British Journal of Medicine & Medical Research 4(34): 5348-5356, 2014
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Prevalence and Determinants of Anaemia among HIV Positive Pregnant Women Attending Ante-Natal Clinic at the Jos University Teaching Hospital, Jos, North-central Nigeria A. G. Ohihoin1*, J. Musa2, A. S. Sagay2, I. A. O. Ujah1, E. C. Herbertson1 and A. Ocheke2 1
Nigerian Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria. 2 Jos University Teaching Hospital (JUTH), Jos, Nigeria. Authors’ contributions
This work was carried out in collaboration between all authors. Author AGO designed the study, performed the statistical analysis, wrote the protocol, and wrote the first draft of the manuscript. Authors JM and AO were involved in data collection had inputs in the manuscript. Authors ASS and IAOU managed the analyses of the study. Author ECH managed the literature searches, proof read and prepared the manuscript for publication. All authors read and approved the final manuscript.
th
Original Research Article
Received 6 June 2014 th Accepted 15 July 2014 th Published 25 July 2014
ABSTRACT Aim: To determine the prevalence and determinants of anaemia in HIV positive pregnant women attending ante-natal clinic at Jos University Teaching Hospital, North-Central Nigeria. Methods: A cross sectional study was carried out among HIV positive pregnant women as the study group and HIV negative pregnant women as control group at the ante-natal clinic of the Jos University Teaching Hospital (JUTH) Jos, North-Central Nigeria from January to December 2007. The prevalence of anaemia in the experimental group was determined. The possible determinants of anemia were ascertained and the relationship between variables determined using methods of linear regression and chi square test. Results: A total of 230 pregnant women were recruited for the study (115 HIV positive versus 115 HIV negative). The overall prevalence of anemia was 27.6%. The prevalence ___________________________________________________________________________________________ *Corresponding author: Email:
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British Journal of Medicine & Medical Research, 4(34): 5348-5356, 2014
among HIV positive pregnant women was 33.7%, compared to a prevalence of 21.7% among HIV negative pregnant women. This difference was however not statistically significant. There was a statistically significant relationship between the use of anti2 retroviral therapy and the development of anaemia (X = 5.98, P = 0.014, OR = 1.15). An inverse relationship was established between haemoglobin status and viral load. Conclusion: The prevalence of anemia is high among HIV positive pregnant women. There is an inverse relationship between viral load and haemoglobin status. The use of highly active anti-retroviral therapy (HAART) for the management of these patients can be regarded as good practice since ART reduces viral load. Keywords: Anaemia; HIV; pregnancy; Jos.
1. INTRODUCTION Anaemia in pregnancy is a major cause of maternal and fetal morbidity and mortality [1]. There are various causes of anaemia in pregnancy such as deficiency in iron or vitamin B12 or folate; malaria; acute and chronic infections; haemoglobinopathies and others. In the category of chronic infections, HIV/AIDS is regarded as a strong risk factor for anaemia in pregnancy [2]. Anaemia is a common manifestation of HIV infection, occurring in approximately 30% of patients with asymptomatic HIV and in as much as 75-80% of those with clinical AIDS [3-4]. Anaemia is associated with a faster rate of disease progression and poor survival in patients with HIV [5,6,7,8]. Anaemia has been linked with HIV/AIDS and also associated with early post-natal death in infants of HIV positive pregnant women [9]. The cut-off point for anaemia in pregnancy is slightly lower than that of the general population and this is largely due to the haemodynamic changes in pregnancy that involve a higher physiological increase in plasma volume relative to red cell mass, creating a physiological anaemia of pregnancy [10]. In the light of the above, the World Health Organization (WHO) has defined anaemia in pregnancy as haemoglobin concentration less than 11.0g/dl. Moderate anaemia is defined as haemoglobin concentration greater than or equal to 7.0g/dl but less than 11g/dl, and severe anaemia as haemoglobin concentration of less than 7.0g/dL [11]. In our environment, many clinicians define anaemia as a haemoglobin concentration of below 10g/dl because it was observed that the proportion of low-birth weight babies and peri-natal mortality rates begin to increase with maternal haematocrit levels below 10g/dl. This observation was reputed to the work done by Harrison [12]. For the purpose of this study and for international comparisons, the WHO definition of anaemia in pregnancy of Hb
