Independent Predictors Of Anemia Research Articles

Prevalence of anemia and associated factors among adult hypertensive patients in Referral Hospitals, Amhara Regional State

Anemia is a risk factor for adverse cardiovascular disease outcomes in hypertensive patients. Chronic anemia increases preload, reduces afterload, and leads to increased cardiac output in hypertension patients. In the long term, this may result in maladaptive left ventricular hypertrophy, which in turn is a well-recognized risk factor for cardiovascular disease outcomes and all-cause mortality in hypertension. Low hemoglobin and hematocrit levels might be strongly indicate hypertensive end-organ damage, specifically kidney failure. Therefore, this study determined the prevalence of anemia and associated factors among hypertensive patients in Referral Hospitals, Amhara Regional State, Ethiopia, in 2020. An institution-based cross-sectional study was conducted in Amhara Regional Referral Hospitals from February 20 to April 30, 2020. Random and systemic sampling techniques were used to select 428 study participants. Data were entered and coded in to Epi data version 3.0 and then exported into STATA 14 for analysis. In bivariable logistic regression, variables with a p-value of < 0.25 were included in multivariable logistic regression. Using a 95% confidence interval, variables having a p-value ≤ 0.05 in multivariable logistic regression were declared as statistically significant variables. In this study, a total of 428 study participants were involved with 99.5% response rate. The prevalence of anemia among hypertensive patients was 17.6%, with a 95% CI (14.3–21.5%). Estimated glomerular filtration rate (eGFR) < 90 ml/min (AOR = 2.77, 95% CI 1.56- 4.92)], duration of hypertension (HTN) ≥ 5 years (AOR = 2.37, 95% CI 1.36–4.15), uncontrolled blood pressure (AOR = 1.91, 95% CI 1.08–3.35), and higher pulse pressure (AOR = 1.05 (95% CI 1.02–1.08) were significantly associated with anemia. Nearly one out of five hypertensive patients had anemia. Impaired estimated glomerular filtration rate, duration of HTN, blood pressure status, and pulse pressure were the independent predictors of anemia among hypertensive patients. Screening hemoglobin level at a regular interval is recommended for the hypertensive patients to take an appropriate intervention.

Prevalence And Determinants of Anemia Among Adolescents in Coimbatore District, Tamil Nadu – A School Based Analytical Cross-Sectional Study

Context: The objective of the study was to estimate the prevalence of anemia among adolescents 10 to 19 years of age disaggregated by age group and gender. We also assessed the determinants of anemia among adolescents. Methods: An analytical cross-sectional study was carried out between July and November 2019 in a senior secondary public school, located in Coimbatore district, Tamil Nadu, India using a predesigned, semi-structured, pretested proforma that included haemoglobin estimation using oxyhemoglobin method. Results: The overall prevalence of anemia was 88.6% (95% CI 87.2 to 89.8); it was ten percent points higher in females (93.8%, 95% CI 92.1 to 95.1) compared to males (83.9%, 95% CI 81.7 to 85.8). Multivariate regression analysis showed that early adolescents (AOR 3.05, 95% CI 2.19 to 4.24), females (AOR 6.94, 95% CI 4.90 to 9.83), those with A or B or AB blood groups (AOR 2.58, 95% CI 1.92 to 3.49), physical inactivity (AOR 2.18, 95% CI 1.43 to 3.33) and attainment of menarche (AOR 2.69, 95% CI 1.73 to 4.21) were independent predictors of anemia in adolescents. Conclusion: It is the need of the hour to identify vulnerable groups; factors that predict occurrence, prioritize them to design and implement an effective public health action. Also, the effectiveness of existing strategies in the form of periodic deworming, Iron and Folic acid tablets (IFA) should be reassessed.

Prevalence and Associated Risk Factors of Anemia Among Hospitalized Children in a Tertiary Level Hospital in Botswana.

