RESUMEN

OBJECTIVE: This study examined the prevalence, severity and risk factors of anaemia among adult people living with HIV attending an antiretroviral therapy centre in Woreta Primary Hospital, Woreta town, Ethiopia. DESIGN: Hospital-based retrospective cross-sectional study. SETTING: Public health facility that provides HIV care in Woreta town. PARTICIPANTS: A total of 289 medical records of adults living with HIV/AIDS on highly active antiretroviral therapy from February 2019 to September 2023 at government hospital were reviewed using a systematic sampling method. The data were entered using Epi-info V.7 and exported to SPSS V.23 for data analysis. The data were analysed using bivariate and then multivariate logistic regression models in order to identify variables associated with anaemia. At the 95% CI level, variables having a p value of <0.05 were deemed to be statistically significant predictors. PRIMARY OUTCOME: Prevalence and severity of anaemia and its predictors among adult patients living with HIV on antiretroviral therapy in Woreta Primary Hospital. RESULTS: The total prevalence of anaemia was 31.5% (95% CI 28.9 to 33.8). The prevalence of mild, moderate and severe anaemia was 20.42%, 10.38% and 0.70%, respectively. Predictors independently linked with anaemia were female sex (adjusted OR (AOR) 1.08), age ≥40 years (AOR 1.21), lived with HIV >10 years (AOR 2.31), CD4 counts <200 cells/µL (AOR 3.81), non-suppressed viral load (AOR 1.28), history of opportunistic infections (AOR 1.54), WHO clinical stages III and IV (AOR 1.37 and 2.23, respectively) and history of parasitic infestation (AOR 2.81). CONCLUSIONS: A sizeable proportion of participants were found anaemic. Female sex, older age, longer periods lived with the virus, lower CD4 count, non-suppressed viral load, history of opportunistic infections, WHO clinical stages III and IV and history of parasitic infestation were the contributing factors. Therefore, to improve the anaemic status and living circumstances of patients living with HIV, immediate action on the linked factors is needed, such as monitoring for maintenance of CD4 counts >200 cells/µL and avoiding progression of HIV to the advanced WHO clinical stages, suppressed viral load, preventing opportunistic infections and parasitic infestation.

Asunto(s)

Anemia , Terapia Antirretroviral Altamente Activa , Infecciones por VIH , Compuestos Heterocíclicos con 3 Anillos , Oxazinas , Piridonas , Humanos , Femenino , Masculino , Adulto , Estudios Transversales , Estudios Retrospectivos , Anemia/epidemiología , Etiopía/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Prevalencia , Persona de Mediana Edad , Factores de Riesgo , Piridonas/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Recuento de Linfocito CD4 , Adulto Joven , Inhibidores de Integrasa VIH/uso terapéutico , Índice de Severidad de la Enfermedad , Piperazinas

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BACKGROUND: Perennial malaria chemoprevention (PMC) is a chemoprevention strategy endorsed by the World Health Organization (WHO) and is increasingly being adopted by National Malaria Programmes. PMC aims to reduce morbidity and mortality caused by malaria and anaemia in in young children through provision of antimalarial drugs at routine contact points with the local health system. This study aims to evaluate the impact of the programmatically-implemented country-tailored PMC programmes targeting children up to two years of age using sulfadoxine-pyrimethamine (SP) on the incidence of malaria and anaemia in children in Cameroon and Côte d'Ivoire. METHODS: We will assess the impact of PMC using passive and active monitoring of a prospective observational cohort of children up to 36 months of age at recruitment in selected study sites in Cameroon and Côte d'Ivoire. The primary and secondary outcomes include malaria, anaemia and malnutrition incidence. We will also conduct a time-series analysis of passively detected malaria and anaemia cases comparing the periods before and after PMC introduction. This study is powered to detect a 30% and 40% reduction of malaria incidence compared to the standard of care in Cameroon and Côte d'Ivoire, respectively. DISCUSSION: This multi-country study aims to provide evidence of the effectiveness of PMC targeting children in the first two years of life on malaria and anaemia and will provide important information to inform optimal operationalization and evaluation of this strategy. TRIAL REGISTRATION: Cameroon - NCT05889052; Côte d'Ivoire - NCT05856357.

Asunto(s)

Anemia , Antimaláricos , Quimioprevención , Malaria , Pirimetamina , Sulfadoxina , Humanos , Camerún/epidemiología , Lactante , Côte d'Ivoire/epidemiología , Estudios Prospectivos , Malaria/prevención & control , Malaria/epidemiología , Antimaláricos/uso terapéutico , Pirimetamina/uso terapéutico , Preescolar , Sulfadoxina/uso terapéutico , Anemia/prevención & control , Anemia/epidemiología , Combinación de Medicamentos , Incidencia , Femenino , Masculino

RESUMEN

AIM: The aim of the present study was to examine the relationship between anemia and basic and instrumental activities of daily living in older female patients. METHODS: 540 older female outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin below 12 g/dL. Patients' demographic characteristics, comorbidities, Geriatric Depression Scale, Mini Nutritional Assessment, and Mini-Mental State Examination (MMSE) were also recorded. Handgrip strength (HGS) was measured with a hand dynamometer to detect dynapenia. Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functional capacity. RESULTS: The mean age of the participants was 77.42 ± 7.42 years. The prevalence of patients with anemia was 35%. A significant difference was observed between anemic and non-anemic groups in terms of age, presence of diabetes mellitus (DM), hypertension, coronary artery disease (CAD), chronic kidney disease (CKD), malnutrition, dynapenia, and MMSE, BADL and IADL scores (p < 0.05). In multivariate analysis, after adjustment for age, DM, hypertension, CAD and CKD; there were significant associations between anemia and reduced BADL/IADL scores, dynapenia, falls, the risk of falls, MMSE, and malnutrition (p < 0.05). After adjusting for all confounding variables, deterioration in total BADL and IADL total scores were still more common among anemic older females than those without anemia (p < 0.05). CONCLUSION: One out of every three older women presenting at one outpatient clinic were anemic. Anemia was observed to be associated with dependence in both BADL and IADL measures. Therefore, the presence of anemia in elderly women should be routinely checked, and possible causes should be investigated and treated to improve their functional capacity.

