Prevalence, severity and associated risk factors of anemia among human immunodeficiency virus-infected adults in Sawla General Hospital, Southern Ethiopia: A facility-based cross-sectional study.

BACKGROUND: Anemia is a significant public health problem in HIV/AIDS patients worldwide. This study is aimed to determine the prevalence of anemia and its risk factors among HIV-infected adults in Sawla General Hospital, southern Ethiopia. METHODS: A facility-based cross-sectional study involving HIV-infected adults was conducted in ART clinic of Sawla General Hospital from April 01 to May 31, 2019. A systematic random sampling technique was employed to recruit the study participants. Socio-demographic and clinical data were collected using a structured questionnaire and checklist. Hemoglobin concentration from venous blood was determined by HemoCue® 301 analyzer. Descriptive and inferential statistics, by Statistical Package for Social Science version 26.0, were applied; p-values ≤ 0.05 in the multivariable logistic regression analysis were considered statistically significant. RESULTS: A total of 220 HIV-infected adults participated in this study. The prevalence of anemia was 38.6%, from which 90.6, 7.1, and 2.3% are mild, moderate, and severe anemia, respectively. Anemia among HIV-infected adults was significantly associated with CD4 cell count below 200 cells/mm3 (AOR: 4.32; 95% CI: 2.10-8.86), clinical stage III or above (AOR: 4.20; 95% CI: 1.06-16.62), five or more years duration of HIV infection (AOR: 2.32; 95% CI: 1.08-4.94) and BMI below 18.5 kg/m2 (AOR: 3.82; 95% CI: 1.83-8.00). CONCLUSION: Anemia is a moderate public health problem among the study population. Longer duration of HIV infection, advanced clinical stage, lower CD4 cell count, and BMI are risk factors for anemia. Therefore, early ART enrolment for HIV-infected adults with nutritional support and rigorous monitoring of CD4 cell count are essential to lower the prevalence.

Biology and epidemiology of Plasmodium falciparum and Plasmodium vivax gametocyte carriage: Implication for malaria control and elimination.

Malaria is among the leading public health problems worldwide. Female anopheles mosquito orchestrates the transmission of malaria by taking gametocytes and introducing sporozoite while taking blood meals. Interrupting transmission is the major strategy for malaria elimination. The gametocyte stage is essential for the onward transmission of malaria. Thus, understanding its basic biology and epidemiology is key to malaria control and elimination. Therefore, the current review focuses on revealing the biology, prevalence, and determinants of gametocyte carriage as well as its implication on mitigation of malaria. It also illustrates the role of asymptomatic and sub-microscopic Plasmodium infections and G-6-PD deficiency in gametocyte carriage and hence malaria transmission. Gametocytogenesis is initiated at committed merozoites and gives rise to the development of gametocytes. The trigger for gametocytogenesis depends on the host, parasite, and intervention factors. Gametocytes pass through five developmental stages identifiable by molecular markers. A considerable number of malaria patients carry gametocytes at a sub-microscopic level, thereby serving as a potential infectious reservoir of transmission. Factors involving the human host, Plasmodium parasite, and intervention parameters play a critical role in gametocyte biology and prevalence. The contribution of asymptomatic and sub-microscopic infections to malaria transmission is unknown. The clear impact of G-6-PD deficiency on malaria control and elimination remains unclear. Lack of clarity on such issues might impede the success of interventions. Basic science and epidemiological studies should continue to overcome the challenges and cope with the ever-evolving parasite and guide interventions.

Prevalence, Severity, and Determinant Factors of Anemia among Pregnant Women in South Sudanese Refugees, Pugnido, Western Ethiopia.

Background. Anemia is one of the major health problems among refugee pregnant women in the world. Anemia among pregnant women is multifactorial and results in detrimental consequences on the mothers and infants. The aim of this study was to determine the prevalence, severity, and determinants of anemia among pregnant women in South Sudanese refugees, Pugnido western, Ethiopia. Methods. A facility-based cross-sectional study was conducted in Pugnido Administration Refugee and Returnee Affairs Health Center from April 15 to June 30, 2015. Demographic and related data were collected using questionnaire based interview. Complete blood count was done using CELL-DYN 1800 (Abbott USA). Blood smear and fecal specimen were examined for hemoparasite and intestinal parasite, respectively. Bivariate and multivariate logistic regression analyses were done using SPSS-Version 20.0. Results. The overall prevalence of anemia was 36.1%, from whom 2.3% had severe anemia. Being in third trimester, eating meat at most once a week, drinking tea immediately after meal at least once a day, having mid-upper arm circumference below 21 centimeters, and intestinal parasitic infection were identified as independent factors of anemia. Conclusion. More than one-third of pregnant women had anemia in this study. Intervention based strategies on identified determinant factors will be very important to combat anemia among the group.