Prevalence of anemia and nutritional status among HIV-positive children receiving antiretroviral therapy in Harar, eastern Ethiopa

Abstract

Zelalem Teklemariam,1 Habtamu Mitiku,1 Firehiwot Mesfin2 1Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Purpose: Anemia and growth retardation are common manifestations of HIV-positive children, which threaten their lives. Therefore, this study tried to assess the burden of anemia and the nutritional status of HIV-positive children receiving antiretroviral therapy (ART) in eastern Ethiopa. Patients and methods: A total of 108 records of children on ART followed up in Hiwot Fana Specialized University Hospital from 2007 to 2010 were retrospectively reviewed from November 1 to November 30, 2011. Results: Approximately 54.4% of the children had been anemic before the initiation of their ART (at baseline): 7.8% were severely anemic and 44.7% were moderately anemic. These percentages were higher in preschool children than in school children (adjusted odds ratio [AOR]: 4.80 [95% confidence interval {CI}: 1.96, 11.75]), and were higher in males than in females (AOR: 2.61 [95% CI: 1.06, 6.45]). The prevalence of anemia was reduced to 39.2% 1 year after initiation of ART. The increasing of hemoglobin values was highly significant for both zidovudine (AZT)- and stavudine (d4T)-based ART (P<0.05). At baseline, 51.6% of the study subjects were underweight (weight-for-age Z score less than -2 standard deviation [SD]); 49.1% were stunted (height-for-age Z score less than -2 SD); and 31.5% were wasted (body mass index less than -2 SD), which, after a year on ART, declined to 8.9%, 15.9%, and 9.8%, respectively. Conclusion: There was high prevalence of anemia and growth failure among HIV-infected children in the study area. However, there was a decline after initiation of ART. Therefore, adherence counseling to strengthen the uptake of ART is recommended. Moreover, large-scale, prospective studies should be done to understand the magnitude and etiology of the problems with HIV-negative control groups. Keywords: hemoglobin, underweight, stunting, wasting