Asunto(s)

Actividades Cotidianas , Anemia , Humanos , Femenino , Anciano , Estudios Transversales , Anemia/epidemiología , Anciano de 80 o más Años , Evaluación Geriátrica/métodos , Fuerza de la Mano/fisiología

RESUMEN

BACKGROUND: Anemia in pregnancy has been associated with a number of adverse birth outcomes, such as low birth weight (LBW) or preterm birth (PTB). However, the evidence from primary studies on anemia in pregnancy with LBW and PTB is contentious. Moreover, a systematic review and meta-analysis to summarize these findings have not been conducted for Ethiopia. This study aimed to synthesize the best available evidence and quantify the strength and direction of the association of anemia in Ethiopia. METHODS: This review examined women with singleton pregnancies with low birth weight (LBW) and preterm birth (PTB). We retrieved studies from PubMed, Wiley, Cochrane databases, and Google Scholar from inception to February 2, 2024. The World Health Organization (WHO) defines anemia in pregnancy as a low blood haemoglobin (Hgb) concentration below 11 g/dl or a hematocrit level of < 33%. When the newborn's weight was below 2500 g, LBW was considered. Preterm birth refers to the birth of a baby before 37 completed weeks of gestation. Meta-analysis was conducted using fixed and random effects models. The degree of heterogeneity, publication bias, and quality of the evidence of studies was assessed. RESULTS: There were 35 and 8 studies, with 14,319 and 3,265 respondents included in the meta-analysis for LBW and PTB, respectively. Neonates born to women who had normal Hgb levels were less likely to be LBW [pooled odds ratio (POR) = 0.22, 95% CI: (0.17, 0.28); I2 = 80%] (low-quality evidence). Neonates born to women with normal Hgb levels had a lower risk of PTB [POR = 0.22, 95% CI: 0.18, 0.28; I2 = 19%] (very low-quality evidence). The effect size estimate remained significant after sub-group analysis based on study design and province, except in two retrospective cohort studies for LBW. CONCLUSION: The findings suggest major implications for strengthening the implementation of nutrition policies to prevent anemia during pregnancy in Ethiopia. Further research is warranted to assess interventions that are effective in combating maternal anemia to reduce rates of LBW and PTB.

Asunto(s)

Anemia , Recién Nacido de Bajo Peso , Nacimiento Prematuro , Humanos , Femenino , Embarazo , Etiopía/epidemiología , Nacimiento Prematuro/epidemiología , Anemia/epidemiología , Anemia/sangre , Recién Nacido , Complicaciones Hematológicas del Embarazo/epidemiología , Complicaciones Hematológicas del Embarazo/sangre

RESUMEN

Purpose: The aim of this study was to explore the relationship between hemoglobin levels, anemia and diabetic lower extremity ulcers in adult outpatient clinics in the United States. Methods: A retrospective cross-sectional study was conducted on 1673 participants in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Three logistic regression models were developed to evaluate the relationship between anemia and diabetic lower extremity ulcers. Model 1 adjusted for demographic and socioeconomic variables (age, sex, race and ethnicity, educational level, family income, and marital status). Model 2 included additional health-related factors (BMI, cardiovascular disease, stroke, family history of diabetes, hyperlipidemia, alcohol and smoking status). Model 3 further included clinical and laboratory variables (HbA1c, CRP, total cholesterol, and serum ferritin levels). Stratified analyses were also conducted based on age, sex, HbA1c level, body mass index (BMI), and serum ferritin level. Results: The study included 1673 adults aged 40 years and older, with a mean age of 64.7 ± 11.8 years, of whom 52.6% were male. The prevalence of diabetic lower extremity ulcers (DLEU) was 8.0% (136 participants). Anemia was found in 239 participants, accounting for 14% of the study group. Model 1 showed an OR of 2.02 (95% CI=1.28~3.19) for anemia, while Model 2 showed an OR of 1.8 (95% CI=1.13~2.87). In Model 3, the OR for DFU in patients with anemia was 1.79 (95% CI=1.11~2.87). Furthermore, when serum ferritin was converted to a categorical variable, there was evidence of an interaction between DLEU status and serum ferritin in increasing the prevalence of DLEU. Conclusion: After adjusting for confounding variables, higher levels of anemia were proportionally associated with an increased risk of incident DLEU. These results suggest that monitoring T2DM patients during follow-up to prevent the development of DLEU may be important. However, further prospective studies are needed to provide additional evidence.