Anemia is a global health concern and has been associated with long term cognitive and behavioral adverse effects. A cross sectional study was conducted to determine the prevalence of and risk factors for anemia in infants and children between 6 months to 5 years of age admitted to a tertiary hospital in Botswana. Baseline full blood count of every patient admitted during the study period was assessed to determine if anemia was present. Data were collected from patient's medical inpatient chart, electronic medical record (Integrated Patient Management System (IPMS)), and through interviewing parents and caregivers. Multivariate logistic regression model was used to identify risk factors of anemia. A total of 250 patients were included in the study. Prevalence of anemia in this cohort was 42.8%. There were 145 (58%) males. Of the patients with anemia, 56.1%, 39.2%, and 4.7% had mild, moderate, and severe anemia, respectively. Microcytic anemia consistent with iron deficiency was identified in 61 (57%) patients. Age was the only independent predictor of anemia. Children aged 24 months and more had a 50% lower risk of having anemia than their younger counterparts (odds ratio (OR) 0.52; 95% Confidence Interval (95% CI) 0.30 to 0.89). The findings of this study demonstrate anemia as a serious health concern in the pediatric population in Botswana.

The impact of anemia on treatment management and clinical outcomes of women hospitalized for uterine leiomyomas.

Uterine leiomyomas are the most common benign gynecological tumors. Symptomatic leiomyomas represent a major cause of hospitalization, particularly those associated with abnormal uterine bleeding (AUB) and anemia. The aim of this study was to identify predictors of anemia in women hospitalized due to uterine leiomyomas and evaluate its impact on treatment management and clinical outcomes. Population-based retrospective study of women hospitalized for uterine fibroids in public hospitals in mainland Portugal between 2010 and 2015. Data were extracted from the national database of the Central Administration of the Portuguese Health System. Comparative and multivariable logistic regression analysis was performed to assess outcomes. A total of 36 295 patients were hospitalized due to uterine leiomyomas during this period. Of those, 11.5% presented with anemia. Age, obesity, intramural type of leiomyoma and AUB are independent predictors of anemia (p < 0.001, AUC 0.7056). Anemia was associated with a high risk of inpatient hospitalization (OR: 5.161, 95% CI: 4.376-6.085), urgent admission (OR: 1.953, 95% CI: 1.797-2.121), radical surgical approach (OR: 2.559, 95% CI: 2.298-2.849), laparoscopic hysterectomy (OR: 1.575, 95% CI: 1.393-1.780) and intra- and post-operative complications (OR: 5.285, 95% CI: 4.332-6.448). It was also associated with longer hospital stays (p < 0.001). These outcomes were more pronounced in acute anemic patients. Anemia has a significant impact on treatment approaches and clinical outcomes of women hospitalized for uterine leiomyomas. Age, obesity, intramural leiomyomas and AUB are some predictors of anemia that could represent a risk-stratification opportunity, allowing for its prompt identification and correction, therefore improving patient care.

Prevalence and Correlates of Anemia among Adolescents Living in Hodeida, Yemen.

This study assesses the prevalence and correlates of anemia among adolescents living in the war-affected region of Hodeida in Yemen. A secondary objective was to examine the effect of a nutrition education intervention on hemoglobin levels among anemic adolescents. A cross-sectional study was conducted on a random sample of adolescents aged 15–19 years in Hodeida (n = 400). A questionnaire was administered to inquire about demographic, socioeconomic, lifestyle and clinical characteristics. Capillary blood was obtained, anthropometric characteristics were measured and stool samples were collected. As for the secondary objective, anemic adolescents were randomly assigned to an intervention group (nutrition education and iron supplementation) and a control group (iron supplements only). The prevalence of anemia was 37.8%. Female gender, khat chewing, excessive menstruation, and experiencing headaches, fatigue, or dizziness were independent predictors of anemia. In contrast, adolescents who attended private schools, and reported snack consumption or handwashing had a significantly lower risk of anemia. A sample of 116 adolescents participated in the intervention (3 months). Hemoglobin levels were significantly higher in the intervention group compared to the control. Our findings contribute to the identification of high-risk groups that should be targeted by context-specific interventions. The implemented multicomponent intervention may serve as a prototype for larger-scale preventive programs.

Anemia and its associated factor among adolescent school girls in GODEY and DEGEHABUR council Somali region, eastern Ethiopia

A cross-sectional study was conducted in a higher secondary school in Godey and Degehabur council to estimate the prevalence of anaemia among school-going adolescent girls and to identify the associated factors. Haemoglobin levels were assessed directly in the school. Data related to socio-demographic, socio-economic characteristics, dietary habits, past health status and anaemia related knowledge among adolescents’ girls were collected by interview method and analyzed with the help of SPSS version 25. The prevalence of anaemia was found to be 31.5% among adolescent girls. Family size ≥5 people and lack of anaemia knowledge were independent predictors of anaemia. Therefore, the present study emphasizes the need for development of health and nutrition education strategies to improve dietary habits, family planning, and intermittent iron-folic acid supplementation with intensifying adolescent anemia prophylaxis programs.

