title: Burden and Determinants of Severe Anemia among HIV-Infected Adults: Results from a Large Urban HIV Program in Tanzania, East Africa.
abstract: METHODS
  This cross-sectional study aimed at determining the prevalence and risk factors for severe anemia, severe microcytic anemia, and severe normocytic anemia among HIV-infected individuals aged >15 years. Univariate and multivariate analyses were performed to identify the risk factors for anemia.
  
  
  RESULTS
  Data from 40 408 patients were analyzed, showing an overall prevalence of 22% for severe anemia. The risk of developing severe anemia increased by 49% among patients with a body mass index of <18.5 kg/m(2), by approximately 2-fold among patients with the World Health Organization (WHO) stage III, and by 3-fold among patients with WHO stage IV illness. Severe normocytic anemia was uniquely increased among patients aged ≥50 years, among those with chronic diarrhea and Kaposi's sarcoma, and those taking cotrimoxazole.
  
  
  CONCLUSIONS
  There was a high prevalence of severe anemia among adults infected with HIV. Focused identification of anemia should be based on the hemoglobin and mean corpuscular volume measurements.
authors.affiliation: School of Medicine, Muhimbili University Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania Management and Development for Health, Tanzania makubi55@gmail.com.
authors.forename: Abel
authors.initials: A
authors.lastname: Makubi
authors.affiliation: Department of Nutrition, Harvard School of Public Health, USA.
authors.forename: James
authors.initials: J
authors.lastname: Okuma
authors.affiliation: Departments of Epidemiology and Biostatistics, Harvard School of Public Health, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.affiliation: Management and Development for Health, Tanzania Northwestern University, Chicago, IL, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Hawkins
authors.affiliation: Department of Nutrition, Harvard School of Public Health, USA.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Darling
authors.affiliation: Department of Nutrition, Harvard School of Public Health, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Jackson
authors.affiliation: School of Medicine, Muhimbili University Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania Management and Development for Health, Tanzania.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mugusi
authors.affiliation: Management and Development for Health, Tanzania Department of Nutrition, Harvard School of Public Health, USA.
authors.forename: Guerino
authors.initials: G
authors.lastname: Chalamilla
authors.affiliation: Management and Development for Health, Tanzania Department of Nutrition, Harvard School of Public Health, USA.
authors.forename: Wafaie
authors.initials: W
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology; D014504:Urban Health; D055815:Young Adult
keywords: HIV; adults; burden; determinants; severe anemia