title: Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania.
abstract: METHODS
  Tuberculosis (TB) infected adults attending out-patient TB clinics in Dar es Salaam, Tanzania.
  
  
  OBJECTIVE
  To examine the association of anemia with human immunodeficiency virus (HIV) co-infection, indicators of socio-economic status (SES) and anthropometric status in TB-infected adults.
  
  
  METHODS
  Cross-sectional data collection during screening for a clinical trial.
  
  
  RESULTS
  Overall, 750 females and 1693 males participated in this study, of whom respectively 49% and 24% were co-infected with HIV-1. Hemoglobin levels were significantly lower in females than in males and in HIV-positive than in HIV-negative participants. HIV co-infection in this antiretroviral-naïve population was also associated with severe anemia (hemoglobin < 85 g/l) in both women (prevalence ratio [PR] = 2.07, 95%CI 1.65-2.59) and men (PR 3.45, 95%CI 2.66-4.47). Although severe anemia was negatively associated with indicators of SES, especially in males, adjustment for SES indicators only marginally changed its association with HIV co-infection. In both sexes, anemia was inversely associated with anthropometric status, independently of HIV infection and SES.
  
  
  CONCLUSIONS
  Among TB-infected adults, anemia is strongly associated with HIV co-infection and anthropometric status, independently of SES indicators. As anemia is a risk factor for morbidity and mortality in both infections, the management of anemia in TB-HIV co-infected patients warrants special attention.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA. saathoff@lrz.uni-muenchen.de
authors.forename: E
authors.initials: E
authors.lastname: Saathoff
authors.forename: E
authors.initials: E
authors.lastname: Villamor
authors.forename: F
authors.initials: F
authors.lastname: Mugusi
authors.forename: R J
authors.initials: RJ
authors.lastname: Bosch
authors.forename: W
authors.initials: W
authors.lastname: Urassa
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000453:epidemiology; D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
chemical_list: D006454:Hemoglobins