Prevalence and predictors of anemia among adults on highly active antiretroviral therapy in Northeast Ethiopia: A retrospective cohort study.

Although antiretroviral therapy has significantly altered the natural history of human immunodeficiency virus infection and improved the quality of life of patients, there are conflicting reports regarding its impact on hematological outcomes. Thus, this study aimed at investigating the prevalence and predictors of anemia among adults on antiretroviral therapy in Northeast Ethiopia. A retrospective cohort study was carried out among adults who began antiretroviral treatment between September 2005 and January 2019 at two governmental hospitals in Dessie town. Data were collected from patients' medical records using a pretested data extraction instrument. Anemia was the primary outcome variable of the study. It was defined based on WHO criteria after adjustment for altitude and smoking status of measured values. Data were entered and validated using EpiData Version 3.1 and then exported to SPSS Version 20.0 for analysis. Descriptive analysis was done for prevalence and binary logistic regression was carried out to assess whether covariates were associated with experiencing anemia. Statistical significance has been considered at p-value <0.05. Medical records of 392 patients (mean age: 35.58 ± 9.46 years) were reviewed. Of the total 392 patients, 218 (55.6%) were females, 261 (66.6%) were categorized under WHO clinical stage III/IV and 134 (34.2%) had a baseline CD4 cell count of <100 cells/mm3. The mean baseline CD4 cell count was 179 cells/mm3 (range: 2 to 853 cells) and 230 (58.7%) of the participants were on zidovudine-based regimen. Anemia was diagnosed among 162 (41.3%) patients. After adjustment for other confounding factors, risk of anemia was significantly associated with low baseline CD4 cell count (AOR 1.80, 95% CI 1.05-3.06) and tenofovir based regimen (AOR 2.05, 95% CI 1.31-3.21). On the other hand, being educated was found to be protective (AOR 0.40, 95% CI 0.21-0.78). In this research, the prevalence of anemia was relatively high. Low baseline CD4 cell count and tenofovir based regimen were independent predictors of anemia; while being educated was protective. Treatment programs should focus on early diagnosis and treatment of HIV as well as routine screening and proper treatment of anemia.

Predictors of Anaemia Prevalence Among Ghanaian Pregnant Women: A Cross-Sectional Study

Anaemia during pregnancy is a major public health concern. Despite its wide scope and adverse effects including increased maternal and perinatal morbidity and mortality, and long-term adverse effects on the newborn, appropriate interventions using upstream approaches to public health have largely not been implemented. This study investigated the prevalence and associated factors of anaemia among pregnant women in four health facilities in the Kwabre East Municipality. A cross-sectional survey with a two-stage sampling technique was conducted on 220 pregnant women who attended antenatal care at the selected health facilities. Interview-based structured questionnaires were used. Bivariate and multivariate logistic regression were used to identify predictors. The prevalence of anaemia was 11.4%. Few women (25) were anaemic and morphologically, 14 (56%) had normocytic normochromic anaemia and 9 (36%) had microcytic hypochromic anaemia. Iron deficiency was reported in 19 (8.6%) pregnant women. Independent predictors of anaemia were iron sulphate intake (AOR [95% CI] = 3.16 [1.15, 7.37], ANC follow-up during pregnancy (AOR [95% CI] = 3.07 [1.59, 7.99], household size of ≥5 (AOR [95% CI] = 3.58 [1.75, 9.52], folic acid intake (AOR [95% CI] = 5.29 [2.65, 12.39] and the period in pregnancy AOR [95% CI] = ≥36 weeks 3.2 (1.3-4.5). Though anaemia prevalence has been low in urban areas as previously reported, collaborated healthcare measures that aim at eradicating the menace are encouraged. Maternal healthcare interventions including the administration of folic acid, regular iron sulphate intake and intensive education on early ANC are recommended.