Asunto(s)

Anemia , Encuestas Nutricionales , Pacientes Ambulatorios , Humanos , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Estudios Retrospectivos , Anemia/epidemiología , Anemia/sangre , Anciano , Estados Unidos/epidemiología , Adulto , Pacientes Ambulatorios/estadística & datos numéricos , Pie Diabético/epidemiología , Pie Diabético/sangre , Prevalencia , Hemoglobina Glucada/análisis , Factores de Riesgo , Extremidad Inferior/patología

RESUMEN

Tea consumption is avoided by some due to concerns about its potential to cause anemia. To clarify this impact, we assessed the association between tea intake and anemia in a Chinese prospective cohort study and by Mendelian randomization (MR). We analyzed associations of tea intake with anemia using data from the baseline (N = 30 085) and three subsequent follow-ups (the first: N = 17 898; the second: N = 10 435; the third: N = 5311) in the Guangzhou Biobank Cohort Study (GBCS). We also assessed the causal effect of tea intake on anemia, hemoglobin (Hgb) and hematocrit (Hct) using two-sample MR with summary statistics from relevant genome-wide association studies and the UK Biobank (N = 447 485). At the baseline, compared with never-drinkers, regular tea drinkers had higher levels of Hgb and Hct and a lower risk of anemia after adjustment for confounders (all P < 0.05; all P for trend ≤0.006). Prospectively, compared with never-drinkers, regular tea drinkers had higher Hgb (g L-1) (ß = 0.69; 95% CI, 0.28 to 1.10; P for trend <0.001) and Hct (%) (ß = 0.30; 95% CI, 0.19 to 0.41; P for trend <0.001), but no significant difference in anemia risk (OR = 0.91; 95% CI, 0.82 to 1.02; P for trend = 0.071). MR analyses showed no association between tea intake and anemia, Hgb and Hct. Through triangulation of evidence using a Chinese cohort and genetics, tea consumption appears unlikely to impact anemia risk.

Asunto(s)

Anemia , Hemoglobinas , Análisis de la Aleatorización Mendeliana , Té , Humanos , Persona de Mediana Edad , Femenino , Masculino , Estudios Prospectivos , Anemia/epidemiología , Anciano , Hemoglobinas/metabolismo , Hemoglobinas/análisis , China/epidemiología , Adulto , Factores de Riesgo , Estudio de Asociación del Genoma Completo , Estudios de Cohortes

RESUMEN

BACKGROUND: Anaemia is one of the most common problems in HIV-infected patients associated with increased HIV progression, decreased functional capacity, survival and quality of life. For better interventions, up-to-date information concerning anaemia among HIV-infected children less than 5 years of age on antiretroviral therapy (ART) is vital. Thus, this study aims to determine the predictors of anaemia among HIV-infected children less than 5 years of age receiving ART in North-West Ethiopia. DESIGN: An institution-based retrospective follow-up study was conducted. STUDY SETTING: Amhara region Comprehensive Specialized Hospitals, North-West Ethiopia. PARTICIPANTS: In total, we examined 460 HIV-infected children less than 5 years of age who had followed highly active antiretroviral treatment from 2010 to 2020. OUTCOME MEASURES: The outcome measures were median time to detection of anaemia, the incidence and the effects of cotrimoxazole preventive therapy (CPT), ART adherence, tuberculosis (TB), WHO clinical stage and wasting on anaemia. RESULTS: The overall follow-up time was 9234 person-months of observation. The incidence density of anaemia was 8.34 per 1000 person-months of observation (95% CI 6.67 to 10.43). The cumulative survival probability of children after the last months of follow-up was 0.54. The independent predictors of anaemia were not receiving CPT (adjusted HR (AHR)=4.44; 95% CI 2.48 to 7.93), poor adherence to ART (AHR=2.46; 95% CI 1.37 to 4.42), TB (AHR=3.40; 95% CI 1.72 to 6.72), severe WHO clinical stage (AHR=3.03; 95% CI 1.40 to 6.58) and severe wasting (AHR=1.98; 95% CI 1.08 to 3.64). CONCLUSION AND RECOMMENDATION: The incidence rate of anaemia was high and it was provoked by predictors like CPT, ART adherence, TB, WHO clinical stage and wasting. Therefore, it is necessary to emphasise for these predictors.

Asunto(s)

Anemia , Terapia Antirretroviral Altamente Activa , Infecciones por VIH , Humanos , Etiopía/epidemiología , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Masculino , Estudios Retrospectivos , Anemia/epidemiología , Preescolar , Terapia Antirretroviral Altamente Activa/efectos adversos , Incidencia , Lactante , Estudios de Seguimiento , Cumplimiento de la Medicación/estadística & datos numéricos , Factores de Riesgo , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Combinación Trimetoprim y Sulfametoxazol/efectos adversos , Tuberculosis/epidemiología

RESUMEN

Iron deficiency in pregnancy is related to many poor health outcomes, including anemia and low birth weight. A small number of previous studies have identified maternal body mass index (BMI) as a potential risk factor for poor iron status. Our objective was to examine the association between pre-pregnancy BMI, iron status, and anemia in a nationally representative sample of US adult women. We used data from the National Health and Nutrition Examination Survey (NHANES; 1999-2010) for pregnant women ages 18-49 years (n = 1156). BMI (kg/m2) was calculated using pre-pregnancy weight (self-reported) and height (measured at examination). Iron deficiency (ID) was defined as total body iron (calculated from serum ferritin and transferrin receptor using Cook's equation) < 0 mg/kg and anemia as hemoglobin < 11 g/dL. Associations were examined using weighted linear and Poisson regression models, adjusted for confounders (age, race/ethnicity, education, and trimester). Approximately 14% of pregnant women had ID and 8% had anemia in this sample. Ferritin and total body iron trended slightly lower (p = 0.12, p = 0.14) in women with pre-pregnancy BMI in the normal and overweight categories compared to the underweight and obese categories; hemoglobin concentrations were similar across BMI groups (p = 0.76). There were no differences in the prevalence of ID or anemia in women with pre-pregnancy overweight and obesity (ID: overweight, adjusted prevalence ratio (PR) = 1.27, 95%CI: 0.89-1.82; obesity, PR = 0.75, 95%CI: 0.39-1.45; anemia: overweight, PR = 1.08, 95%CI: 0.53-2.19; obesity, PR = 0.99, 95%CI: 0.49-2.01) compared to women with a normal BMI. Findings from these US nationally representative data indicate that total body iron, serum hemoglobin, ID, and anemia in pregnancy do not differ by pre-pregnancy BMI. Since ID and anemia during pregnancy remain significant public health concerns, NHANES should consider measuring current iron status in upcoming cycles.

