Incidence and predictors of Anemia among Children who are on Antiretroviral Therapy at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia 2007-2017.

Abstract

Abstract Introduction: anemia is the most common hematological abnormality among children who are on anti -retroviral therapy. In Africa, regardless of the initiation of antiretroviral therapy the incidence of anemia among children who are on Human immunodeficiency virus care is high. In Ethiopia, as far as my search, there is no studies done on incidence and predictors of anemia among children who are on anti -retroviral therapy. Objective: This study was aimed to assess the incidence and predictors of anemia among children who are on anti-retroviral therapy, attending antiretroviral therapy care at the University of Gondar comprehensive specialized Hospital, North west Ethiopia, from 2007 to 2017. Methods: A retrospective follow-up study was conducted among 405 children who are on antiretroviral therapy with simple random sampling technique., the extracted data was entered to EPi info version seven and exported into a statically package of social science version twenty software. Mean survival time for children to be anemia free was estimated. Kaplan -Meir was employed for analysis of probabilities of developing anemia.log rank test was used to compare survival curves among different independent variables. Cox regression was used. P-value less than or equal to 0.05 was considered statically significant. Results: The total follow-up period was 935 child-years of observation with a median followup times of 1.75 years. With this follow-up 98(25.1%) of child developed anemia which gives the

overall incidence rate of anemia 10.5(95% confidence interval (8.6, 12.8)) per 100 child-year. The independent predictors of anemia were being severe-immunosuppressed (adjusted hazard ratio=2.9, (95% confidence interval (1.23-6.77)), under nutrition (adjusted hazard ratio =2.8, (95% confidence interval (1.467-4.6)), taking zidovudine based ART regimen (adjusted hazard ratio =4, (95% confidence interval (1.23-12.9)), and tuberculosis (adjusted hazard ratio =2.1(95% confidence interval (1.4-3.3)). Conclusion: Anemia incidence rate among children who are on Antiretroviral Therapy at University Of Gondar comphrensive Specialized Hospital was high. Tuberculosis, zidovudine based drugs, severe immunosuppression, and under nutrition were remained statically significant predictors of anemia among children with Antiretroviral Therapy. Hence, it is better to give nutritional screening and management along with HIV care. Key Words: Anemia, Anti-Retroviral-Therapy, children, Ethiopia and incidence