Hypochromic red cells as predictors of anemia in patients undergoing hemodialysis: an observational retrospective study

The percentage of hypochromic red blood cells (%HRC) estimates the availability of iron by evaluating the degree of hemoglobinization. We investigated whether %HRC was a predictor of anemia in patients undergoing hemodialysis. We recruited 142 patients undergoing routine hemodialysis between 2017 and 2019. Delta hemoglobin level (ΔHb)1mo-baseline was calculated as the difference between the hemoglobin level at 1 month after study enrollment and that at the time of study enrollment. Development of anemia was defined as hemoglobin level ≤ 15% of baseline. The median %HRC was 3.1%. There was a significant negative correlation between (ΔHb)1mo- baseline and %HRC (r = − 0.63, P < 0.001). The incidence of anemia was significantly higher in patients with %HRC > 3.1% than in those with %HRC ≤ 3.1%. In the multivariate logistic regression analysis, %HRC was significantly related to the development of anemia (odds ratio 2.57, 95% confidence interval [CI] 1.72–3.85, P < 0.001). The best cutoff value for %HRC to predict the development of anemia was 4.3%, with a sensitivity and specificity of 67.74 (95% CI, 54.7–79.1) and 97.50 (95% CI, 91.3– 99.7), respectively. %HRC is an independent predictor of anemia in patients undergoing hemodialysis. %HRC ≤ 4.3% is an early marker to consider changing the anemia treatment.

Prevalence of Anemia and Associated Risk Factors among Pregnant Women, What is the Role of Antenatal Care in Prevention? A Cross-sectional Study.

To determine the prevalence of anemia with the associated factors in pregnant women and the effect of family medicine practice and antenatal care services provided by family physicians on the prevention of anemia during pregnancy. Community-based cross-sectional study. Family Health Centres in the Elazig region, Turkey from January to June 2019. A total of 495 pregnant women, attending the family health centres, were included. Women were administered a questionnaire related with the anemia and related factors; and hemoglobin values were drawn. Hemoglobin concentration <11 g/dl was classified as anaemic. Sociodemographic, individual dietary diversity and obstetric characteristics of the participants were obtained from structured questionnaire form. Binary logistic regression model was employed to determine the effect of explanatory variables on dependent variable anemia. Results: The prevalence of anemia during pregnancy was 27.9% (Hb<11.0 gr/dl). Prevalence of anemia was found lower in participants with higher education levels (p=0.005) and having nutrition education (p=0.004). Income status (OR=0.017 [95%Cl:0.002-0.15, p<0.001]), dark tea preference (OR=87.127 [95%Cl:17.68-429.36, p<0.001]), and iron supplementation time (OR=0.945 [95%Cl: 0.91-0.98, p=0.002]) were determined as the independent predictors of anemia in pregnancy. Low income, insufficient iron supplementation treatment and dark tea preference were the main predictors of anemia. Most of the factors that cause anemia during pregnancy can be prevented with patient education and supportive treatments. Therefore, the authors recommend applying effective and quality prenatal care and patient education programs to reduce anemia during pregnancy. Key Words: Pregnant women, Anemia, Prenatal care, Family practice, Turkey.

Prevalence of Clonal Hematopoiesis and Mutation Patterns in Unexplained Anemia of Community-Dwelling Elderly Individuals: A Case-Control Study

