Abstract
BackgroundAnemia is a common hematologic disorder among human Immunodeficiency virus (HIV) infected adult Individuals. However, there is no concrete scientific evidence established at national level in Ethiopia. Hence, this review gave special emphasis on Ethiopian HIV infected adult individuals to estimate pooled prevalence of anemia and its associated factors at national level.MethodsStudies were retrieved through search engines in PUBMED/Medline, Cochrane Library, and the web of science, Google and Google scholar following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of the included studies. Random effects meta-analysis was used to estimate the pooled prevalence of anemia and associated factors at 95% Confidence interval with its respective odds ratio (OR). Meta regression was also carried out to identify the factors. Moreover, Sub-group analysis, begs and egger test followed by trim-and-fill analysis were employed to assess heterogeneity and publication bias respectively.ResultA total of 532 articles were identified through searching of which 20 studies were included in the final review with a total sample size of 8079 HIV infected adult individuals. The pooled prevalence of anemia was 31.00% (95% CI: 23.94, 38.02). Cluster of Differentiation 4 (CD4) count <= 200 cells/μl with OR = 3.01 (95% CI: 1.87, 4.84), World Health Organization (WHO) clinical stage III&IV with OR = 2.5 (95% CI: 1.29, 4.84), opportunistic infections (OIs) with OR = 1.76 (95% CI: 1.07, 2.89) and body mass index (BMI) < 18.5 kg/M2 with OR = 1.55 ((95% CI: 1. 28, 1.88) were the associated factors.ConclusionThis review demonstrates high prevalence of anemia among HIV infected adults. Low CD4 count, WHO clinical stage III&IV, OIs and low level of BMI were found to have significant association with the occurrence of anemia. Therefore, the responsible stockholders including anti retro viral treatment (ART) clinics should strengthen the system and procedures for the early diagnosis of opportunistic infection and screening of underlying problems. There should be also early screening for OIs and under nutrition with strict and frequent monitoring of HIV infected individuals CD4 count.
Highlights
Anemia is a common hematologic disorder among human Immunodeficiency virus (HIV) infected adult Individuals
There should be early screening for Opportunistic Infections (OIs) and under nutrition with strict and frequent monitoring of HIV infected individuals Cluster of differentiation 4 (CD4) count
We systematically reviewed and analyzed published research articles to determine the pooled prevalence of anemia and its associated factors among HIV infected adult individuals in Ethiopia
Summary
Anemia is a common hematologic disorder among human Immunodeficiency virus (HIV) infected adult Individuals. This review gave special emphasis on Ethiopian HIV infected adult individuals to estimate pooled prevalence of anemia and its associated factors at national level. Anemia is common hematologic disorder among HIV infected individuals [2] with impact on quality of life and clinical outcomes among these individuals [3]. This hematologic disorder may be attributed by HIV infection itself (the incidence is increased from asymptomatic to final Acquired Immuno Deficiency Syndrome (AIDS) stage) [4],OIs, gastrointestinal bleeding, nutritional deficiencies and erythropoietin depletion [5,6,7]. Another systematic analysis of global anemia in the year 1990–2013 reported the high burden of anemia in which developing countries account nearly 90 % of all anemia-related disability [10]
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