Asunto(s)

Anemia Ferropénica , Índice de Masa Corporal , Hierro , Encuestas Nutricionales , Humanos , Femenino , Embarazo , Adulto , Hierro/sangre , Estados Unidos/epidemiología , Adulto Joven , Adolescente , Anemia Ferropénica/epidemiología , Anemia Ferropénica/sangre , Persona de Mediana Edad , Anemia/epidemiología , Anemia/sangre , Ferritinas/sangre

RESUMEN

BACKGROUND: There is currently no research on the correlation between novel inflammatory indexes systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the risk of anemia in chronic kidney disease (CKD) population, as well as survival analysis in CKD with anemia. METHODS: This investigation encompassed 4444 adult subjects out of the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. The study utilized multi-variable logistic regression to assess the relationship between SII, NLR, PLR, and anemia risk occurrence in CKD population. Survival differences in CKD patients with anemia, based on varying levels of SII, NLR, and PLR were evaluated employing Kaplan-Meier and Cox proportional hazards models. RESULTS: The adjusted logistic regression model demonstrates that SII, NLR, and PLR are associated with the risk of anemia occurrence in CKD population. Kaplan-Meier's analysis reveals significant differences in survival rates among CKD patients with anemia stratified by NLR levels. The adjusted Cox proportional hazards model shows that the higher NLR group has a 30% elevated risk of all-cause mortality contrasted with lower group (hazard ratio, HR: 1.30, confidence interval (CI) [1.01, 1.66], p value <.04). Restricted cubic spline (RCS) demonstrates no nonlinear relationship between NLR and all-cause mortality. Lastly, sub-cohort analysis indicates that in populations with diabetes, hypertension, and hyperuricemia, NLR levels have a greater impact on all-cause mortality. CONCLUSIONS: Controlling inflammation may reduce the occurrence of anemia in CKD populations, with NLR serving to be a potential prognostic indicator for survival results within CKD patients suffering from co-morbid anemia.

Asunto(s)

Anemia , Inflamación , Encuestas Nutricionales , Insuficiencia Renal Crónica , Humanos , Masculino , Femenino , Anemia/complicaciones , Anemia/epidemiología , Anemia/sangre , Insuficiencia Renal Crónica/mortalidad , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/sangre , Persona de Mediana Edad , Adulto , Inflamación/sangre , Anciano , Neutrófilos , Estimación de Kaplan-Meier , Modelos de Riesgos Proporcionales , Análisis de Supervivencia , Estados Unidos/epidemiología , Linfocitos , Modelos Logísticos

RESUMEN

Initial research indicates a possible connection between exposure to phthalates and the development of anemia. To fill the gap in epidemiological data, our study utilized data from across the United States, representative on a national scale, to evaluate the association between the concentration of phthalate metabolites in urine and both anemia and iron levels. We gathered data on 11,406 individuals from the National Health and Nutrition Examination Survey (NHANES) database, spanning 2003-2018. We conducted logistic and linear regression analyses, adjusted for potential confounding factors, to evaluate the correlations between different phthalate metabolites and anemia, as well as serum iron levels, including gender-stratified analysis. Most urinary phthalate metabolites were positively correlated with an increased risk of anemia, and the majority were negatively correlated with serum iron levels. The study revealed that for every unit increase in ln-transformed metabolite concentrations, the odds ratios (ORs) for anemia increased to varying degrees, depending on the phthalate: Monobutyl phthalate (MBP) at 1.08 (95% CI 1.01-1.17, P = 0.0314), mono(3-carboxypropyl) phthalate (MCPP) at 1.17 (95% CI 1.10-1.24, P < 0.0001), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) at 1.08 (95% CI 1.02-1.15, P = 0.0153), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) at 1.14 (95% CI 1.07-1.21, P < 0.0001), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) at 1.11 (95% CI 1.03-1.18, P = 0.0030), monocarboxynonyl phthalate (MCNP) at 1.11 (95% CI 1.03-1.19, p = 0.0050), and monocarboxyoctyl phthalate (MCOP) at 1.13 (95% CI 1.07-1.19, P < 0.0001). Increased levels of MBP, MEHP, MBzP, MCPP, MEHHP, MEOHP, MIBP, MECPP, MCNP, and MCOP were linked with changes in serum iron levels, ranging from - 0.99 µg/dL (95% CI - 1.69 to - 0.29) to - 3.72 µg/dL (95% CI - 4.32 to - 3.11). Mixed-exposure analysis shows consistency with single-exposure model. Further mediation analysis showed that the association between single urinary phthalates and the risk of anemia was mediated by serum iron with a mediation ratio of 24.34-95.48% (P < 0.05). The presence of phthalate metabolites in urine shows a positive correlation with the prevalence of anemia, which was possibly and partly mediated by iron metabolism. Nonetheless, to confirm a definitive causal link and comprehend the underlying mechanisms of how phthalate exposure influences anemia, additional longitudinal and experimental research is required.