The prevalence of anemia in the general population rises sharply after the age of 50, reaching 20% or more in individuals aged 85 years or older. In up to one third of cases, the origin of anemia remains unexplained, i.e. not attributable to causes detectable with conventional tests or to any concomitant diseases, and several potential mechanisms have been proposed, including myelodysplasia (MDS) (PMID 15238427). Recent studies showed that somatic mutations are commonly acquired in hematopoietic cells during aging, and are associated with increased risk of hematologic malignancies (PMID 25426837; 25426838). In a recent analysis in patients with unexplained cytopenia undergoing a comprehensive diagnostic workup, we found that mutation profiling was highly predictive of myeloid neoplasm (PMID 28424163).In this study, we performed a mutation analysis in a cohort of elderly individuals with unexplained anemia and in sex- and age-matched control subjects both selected from a population-based study, as well as in a matched group of patients with MDS, with the aim to investigate the relationship between clonal hematopoiesis, mutation profile and unexplained anemia in community-dwelling elderly subjects.Seventy individuals aged 60 years or older having anemia according to WHO criteria, not explained by nutritional deficiency, renal failure or inflammation, and 105 sex- and age-matched control subjects (ratio 1:1.5) were selected from the “Val Borbera” Study, a population-based study recruiting a total of 1803 people. In addition, 105 matched control patients with newly diagnosed MDS without excess blasts was analyzed. Median age was 78 years (range 62-102), 133 individuals were males, 147 females. A panel of 54 genes was analyzed on peripheral blood cells, using a HiSeq 2500 platform (Illumina, San Diego, CA) (median depth 1550, range 845-2057).Among community-dwelling individuals, a significant effect of age was observed on mutation prevalence (P=.023); however, this effect was limited to controls. A significantly higher mutation rate was observed in cases compared with controls (42.9% vs 24.8%, P=.014). This rate was even higher when restricting the analysis to individuals with hemoglobin <12.5 g/dL in males and <11.5 g/dL in females and/or MCV>105 fL (63% vs 24.8%, P<.001). A significantly higher Variant Allele Frequency (VAF) was found in cases compared with controls (median value 0.21, range 0.02-0.51 vs 0.07, 0.02-0.38; P=.035). A significantly higher number of individuals with two somatic mutations was found among cases compared with non-anemic controls (14.3% vs 1.9%, P=.003). Subjects with two somatic mutations showed a significantly higher VAF compared with those having an isolated mutation (median value 0.31, range 0.03-0.50 vs 0.06, 0.06-0.51; P=.008). In a multivariable regression analysis, number of mutations per subject and VAF were independent predictors of anemia (OR=7.55, P=.03, and OR=1.67, P=.037, respectively). A significantly higher prevalence of splicing factor mutations was found in cases compared with controls (11.1% vs 0%, P=.008). In most individuals with multiple mutated genes, mutation pattern included a DNA methylation gene mutation associated with a subclonal mutation.When comparing community dwelling individuals with unexplained anemia with a matched group of patients with MDS, a significantly higher number of subjects with two or more mutations was found in MDS compared with unexplained anemia (47.6% vs 14.3%, P<.001). MDS patients showed a significantly higher VAF compared with individuals with unexplained anemia (median value 0.41, range 0.02-0.93 vs 0.21, 0.02-0.51; P<.001). Finally, a significantly higher prevalence of splicing factor mutations was observed in MDS compared with unexplained anemia (55.2% vs 11.1%, P<.001).In conclusion, this study provides evidence of a high rate of clonal hematopoiesis in community-dwelling elderly individuals with unexplained anemia compared with matched controls with normal hemoglobin values, mainly sustained by an enrichment in subjects with accumulation of mutations proven highly predictive of myeloid neoplasm with myelodysplasia. Mutation analysis on peripheral blood cells may complement current diagnostic approach to unexplained anemia in the frail population of elderly individuals, increasing compliance to diagnostic tests and overall the diagnostic accuracy of myeloid neoplasms. DisclosuresRizzo:enGenome srl: Employment. Camaschella:Vifor Pharma: Membership on an entity's Board of Directors or advisory committees.

Effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia: Institution based prospective cohort study.

Intestinal parasitosis is a common disease that causes misery and disability in poor populations. The number of individuals affected is staggering. From two billion peoples who harbor parasites worldwide, 300 million suffer severe morbidity and more than 25% of pregnant women are infected with hookworm, which causes intestinal bleeding and blood loss, and has been most commonly associated with anemia. Intestinal parasite infection during pregnancy has been associated with iron deficiency, maternal anemia, and impaired nutritional status, as well as decreased infant birth weight. This study aimed to assess the effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care in Debre Markos Referral Hospital from December 2017 to February 2019. A prospective cohort study design was conducted among 94 intestinal parasite-infected pregnant women as an exposed group and 187 pregnant women free from intestinal parasite were used as a control group. The effect of intestinal parasites on hematological profiles of pregnant women was assessed at Debre Markos Referral Hospital antenatal care ward. Socio-demographic data and nutrition status were assessed by using structured questionnaires and mid-upper arm circumference (MUAC), respectively. Two ml of venous blood and 2 gm of stool samples were collected to analyze the hematological profiles and detect intestinal parasites, respectively. Wet mount and formol-ether concentration (FEC) techniques were used to detect intestinal parasites. Hematological profile was analyzed using Mind ray BC-3000 plus instrument. Data were double entered into EpiData version 3.1 software and exported to SPSS version 24 software for analysis. Results were presented using tables and graphs. Associations of hemoglobin levels with intestinal parasitic infections were determined using binary logistic regression models. P≤0.05 was considered statistically significant. The mean hematological profile difference between parasite-infected and parasite-free pregnant women was computed using independent t-test. In the present study, the predominant parasites identified were Entamoeba histolytica, hookworm, Giardia lamblia, Schistosoma mansoni, and Ascaris lumbricoides. About 8.2% of intestinal parasite-infected pregnant women had mild anemia while 4% had moderate anemia. Only 1.2% of intestinal parasite-free pregnant women developed moderate anemia. The mean HGB, HCT, MCV, MCH, and MCHC values of intestinal parasite-infected pregnant women were 12.8g/dl, 38.2%, 94.7fl, 33.1pg and 34.7g/dl, respectively. But the mean HGB, HCT, MCV, MCH and MCHC values of pregnant women who were free from intestinal parasites were 14.4 g/dl, 39.8%, 94.9fl, 33.9pg and 35.5g/dl, respectively. Anemia was strongly associated with hookworm (AOR = 21.29, 95%CI: 8.28-54.75, P<0.001), S.mansoni (AOR = 63.73, 95% CI: 19.15-212, P<0.001) and A.lumbricoide (AOR = 14.12, 95% CI 3.28-60.65, P<0.001). Intestinal parasitic infection in pregnant women caused adverse impact on hematological profiles and was an independent predictor of anemia. Intestinal parasitic infection significantly decreased pregnant the level of HGB, HCT, MCV, MCH, and MCHC values. To minimize maternal anemia deworming could be good before pregnancy.

