title: Prevalence and associated risk factors of anemia among HIV infected children attending Gondar university hospital, Northwest Ethiopia: a cross sectional study.
abstract: BACKGROUND
  Anemia is the most common hematological abnormalities in HIV patients and it is a wide spread public health problem. The World Health Organization estimates that over 2 billion people are anemic worldwide with more than 100 million of these anemic children living in Africa. In Ethiopia, there is limited information about the prevalence and factors associated with anemia among HIV positive children. Thus, this study aimed to determine the prevalence and associated factors of anemia among HIV infected children aged 6 months to 14 years in Gondar university Hospital antiretroviral treatment clinic.
  
  
  METHODS
  A cross-sectional study was conducted on 265 HIV infected children from February to June 2013 on HIV infected children attending Gondar university Hospital ART clinic. The study subjects were selected with systematic random sampling technique. Data of socio demographic characteristics and clinical conditions of the study subjects was collected using a structured pretested questionnaire. Hemoglobin value and CD4 counts were determined by cell Dyne 1800 and FACS count machine respectively. WHO Cut off value of hemoglobin was taken and adjusted to altitude to define anemia. Data was analyzed by using the SPSS version 20 statistical software and bivariate and multivariate logistic regression was used to identify predictors.
  
  
  RESULTS
  Anemia was present in 16.2 % (43 /265) of children, 60.5 % of them had mild anemia, 37.2 % had moderate anemia and 2.3 % had severe anemia. About 46.5 % of anemic children had normocytic-normochromic anemia followed by macrocytic-normochromic anemia (39.5 %). In this study, anemia was associated with eating green leafy vegetables (OR = 0.43, 95 % CI (0.188-0.981) and being on cotrimoxazole treatment (OR = 2.169, 95 % CI (1.047-4.49). But there was no significant association with age, sex, WHO clinical stage, opportunistic infections, intestinal parasitic infection and CD4 count percentage.
  
  
  CONCLUSIONS
  The majority of HIV positive children in Northwest Ethiopia have a mild type of anemia and the increase in prevalence of anemia is due to being on cotrimoxazole and eating green leafy vegetables. Therefore, early diagnosis and treatment of anemia is essential in these patients.
authors.affiliation: Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
authors.forename: Bamlaku
authors.initials: B
authors.lastname: Enawgaw
authors.affiliation: Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Meseret
authors.initials: M
authors.lastname: Alem
authors.affiliation: Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
authors.forename: Mulugeta
authors.initials: M
authors.lastname: Melku
authors.affiliation: Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Zelalem
authors.initials: Z
authors.lastname: Addis
authors.affiliation: Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
authors.forename: Betelihem
authors.initials: B
authors.lastname: Terefe
authors.affiliation: Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
authors.forename: Gashaw
authors.initials: G
authors.lastname: Yitayew
keywords: Anemia; Children; HIV; Risk factors