Asunto(s)

Anemia , Encuestas Nutricionales , Ácidos Ftálicos , Humanos , Ácidos Ftálicos/orina , Ácidos Ftálicos/sangre , Masculino , Femenino , Anemia/orina , Anemia/epidemiología , Anemia/inducido químicamente , Anemia/sangre , Estados Unidos/epidemiología , Adulto , Persona de Mediana Edad , Hierro/orina , Hierro/sangre , Hierro/metabolismo , Exposición a Riesgos Ambientales/efectos adversos

RESUMEN

INTRODUCTION: In Ethiopia, more than half (57%) of children aged 6-59 months were estimated to be anemic in 2016 alone. The country had about 37% of under-five children suffering from stunting and under-five mortality rate of 59 deaths per 1000 live births in 2019. The main purpose of this paper was to estimate the proportion of under-five children prevented from childhood undernutrition, anemia, and under-five mortality by removing the risk factors or inequalities. METHOD: This cross-sectional study was based on a pooled total sample of 29,831 children aged 0-59 months drawn from three rounds of the Ethiopian Demography and Health Surveys (2005-2016). We employed multiple logistic regression analysis to identify the modifiable risk factors associated with childhood anemia, undernutrition, and under-five mortality among under-five children. We also used Population Attributable Fractions (PAFs) to estimate the proportion of under-five children that could be prevented from childhood undernutrition, anemia, and under-five mortality by removing inequalities. RESULT: PAF analyses of risk factors of childhood anemia confirmed that 38.5% of occurrence of childhood anemia was attributed to five selected risk factors, which include having a large household size (5+), being in a poor household, being born from anemic and unemployed mothers, and being breastfed for less than six months. About 45.6% of occurrences of childhood undernutrition were attributed to unimproved toilet facility, solid cooking fuel, and home delivery. About 72% of the reported under-five mortality could possibly be averted by removing the use of unimproved toilet facilities, early age childbirth (< 18 years old mothers), and a large number of children ever born to mothers and less than six months breastfeeding practice at the population level. CONCLUSION: The present study suggests that a substantial reduction in the prevalence of childhood anemia, undernutrition, and under-five mortality in the country is attainable if child survival-focused program interventions and policies target households and mothers with low socioeconomic status and those who have low awareness of child healthcare, including breastfeeding practice and use of safe sanitation facilities.

Asunto(s)

Anemia , Mortalidad del Niño , Encuestas Epidemiológicas , Humanos , Etiopía/epidemiología , Lactante , Preescolar , Anemia/epidemiología , Femenino , Estudios Transversales , Factores de Riesgo , Masculino , Recién Nacido , Factores Socioeconómicos , Salud Infantil , Trastornos de la Nutrición del Niño/epidemiología

RESUMEN

Objective: To identify the correlation of preventive nutrition for anaemia with perceived benefits, perceived barriers and commitment among young females. METHODS: The correlational, cross-sectional study was conducted from June to July 2022 in Surabaya, East Java, Indonesia, and comprised young females. The independent variables were perceived benefits, perceived barriers, and commitment. The dependent variable was preventive nutrition for anaemia. Data was collected online using Google Form. Data was analysed using a software SPSS version 23. RESULTS: There were 112 females with mean age 19.63±1.501 years. There were 101(90.2%) aged 18-24 years, and 100(89.3%) were in senior high school. Perceived benefits (p=0.021; r=0.218), perceived barriers (p=0.002; r=-0.286) and commitment (p=0.000; r=0.345) had a significant relationship with preventive nutrition for anaemia. Conclusion: Perceived benefits and high commitment to increase preventive nutrition against anaemia was seen in female adolescents. However, high perceived barrier could suppress their preventive nutrition.

Asunto(s)

Anemia , Humanos , Femenino , Adolescente , Estudios Transversales , Adulto Joven , Indonesia/epidemiología , Anemia/prevención & control , Anemia/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Estado Nutricional

RESUMEN

OBJECTIVES: Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN: Retrospective analysis of prospectively collected database. SETTING: A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0-11.9 g/dL for women, 10.0-13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS: Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05-1.67). CONCLUSIONS: In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.

Asunto(s)

Anemia , COVID-19 , Paro Cardíaco , Hemoglobinas , Insuficiencia Respiratoria , Accidente Cerebrovascular , Humanos , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/sangre , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Paro Cardíaco/epidemiología , Paro Cardíaco/etiología , Hemoglobinas/análisis , Hemoglobinas/metabolismo , Anciano , Anemia/epidemiología , Anemia/sangre , Insuficiencia Respiratoria/epidemiología , Insuficiencia Respiratoria/etiología , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/sangre , Unidades de Cuidados Intensivos , SARS-CoV-2 , Sistema de Registros , Factores de Riesgo , Adulto

RESUMEN

Anemia is a common but often underdiagnosed and undertreated geriatric syndrome in hospitalized older patients. In this retrospective multicenter study, we aimed at characterizing the prevalence, risk factors, diagnostic and treatment approach to anemia in older patients admitted to acute care hospitals, focusing on differences between nephrology and geriatrics units. Prevalence and risk factors for anemia, diagnostic inertia (lack of iron, vitamin B12, and folate status assessment), replacement inertia (omitted treatment with iron, vitamin B12 or folic acid), and erythropoiesis-stimulating agents (ESA) inertia were explored. 1963 patients aged 82.7 (6.8) years were included in the study; 66.7% of the study population had anemia; among anemic patients, diagnostic inertia and replacement inertia were common with rates of 22-31% and 50-87%, respectively; omitted treatment with ESA affected 67.2% of patients and was more prevalent in geriatric units. In most cases, patients with ESA inertia were not routinely screened for iron tests. COPD, cancer, eGFR 45-60 ml/min were associated with increased tendency to ESA inertia. In conclusion, anemia had a high prevalence in older patients discharged from acute care units, but it is often underdiagnosed and undertreated.

