Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania
OBJECTIVE: To examine the association of anemia with human immunodeficiency virus (HIV) co-infection, indicators of socio-economic status (SES) and anthropometric status in TB-infected adults.
DESIGN: Cross-sectional data collection during screening for a clinical trial.
RESULTS: Overall, 750 females and 1693 males participated in this study, of whom respectively 49% and 24% were co-infected with HIV-1. Hemoglobin levels were significantly lower in females than in males and in HIV-positive than in HIV-negative participants. HIV co-infection in this antiretroviral-naïve population was also associated with severe anemia (hemoglobin < 85 g/l) in both women (prevalence ratio [PR] = 2.07, 95%CI 1.65–2.59) and men (PR 3.45, 95%CI 2.66–4.47). Although severe anemia was negatively associated with indicators of SES, especially in males, adjustment for SES indicators only marginally changed its association with HIV co-infection. In both sexes, anemia was inversely associated with anthropometric status, independently of HIV infection and SES.
CONCLUSION: Among TB-infected adults, anemia is strongly associated with HIV co-infection and anthropometric status, independently of SES indicators. As anemia is a risk factor for morbidity and mortality in both infections, the management of anemia in TB-HIV co-infected patients warrants special attention.
Document Type: Regular Paper
Affiliations: 1: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA; Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany 2: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA 3: Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania 4: Center for Biostatistics in AIDS Research and Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA 5: Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania 6: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
Publication date: 2011-07-01
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