Prevalence, Severity and Relationship of Anaemia with Immune Status and Use of Highly Active Antiretroviral Therapy among Human Immunodeficiency Virus-Infected Adults in South-eastern Nigeria

Objective: Anaemia is a significant complication of human immunodeficiency infection, causing life-threatening symptoms and impairing quality of life. This study aimed to assess the prevalence, severity and associations of anaemia, with cluster of differentiation 4 (CD4+) cell count and use of highly active antiretroviral therapy (HAART), in human immunodeficiency virus-infected patients. Material and Methods: Haemoglobin concentration, CD4+ count, HAART use and other factors were assessed in 372, adult HIV-infected out-patients; enrolled at a tertiary hospital in South-Eastern Nigeria. Anaemia was defined according to World Health Organisation criteria. Independent predictors were determined using bivariate analysis and enter method logistic regression analysis, at a p-value&lt;0.05.Results: Prevalence of anaemia was 76.3% overall; 79.9% in females and 67.6% in males. Median CD4+ cell count was 609.50 (interquartile range 379) cells per microlitre (cells/μl). Females were more likely to be anaemic than males [odds ratio (OR)=1.88, 95% confidence interval (CI) 1.07, 3.31; p-value=0.011]. Furthermore, the odds of being anaemic were higher in participants 50 years or older (OR 3.79, 95% CI 1.36, 10.55; p-value=0.023). A CD4+ count &lt;200 cells/μl. Not being on cotrimoxazole preventive therapy and a low monthly household income were associated with higher odds of anaemia. Tenofovir- and abacavir-based regimens were associated with lower odds of anaemia compared to zidovudine. Conclusion: Gender and the age of patients were independent predictors of anaemia. Pre-treatment screening, and close follow-up monitoring for anaemia as well as increased access to less haematotoxic HAART regimens are needed.

Clinical Predictors of Iron Deficiency Anemia in Emirati Population with T2DM

Aim: To establish the prevalence of iron deficiency anemia and its clinical predictors in Emirati patients with type 2 diabetes. Patients & Methods: 237 patients were included in the study. A full blood count was obtained in addition to routine blood and urine tests for all patients. Hemoglobin level and iron studies were done for diagnosis of anemia. Statistical analysis was done to find out the prevalence and independent predictors of anemia in the study population of Emirati type 2 diabetic patients. Results: Of the studied 237 patients; 36.3% had iron deficiency anemia as per the WHO criteria. Independent predictors of iron deficiency anemia were age ≥ 60 years, female gender and wide pulse pressure ≥ 60 mmHg. Hemoglobin level was directly proportionate to e GFR (p < 0.001). Participants with age ≥ 60 years had 4.2 times higher odds to exhibit anemia. Female participants had 1.95 times higher odds to exhibit anemia. Participants with wide pulse pressure ≥ 60 mmHg have 2.4 higher odds to exhibit anemia. Conclusion: Iron deficiency anemia is common in type 2 diabetic patients. Testing the patient for iron deficiency anemia should be considered in type 2 diabetes patients especially with age ≥ 60 years, female patients and those with wide pulse pressure ≥ 60 mmHg.