Asunto(s)

Anemia , Hospitalización , Humanos , Anciano de 80 o más Años , Anemia/epidemiología , Anemia/terapia , Femenino , Masculino , Factores de Riesgo , Prevalencia , Italia/epidemiología , Anciano , Estudios Retrospectivos , Hematínicos/uso terapéutico , Nefrología , Geriatría/métodos

RESUMEN

OBJECTIVE: Anaemia is associated with an increased risk of disease progression and all-cause mortality among HIV-infected individuals, regardless of the type of anaemia, but the magnitude of the risk is greater with more severe forms of anaemia. Although anaemia PLWH has been extensively studied, the focus has primarily been on its prevalence and association with disease progression in untreated or poorly controlled HIV cases. This study aimed to investigate the prevalence, and factors associated with moderate-to-severe anaemia among virally suppressed HIV patients at a tertiary hospital in Zambia. METHODS: We conducted a cross-sectional study of ART-treated PLWH for at least 6 months at Livingstone University Teaching Hospital (LUTH). Sociodemographic, clinical, and laboratory were the data collected. The primary outcome moderate to severe anaemia was defined as follows; moderate anemia as haemaoglobin levels between 8.0-10.9 g/ and severe anemia as haemoglobin levels less than 8.0 g/dL according to the WHO classification. Logistic regression was performed to identify factors associated with moderate-to-severe anaemia. RESULTS: Among 823 participants with viral suppression, the overall prevalence of anaemia and moderate-to-severe anaemia was 29.4% (n = 242; 95% confidence interval (CI): 26.3-32.6) and 14.2% (n = 117, 95% CI: 11.7-18), respectively. In the adjusted logistic regression analysis, women had higher odds of moderate to severe anaemia compared to men (AOR 2.618, 95% CI 1.182-5.799). Lymphocyte count (AOR 0.525, 95% CI 0.31-0.90) and higher BMI (AOR 1.0671, 95% CI 1.01-1.13) were also significant factors. Microcytosis (AOR 49.79, 95% CI 12.95-191.49) and normocytosis (AOR 4.38, 95% CI 1.22-15.75) were strongly associated with higher odds compared to macrocytosis. NNRTI treatment was associated with higher odds of anaemia compared to INSTI treatment (AOR 5.231, 95% CI 1.04-26.33). Traditional risk factors for anaemia like CD4+ count and tuberculosis infection were not significant. CONCLUSION: We found a higher prevalence of anaemia and moderate-to-severe anaemia in virally suppressed PLWH, suggesting factors beyond HIV contribute to the persistence of anaemia in this cohort. Women, lower lymphocyte count, higher BMI, low mean corpuscular volume (microcytosis) indicative of microcytic anaemia, and NNRTI-based ART regimens were independently associated with moderate-to-severe anaemia. Further research is warranted to explain the underlying mechanisms and optimize clinical management to improve outcomes among virally suppressed PLWH.

Asunto(s)

Anemia , Infecciones por VIH , Centros de Atención Terciaria , Humanos , Anemia/epidemiología , Anemia/complicaciones , Femenino , Masculino , Zambia/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Infecciones por VIH/tratamiento farmacológico , Adulto , Prevalencia , Estudios Transversales , Persona de Mediana Edad , Factores de Riesgo , Fármacos Anti-VIH/uso terapéutico

RESUMEN

BACKGROUND: Anemia is common and associated with increased morbidity among people with HIV (PWH). Classification of anemia using the mean corpuscular volume (MCV) can help investigate the underlying causative factors of anemia. We characterize anemia using MCV among PWH receiving antiretroviral therapy (ART), and identify the risk factors for normocytic, macrocytic, and microcytic anemias. METHODS: Including PWH with anemia (hemoglobin measure < 12.9 g/dL among men and < 11.9 g/dL among women) in the NA-ACCORD from 01/01/2007 to 12/31/2017, we estimated the annual distribution of normocytic (80-100 femtolitre (fL)), macrocytic (> 100 fL) or microcytic (< 80 fL) anemia based on the lowest hemoglobin within each year. Poisson regression models with robust variance and general estimating equations were used to estimate crude and adjusted prevalence ratios and 95% confidence intervals for risk factors for macrocytic (vs. normocytic) and microcytic (vs. normocytic) anemia stratified by sex. RESULTS: Among 37,984 hemoglobin measurements that identified anemia in 14,590 PWH, 27,909 (74%) were normocytic, 4257 (11%) were microcytic, and 5818 (15%) were macrocytic. Of the anemic PWH included over the study period, 1910 (13%) experienced at least one measure of microcytic anemia and 3208 (22%) at least one measure of macrocytic anemia. Normocytic anemia was most common among both males and females, followed by microcytic among females and macrocytic among males. Over time, the proportion of anemic PWH who have macrocytosis decreased while microcytosis increased. Macrocytic (vs. normocytic) anemia is associated with increasing age and comorbidities. With increasing age, microcytic anemia decreased among females but not males. A greater proportion of PWH with normocytic anemia had CD4 counts ≤ 200 cells/mm3 and had recently initiated ART. CONCLUSION: In anemic PWH, normocytic anemia was most common. Over time macrocytic anemia decreased, and microcytic anemia increased irrespective of sex. Normocytic anemia is often due to chronic disease and may explain the greater risk for normocytic anemia among those with lower CD4 counts or recent ART initiation. Identified risk factors for type-specific anemias including sex, age, comorbidities, and HIV factors, can help inform targeted investigation into the underlying causes.

