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Free Content Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania

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Abstract:

SETTING: Tuberculosis (TB) infected adults attending out-patient TB clinics 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-na├»ve 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.

Keywords: HIV; anemia; anthropometric status; pulmonary tuberculosis; socio-economic status

Document Type: Regular Paper

DOI: http://dx.doi.org/10.5588/ijtld.10.0477

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: July 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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