Abstract
Context: The burden of TB in Africa tends to be exacerbated by the socio-economic situation and the high prevalence of intercurrent infections such as HIV, malaria and non-specific bacterial infections. These factors often result in anemia, making patients at high risk for anemia. Objective: We aimed to gain insights into the characteristics of anemia, hematologic variations and socio-economic status in untreated pulmonary TB patients (PTB) in Kinshasa, the Democratic Republic of Congo. Methods: We conducted a cross-sectional analysis of 200 smear-positive pulmonary TB patients (PTB) recruited at the initiation of TB treatment. Complete Blood Count, Iron profile, BMI, CRP and albuminemia were assessed. Data were analyzed using Student t or Mann Whitney tests as appropriate, and logistic regression was performed to assess the strength of associations. Results: Anemia was a regular finding in (69%). This anemia was mostly moderate (92.2%) and with iron deficiency pattern (48%). Hypoalbuminemia was observed in half of the subjects and appears to be correlated with the severity of anemia. Surprisingly, the severity of inflammation, as reflected by the CRP, was inversely correlated with the anemia. In the multivariate analysis, alcohol intake (OR: 2.38; IC 95%: 1.05 - 5.38), hypoalbuminemia (OR: 1.98; IC 95%: 1.02 - 3.82) and CRP rate were significantly associated with the presence of anemia among pulmonary tuberculosis at the diagnostic. Conclusion: This study demonstrates the heavy burden of the iron responsive anemia and risky life conditions in newly diagnosed TB patients, and underscores the potential usefulness of iron supplementation in the Congolese context.
Highlights
More than 130 years after the identification of Mycobacterium tuberculosis and 60 years after the first discovery of anti-tuberculous antibiotics, tuberculosis (TB) remains a public health concern, especially in developing countries
Alcohol intake (OR: 2.38; IC 95%: 1.05 - 5.38), hypoalbuminemia (OR: 1.98; IC 95%: 1.02 - 3.82) and CRP rate were significantly associated with the presence of anemia among pulmonary tuberculosis at the diagnostic
This study demonstrates the heavy burden of the iron responsive anemia and risky life conditions in newly diagnosed TB patients, and underscores the potential usefulness of iron supplementation in the Congolese context
Summary
More than 130 years after the identification of Mycobacterium tuberculosis and 60 years after the first discovery of anti-tuberculous antibiotics, tuberculosis (TB) remains a public health concern, especially in developing countries. TB is still a major cause of mortality in the world, after HIV/AIDS. The World Health Organization reported an estimate of 1.4 million TB deaths for 2015 [1]. Sickle Cell Anemia (SCA), a chronic hemolytic anemia, is highly prevalent in DRC and co-morbidity TB-SCA can be expected in this country as reported elsewhere [2] [3]. Each of these factors often results in anemia among other complications, making the Congolese population one at high risk for anemia of various origins
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