Determinants of Anemia among Pregnant Women at Debre Tabor Comprehensive and Specialized Hospital

Background: Anemia is one of the most occurring nutritional deficiency problems in the world especially in Africa. It can be prevalent in women of reproductive age, particularly during pregnancy when it is often a contributory cause of maternal mortality. In our country Ethiopia, anemia prevalence is increased from 2011 to 2016 in all anemia categories. Even though scarce information is known about the problem in Ethiopia and studies related to the problem are not available at Debre Tabor comprehensive and specialized hospitals. Hence, we aimed to assess the prevalence and factors associated with anemia among pregnant women who are attending antenatal care at Debre Tabor Comprehensive and specialized hospitals. Methods: Institution-based cross-sectional study was conducted from October 15 to November 15, 2020, with a sample size of 232 pregnant women participants selected using a systematic random sampling method. Laboratory determination of hemoglobin level was done at Anti-natal care follow-up. The data was entered into Epi info Version 7.2 and exported to SPSSS version 23 for analysis. Descriptive statistics using frequency and other summary statistics were used to present the socio-demographic and clinical characteristics of women. Binary and multivariable logistic regression was done to identify factors associated with anemia using an odds ratio at 95% CI and p-value Result: The magnitude of anemia showed that 12.9% with 95% CI (9.4% - 17.7%). The mean age of the participants was 33 years with a range of 18 - 39 years. Rural residency (AOR: 2.82; 95% CI: 1.02 - 4.87, p-0.001), multi-parity were (AOR: 3.12; 95% CI: 2.43 - 7.56, p-0.045), previous malaria attack (AOR: 1.91; 95% CI: 1.04 - 4.88, p-0.023), and having history of abortion (AOR: 2.10; 95% CI: 1.18 - 6.79, p-0.014) were factors associated to anemia in pregnancy. Conclusion: This study found a relatively high magnitude of anemia among pregnant women. Rural residency, multi-parity, previous malaria attack, and having a history of abortion were found to be independent predictors of anemia in pregnancy.

Anemia following acute kidney injury after noncardiac surgery and long-term outcomes: the NARA-AKI cohort study.

BackgroundThis study was conducted to investigate whether acute kidney injury (AKI) is an independent predictor of anemia and whether anemia following AKI is a mediator of mortality after AKI.MethodsThis is a retrospective cohort study. Adults with noncardiac surgery from 2007 to 2011 were included. Obstetric or urological surgery, missing data or preoperative dialysis were excluded. Subjects were followed until the end of 2015 or lost to follow-up. Exposures of interest were postoperative AKI. Outcome variables were hematocrit values at 3, 6 and 12 months postoperatively and mortality. Associations between AKI and hematocrit or association between AKI and mortality were examined by multivariable linear regression or Cox regression, respectively.ResultsAmong 6692 subjects, 445 (6.6%) developed AKI. Among those with postoperative data, AKI was independently associated with lower hematocrit at 3, 6 and 12 months postoperatively, with coefficients of −0.79 [95% confidence interval (CI) −1.47 to −0.11; n = 1750], −1.35 (−2.11 to −0.60; n = 1558) and −0.91 (−1.59 to −0.22; n = 2463), respectively. Higher stages or longer duration of AKI were associated with more severe anemia. AKI was associated with higher mortality after 3 months postoperatively with a hazard ratio of 1.54 (95% CI 1.12–2.12). Further adjustment with hematocrit at 3 months attenuated the association. The mediation effect was significant (P = 0.02) by mediation analysis.ConclusionsAKI was an independent predictor of anemia following AKI. Higher mortality associated with AKI was at least partially mediated by anemia following AKI. Whether correction of anemia following AKI improves mortality requires further research.

Impact of transcatheter aortic valve replacement on anemia: new approach to Heyde's syndrome

