who were not stunted, respectively. Children whose mothers had not attended ANC follow-up were more than three (AOR = 3.68, 95% CI (1.38, 9.81)) times more likely to be anemic than children whose mothers attended ANC. Children who were in clinical stages 3 and 4 were more than five (AOR = 5.07, 95% CI (1.79, 14.37)) times more likely to be anemic than children who were in clinical stage 1 and 2.
The magnitude of anemia among HIV-infected children was found to be high, which is 53.9%. Nutritional status (stunting), WHO clinical stage, and history of ANC follow-up were the predictors significantly associated with childhood anemia. Thus, interventions for HIV-infected children should consider those factors.
两种主要的合并症（贫血和营养不良）是感染艾滋病毒儿童的常见表现，威胁着他们的生命。在埃塞俄比亚，关于感染艾滋病毒儿童贫血的严重程度及相关因素的信息有限。因此，本研究旨在确定埃塞俄比亚阿法尔地区接受抗逆转录病毒治疗的感染艾滋病毒儿童贫血的严重程度及相关因素。
2018年5月1日至25日，在阿法尔地区选定的抗逆转录病毒治疗点，对102名年龄在6个月至15岁以下的感染艾滋病毒儿童进行了横断面回顾性记录审查。考虑了2009年至2017年包含所需信息的患者卡片。采用配对样本检验来评估高效抗逆转录病毒治疗方案前后血红蛋白水平是否存在显著差异。使用多变量逻辑回归来确定贫血的预测因素。当值<0.05时确定具有统计学意义。
在基线时，53.9%的研究参与者患有贫血，其中轻度、中度和重度贫血分别占8.7%、36.3%和9.8%。经过一年的抗逆转录病毒治疗后，血红蛋白水平有统计学意义的改善，从10.67±1.82提高到11.5±1.5（值≤0.001）：提高了0.83±1.74。中度和重度发育迟缓的儿童贫血的可能性分别是未发育迟缓儿童的五倍多（调整后比值比=5.16，95%置信区间（1.71，15.56））和十二倍多（调整后比值比=12.45，95%置信区间（2.62，59.21））。母亲未参加产前保健随访的儿童贫血的可能性是母亲参加产前保健儿童的三倍多（调整后比值比=3.68，95%置信区间（1.38，9.81））。处于临床3期和4期的儿童贫血的可能性是处于临床1期和2期儿童的五倍多（调整后比值比=5.07，95%置信区间（1.79，14.37））。
发现感染艾滋病毒儿童的贫血严重程度很高，为53.9%。营养状况（发育迟缓）、世界卫生组织临床分期和产前保健随访史是与儿童贫血显著相关的预测因素。因此，针对感染艾滋病毒儿童的干预措施应考虑这些因素。