Asunto(s)

Anemia , Índices de Eritrocitos , Infecciones por VIH , Humanos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/sangre , Masculino , Femenino , Anemia/epidemiología , Anemia/sangre , Adulto , Persona de Mediana Edad , Factores de Riesgo , América del Norte/epidemiología , Prevalencia , Hemoglobinas/análisis , Fármacos Anti-VIH/uso terapéutico , Recuento de Linfocito CD4

RESUMEN

BACKGROUND: Plasmodium falciparum infection is associated with the human ABO blood group. However, there is a paucity of data on the role that ABO and Rhesus blood groups play in malaria clinical presentations. Therefore, the objective of this study was to assess the association of human ABO blood groups and the Rhesus blood (Rh) types with the severity of malaria. METHODS: This cross-sectional study was carried out at the Suhum Government Hospital in the Eastern region of Ghana. Conveniently, study participants with malaria, diagnosed by microscopy, were selected into the study. Subsequently, their ABO and Rh blood groups were determined (Accucare ABO/Rh monoclonal antibodies, Chennai, India). Malaria severity was assessed using the criteria for assessing severe malarial anaemia published by the World Health Organization. According to the criteria, severe malarial anaemia was classified as having haemoglobin (Hb) < 5 g/dL for children < 12 years and in patients ≥ 12 years, Hb level < 7 g/dL, with parasitaemia > 10,000/µL in both cases. Severe malarial anaemia was also classified as having plasma bilirubin > 50 µmol/L with parasitaemia ≥ 100,000/µL, for all ages. Chi square statistical analysis was used to test the association between the blood groups and the clinical or laboratory findings, while multivariate analysis was performed to identify which blood groups were more vulnerable to develop severe malarial anaemia. RESULTS: Of the total number of the study participants (n = 328), most of the patients had blood group O Rh positive (35.7%) while few of them had blood group AB Rh negative (2.1%). The types of Rhesus did not associate with malaria. However, compared to blood group O, the odds of developing severe malarial anaemia, in children < 12 years and in patients ≥ 12 years, were 16 times and 17.8 times higher among patients with blood group A, respectively. Furthermore, the odds of having bilirubin level > 50 µmol/L with parasitaemia ≥ 100,000 /µL was 10 times higher among patients with blood groups A and 2.6 times higher in patients with blood group B, compared to blood group O. Finally, in patients with blood group A majority (71.6%) of them developed high temperature (> 37.5 °C) while 43.3% of them vomited and had diarrhoea. However, pallor (group B = 46.2% vs group A = 37.3%), fever (group B = 84.6% vs group A = 79.1%) and nausea (group B = 46.2% vs group A = 25.4%) were more frequent in patients with blood group B than A. CONCLUSIONS: This study found that people with blood groups A and B were severely affected by malaria, with group A being the most vulnerable. It is recommended that blood group assessment be performed for all patients with malaria. Patients found to have blood group A or B must be promptly and efficiently managed to avoid the development of severe malaria anaemia.

Asunto(s)

Sistema del Grupo Sanguíneo ABO , Anemia , Malaria Falciparum , Sistema del Grupo Sanguíneo Rh-Hr , Humanos , Estudios Transversales , Masculino , Femenino , Preescolar , Niño , Ghana/epidemiología , Adulto , Malaria Falciparum/complicaciones , Malaria Falciparum/epidemiología , Malaria Falciparum/sangre , Anemia/etiología , Anemia/sangre , Anemia/epidemiología , Adolescente , Adulto Joven , Lactante , Persona de Mediana Edad , Anciano

RESUMEN

This study aimed to assess the prevalence of anemia in children of two Guarani communities in Misiones, Argentina, and to analyze its association with socioenvironmental and parasitic factors. This cross-sectional study took place in two villages, Koen Ju and Kaa Poty, and included Mbya Guarani children aged 6 months to 14 years. A multivariable analysis was performed to evaluate the association of anemia with the presence of intestinal parasites. Altogether, 162 children were included in the study: 53.1% were boys, 32.7% had low weight-for-age, and 22.2% low height-for-age. Nearly half (46.9%, n=76) had anemia, which was mainly mild (92.1%), with a few moderate cases (7.9%). Of the 109 children who underwent testing for intestinal parasites, 89 (81.7%) had at least one, and 53 (59.5%) had more than one. The main parasite was Blastocystis hominis (49.5%), followed by Entamoeba coli (47.7%), hookworms (36.7%), and Ascaris lumbricoides (31.5%). In the multivariable analysis, anemia was associated with intestinal parasitosis (adjusted odds ratio [OR] 4.24, 95% confidence interval [CI] 1.08-16.5; p=0.038) and male sex (adjusted OR 2.66; 95% CI 1.08-6.47; p= 0.01). Overall, we found that both anemia and intestinal parasites are common in the pediatric population of the Guarani ethnic group. Intestinal parasites and male sex were associated with the presence of anemia.

