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在选定的卫生机构中,接受抗逆转录病毒治疗的人类免疫缺陷病毒阳性儿童贫血的决定因素:一项病例对照研究。

Determinates of anemia among Human Immune Deficiency Virus positive children on Anti-retro Viral Therapy in selected health facilities, Northwest Ethiopia: A Case-Control Study.

机构信息

Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia.

Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia.

出版信息

J Nutr Sci. 2023 Aug 30;12:e95. doi: 10.1017/jns.2023.79. eCollection 2023.

Abstract

Even though antiretroviral therapy (ART) access for human immunodeficiency virus (HIV)-infected children increased dramatically, anaemia has continued as a challenge regardless of a cluster of differentiation (CD4) count and viral load. Hence, the present study aimed to assess the determinants of iron deficiency anaemia among children living with HIV after the initiation of ART. An institution-based unmatched case-control study was conducted among consecutively selected 712 children on HIV care from 1 September to 30 October 2022 in the Metekel zone. A pre-tested and structured data extraction checklist was used to collect the data. Data were analysed using STATA version 16 software. Binary logistic regression was used to find the association between independent variables and anaemia. The level of statistical significance was declared at a value of < 0⋅05. A total of 712 HIV-positive children (178 cases and 534 controls) were included in this study, with a completeness rate of 98⋅8 %. In multivariable analysis, variables that have a statistically significant association with anaemia were as follows: CD4 count <350 (Adjusted Odds Ratio [AOR] 2⋅76; 95 % CI 1⋅76, 4⋅34), World Health Organization (WHO) clinical stage III (AOR 7⋅9; 95 % CI 3⋅5, 17⋅91) and stage IV (AOR 7⋅8; 95 % CI 3⋅37, 18⋅1), cotrimoxazole prophylaxis therapy (AOR 0⋅5; 95 % CI 0⋅31, 0⋅8) and mid-upper arm circumference (MUAC) ≤11⋅5 mm (AOR 2⋅1; 95 % CI 1⋅34, 3⋅28). The present study found that CD4 count, WHO clinical stage, cotrimoxazole prophylaxis therapy and MUAC were significantly associated with anaemia in children on ART. Therefore, continuous screening of anaemia and nutritional treatment is essential in these patients.

摘要

尽管抗逆转录病毒疗法(ART)可用于感染人类免疫缺陷病毒(HIV)的儿童,但无论 CD4 计数和病毒载量如何,贫血仍然是一个挑战。因此,本研究旨在评估接受 ART 治疗后 HIV 感染儿童缺铁性贫血的决定因素。这是一项在 2022 年 9 月 1 日至 10 月 30 日期间在梅特克尔地区连续选择的 712 名接受 HIV 护理的儿童中进行的基于机构的未匹配病例对照研究。使用预先测试和结构化的数据提取清单来收集数据。使用 STATA 版本 16 软件进行数据分析。二项逻辑回归用于发现自变量与贫血之间的关联。统计显著性水平定义为 < 0.05。本研究共纳入 712 名 HIV 阳性儿童(178 例病例和 534 例对照),完整性率为 98.8%。多变量分析显示,与贫血有统计学显著关联的变量如下:CD4 计数 <350(调整后的优势比 [AOR] 2.76;95%CI 1.76,4.34)、世界卫生组织(WHO)临床分期 III(AOR 7.9;95%CI 3.5,17.91)和 IV 期(AOR 7.8;95%CI 3.37,18.1)、复方新诺明预防疗法(AOR 0.5;95%CI 0.31,0.8)和中上臂围(MUAC)≤11.5 毫米(AOR 2.1;95%CI 1.34,3.28)。本研究发现,CD4 计数、WHO 临床分期、复方新诺明预防疗法和 MUAC 与接受 ART 的儿童贫血显著相关。因此,在这些患者中,持续筛查贫血和进行营养治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40a9/10495818/518c580d8601/S2048679023000794_fig1.jpg

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