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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Anaemia in a rural Ugandan HIV cohort: Prevalence at enrolment, incidence, diagnosis and associated factors
Tropical Medicine and International Health, Volume 13, No. 6, Year 2008
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Description
Objectives: To determine the prevalence and incidence of anaemia in HIV-positive and negative individuals; to identify risk factors for anaemia, prior to the introduction of HAART; and to determine the validity of the clinical diagnosis of anaemia. Methods: Between 1990 and 2003, we followed a rural population based cohort of HIV-infected and uninfected participants. Prevalence and incidence of anaemia were determined clinically and by laboratory measurements. The sensitivity, specificity and predictive values of clinical diagnosis were calculated. Results: The prevalence of anaemia at enrolment was 18.9% among HIV-positive and 12.9% among HIV-negative participants (P = 0.065). Incidence of anaemia increased with HIV disease progression, from 103 per 1000 person-years of observation among those with CD4 counts >500 to 289 per 1000 person-years of observation among those with CD4 counts <200. Compared to laboratory diagnosis, the clinical diagnosis of anaemia had a sensitivity of 17.8%, specificity of 96.8%, a positive predictive value of 50.6% and a negative predictive value of 86.4%. Being female, low CD4 cell counts, HIV-positive, wasting syndrome, WHO stage 3 or 4, malaria, fever, pneumonia and oral candidiasis were associated with prevalent anaemia. Conclusions: Anaemia prevalence and incidence were higher among HIV-positive than negative participants. Compared to laboratory diagnosis, clinical detection of anaemia had a low sensitivity. Clinicians working in settings with limited laboratory support must be conscious of the risk of anaemia when managing HIV/AIDS patients, particularly when using antiretroviral drugs which by themselves may cause anaemia as a side effect. We recommend that haemoglobin should be measured before starting ART and monthly for the first three months. © 2008 Blackwell Publishing Ltd.
Authors & Co-Authors
Mugisha, Joseph Okello
Uganda, Entebbe
Uganda Virus Research Institute
United Kingdom, London
Medical Research Council
Shafer, Leigh Anne
United Kingdom, London
Medical Research Council
Der Paal, Lieve Van
United Kingdom, London
Medical Research Council
Mayanja, Billy Nsubuga
United Kingdom, London
Medical Research Council
Eotu, Henry
United Kingdom, London
Medical Research Council
Hughes, Peter
United Kingdom, London
Medical Research Council
Whitworth, James Ag
United Kingdom, London
Wellcome Trust
Grosskurth, Heiner
United Kingdom, London
Medical Research Council
Statistics
Citations: 8
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1111/j.1365-3156.2008.02069.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Female