Fasil Wagnew1, Setegn Eshetie2, Animut Alebel3,4, Cheru Tesema3,4, Getiye Dejenu Kibret3,4, Alemu Gebrie3, Getenet Dessie5, Amanuel Alemu Abajobir6,7. 1. College of Health Science, Debre Markos University, Debre Markos, Ethiopia. fasilw.n@gmail.com. 2. College of Health Science, University of Gondar, Gondar, Ethiopia. 3. College of Health Science, Debre Markos University, Debre Markos, Ethiopia. 4. Faculity of health, University of Technology Sidney, Sidney, Australia. 5. College of Health Sciences, Bahirdar University, Bahirdar, Ethiopia. 6. Faculty of Medicine, The University of Queensland, Brisbane, Australia. 7. African Population and Health Research Center, Maternal and Child Wellbeing Unit, Nairobi, Kenya.
Abstract
BACKGROUND: Anemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. METHODS: MEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out. RESULTS: In Ethiopia, the overall prevalence of anemia in HIV infected children was 22.3% (95% CI: 18.5-26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2-0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias. CONCLUSION: On aggregate, anemia is a common comorbidity in pediatric HIV patients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.
BACKGROUND:Anemia is a common problem in HIV (human immunodeficiency virus) infectedpatients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. METHODS: MEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out. RESULTS: In Ethiopia, the overall prevalence of anemia in HIV infectedchildren was 22.3% (95% CI: 18.5-26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2-0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias. CONCLUSION: On aggregate, anemia is a common comorbidity in pediatric HIVpatients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.
Entities:
Keywords:
Anemia; Children; Comorbidity; Epidemiology; Ethiopia; HAART; HIV; Human immunodeficiency virus; Iron status; Meta-analysis; Prevalence; Systematic review
Authors: Rimel N Mwamba; Saumya S Sao; Brandon A Knettel; Linda M Minja; Haika Osaki; Blandina T Mmbaga; Melissa H Watt Journal: AIDS Behav Date: 2020-10-03