Asunto(s)

Anemia , Parasitosis Intestinales , Humanos , Argentina/epidemiología , Masculino , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Femenino , Estudios Transversales , Niño , Preescolar , Prevalencia , Lactante , Anemia/epidemiología , Anemia/parasitología , Adolescente , Factores Socioeconómicos , Indígenas Sudamericanos/estadística & datos numéricos , Heces/parasitología , Factores de Riesgo

RESUMEN

INTRODUCTION: Currently, kidney disease is an increasing major health problem worldwide. It is expected to be the 5th ranked cause of death by 2040. If it is early detected, further complication caused by kidney disease will be minimized. An assessment of impaired glomerular filtration rate (eGFR) has potential aids in early identification and treatment of kidney disease. However, in hospital practice instead of using eGFR, direct measurement of serum creatinine level is used for assessing renal function. Hence, this study is aimed to assess the magnitude and associated factors of impaired glomerular filtration rate among admitted patients in Wolkite University Specialized Teaching Hospital (WKUSTH). OBJECTIVE: To assess the magnitude and associated factors of impaired glomerular filtration rate in WKUSTH, Ethiopia 2023. METHOD: Institutional based cross-sectional study with secondary data was conducted. 338 participants were selected by a convenient sampling technique. Epidata 3.1 version for data entry and SPSS version 20 for data analysis was used. Bivariate analysis was used to screen candidate variables for multivariate analysis. In the multivariate analysis a P-value < 0.05 were considered statistically significant. RESULTS: The study enrolled 338 patients admitted to WUSTH. Seventy (20.7%) (95% CI: 16.6-25.4%) of them had impaired eGFR according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and Modification of Diet in Renal Disease (MDRD-4). older age (AOR 3.38, 95% CI; 1.31, 8.71), hypertension (AOR 17.8, 95% CI; 7.75, 41.22), anemia (AOR 2.51, 95% CI; 1.11, 5.83) DM (AOR 11.2, 95% CI; 4.11, 30.73), and high BMI (AOR 7.56, 95% CI; 3.16, 18.08), were independently associated with impaired eGFR. CONCLUSIONS: The magnitude of impaired eGFR was prevalent among adult patients admitted to WKUSTH medical ward with different medical conditions. Old age, Hypertension, Diabetes, high body mass index, and Anemia were significantly associated with impaired eGFR both in CKD-EPI and MDRD-4 equation. Estimation of GFR for all hospitalized adults with known CKD risk factors might help in early detection of CKD and prevent complications.

Asunto(s)

Tasa de Filtración Glomerular , Humanos , Etiopía/epidemiología , Estudios Transversales , Femenino , Masculino , Persona de Mediana Edad , Adulto , Factores de Riesgo , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/fisiopatología , Anciano , Adulto Joven , Hipertensión/epidemiología , Anemia/epidemiología

RESUMEN

BACKGROUND: Despite the intended 50% reduction in anemia in women of reproductive age, this tendency has only worsened. Even though iron deficiency is the most prevalent cause of anemia, anemia and chronic illnesses like HIV are closely associated; in fact, 48.6% of people living with HIV who were 15 years of age or older had anemia. However, the burden of anemia among HIV-positive women in sub-Saharan African (SSA) countries is not well documented. Therefore, the goal of our research was to investigate anemia and the factors that are linked to it in SSA women who had HIV infections. METHODS: A cross-sectional study was conducted using demographic and health survey datasets from 18 SSA countries. A total of 7823 weighted samples were included. STATA version 16 software was used for analysis. A multilevel logistic regression model was fitted. An adjusted odds ratio with a 95% CI and a p-value < 0.05 was used to declare significantly associated factors. RESULT: The overall prevalence of anemia was found to be 45.1% [95% CI: 43.97-46.18%]. Of those 5.05%, 37.97%, and 56.97% were severely, moderately, and mildly anemic, respectively. Education level of primary [AOR = 0.74, 95% CI: 0.62, 0.89], secondary [AOR = 0.81, 95% CI: 0.68, 0.98], and higher [AOR = 0.74, 95% CI: 0.55, 0.99], as well as current contraceptive use [AOR = 0.74, 95% CI: 0.63, 0.87] were negatively associated with anemia. While pregnancy [AOR = 1.51, 95% CI: 1.17, 1.94], breast feeding [AOR = 1.38, 95% CI: 1.17, 1.64], health insurance [AOR = 1.50, 95% CI: 1.25, 1.80], and menstruation within six weeks prior to data collection [AOR = 1.36, 95% CI: 1.20, 1.54] had a significant positive relation with anemia among HIV-infected women in SSA countries. CONCLUSION: Anemia is a serious public health problem among HIV-infected women in SSA countries. Pregnancy, breast feeding, health insurance, and menstruation within six weeks prior to data collection were significant risk factors. On the other education and current contraceptive use were significant protective factors for anemia among HIV-infected women in SSA countries. Therefore, strategies aimed at early identification of anemia may lead to an improvement in the health of HIV-infected women.

Asunto(s)

Anemia , Infecciones por VIH , Humanos , Femenino , África del Sur del Sahara/epidemiología , Adulto , Estudios Transversales , Anemia/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Prevalencia , Adulto Joven , Adolescente , Persona de Mediana Edad , Factores de Riesgo , Análisis Multinivel