Abstract Background There is an association between aortic stenosis and anaemia known as Heyde's syndrome. It is caused by an acquired von Willebrand (VW) deficiency related to turbulent flow. Patients with significant paravalvular leak (SPL) remain with VW deficit. The aim of this work is to assess impact on prognosis and anaemia of SPL. Methods Observational analytic study developed at two university hospitals, including all consecutive patients who underwent TAVI during a 10-year period (2009 to 2018). A logistic regression model was created to determine independent predictors of anaemia at 3 months. Time to event outcomes were analysed with Cox regression. Median follow-up was 21.3±21.9 months. Results 5.3% of 788 patients had SPL, with no differences on their basal characteristics compared to the rest of the cohort. SPL was an independent predictor of anaemia 3 months after TAVI (Odds Ratio: 8.31, Confidence Interval 95% [CI]: 2.06–33.50). SPL had negative impact on mortality: Hazard Ratio (HR): 1.85, CI 1.2–2.9; but not on cardiovascular mortality (CV): HR 1.13, CI 0.4–3.1. Patients who had anaemia three months after TAVI had an increased mortality. (HR 2.17, CI 1.5–3.3) Conclusion SPL after TAVI increases mortality with no impact on CV mortality. SPL is independent predictor of anaemia 3 months after TAVI, a condition that doubles the mortality. The impact of SPL on mortality could be explained by the increase in anaemia that SPL causes. More aggressive approach to SPL could have a benefit on prognosis. Figure 1 Funding Acknowledgement Type of funding source: None

Impact of significant paravalvular leaks after transcatheter aortic valve implantation on anaemia and mortality

ObjectiveThe aim of this work is to assess the relationship between significant paravalvular leak (SPL) after transcatheter aortic valve implantation (TAVI) on anaemia and their impact on prognosis.MethodsObservational analytic study...

Prevalence and correlates of anemia in type 2 diabetes mellitus: A study of a Nigerian outpatient diabetic population

Background: Anemia is reportedly common in type 2 diabetes mellitus (T2DM), and it is often unrecognized or overlooked, despite its contribution to the morbidity and mortality. With the growing burden of diabetes in sub-Saharan Africa, the occurrence of anemia among T2DM patients needs to be adequately characterized. Objective: We aimed to determine the prevalence and correlates of anemia among Nigerian patients with T2DM attending a tertiary outpatient clinic. Materials and Methods: It was a cross-sectional study involving 155 patients with T2DM and 78 controls without diabetes. Full blood count, serum creatinine, fasting plasma glucose, glycosylated hemoglobin (HbA1c), and spot urinary albumin–creatinine ratio were determined in the patients. The frequency and determinants of anemia among the participants were determined. Results: Anemia was found in 45.2% of the T2DM patients, compared to 28.2% of the controls (P = 0.012). The T2DM patients were twice as likely to have anemia as the controls. Among the T2DM patients with anemia, majority (68.6%) had a normocytic anemia, while 25.7% and 5.7% had microcytic and macrocytic anemia, respectively. The independent predictors of anemia were longer duration of diabetes and lower estimated glomerular filtration rate (eGFR) with odds ratio of 2.1 and 4.7, respectively. Conclusion: Anemia is common in T2DM patients including those with normal eGFR. Longer duration of diabetes and declining eGFR were the major factors associated with anemia. Screening for anemia is recommended for patients with T2DM as part of their routine annual evaluation, especially in those with longer disease duration and eGFR

Prevalence and predictors of blood transfusion after pediatric kidney transplantation.

Blood transfusion after kidney transplant carries a risk of sensitization to the graft as well as blood borne infections. The aim of this study was to describe the prevalence of blood transfusions in pediatric recipients of kidney transplants and to determine the factors associated with transfusions during the perioperative period. Additionally, to describe the changes in hemoglobin levels during the first 12months following transplant. A retrospective, single center analysis using data collected prospectively between 2010 and 2017. Red blood cell transfusion within the first week after transplant and anemia at 3months were used as outcomes. Multivariate analysis was performed on significant variates with results described according to odds ratio (OR) and interquartile range (IQR). Transfusions were given after 21 of 42 (50%) transplants in recipients aged between 1 and 17years (median 14years). Age, height, weight, and pre-transplant hemoglobin predicted transfusion in univariate analyses. Regression analysis identified pre-transplant hemoglobin as an independent factor (OR 0.85, IQR 0.73-0.98; p = 0.02). Anemia was present at 3months after 15 (36%) transplants. Anemia at 3months was associated with older and larger recipients, lower pre-transplant hemoglobin, and lower estimated glomerular filtration rate (eGFR) on univariate analysis. Logistic regression analysis identified eGFR at 3months as the only independent predictor of anemia at 3months (OR 0.93, IQR 0.87-0.99; p = 0.04). Transfusions are prevalent in the perioperative period after pediatric kidney transplantation. Lower pre-transplant hemoglobin increases the risk of transfusion. Graft function predicts hemoglobin levels at 3months.