1.0 INTRODUCTION

1.1 BACKGROUND

Anaemia is a condition in which there is a decrease in the red blood cell count, haemoglobin and/or hematocrit values as compared to the normal reference range for age, sex, race and altitude which decreases the oxygen-carrying capacity of red blood cells to tissues. Anaemia is the most frequent hematologic abnormality of HIV disease and one of the most common manifestations of nutritional deficiency disorders in the world. In sub-Saharan Africa, where about 70% of people living with HIV/AIDS worldwide reside, the prevalence of anaemia is higher than in developed countries (3). Also, anaemia is the most frequent haematologic abnormality among people living with human immunodeficiency virus (HIV) and is associated with HIV disease progression and a higher risk of mortality in the patients(1). The prevalence of anaemia among the patients living with HIV as reported in a worldwide study was 39.7% for children aged <15 years, 46.6% for adults aged ≥15 years (men and non-pregnant women), and 48.6% for pregnant women, while the pooled prevalence of severity of anaemia was 21.6%, 22.6%, and 6.2% for mild, moderate and severe anaemia, respectively(1). In a study conducted in Benin, Nigeria, the overall prevalence of anaemia was 60.6%, whereby males had a prevalence of 62.0% and females had a prevalence of 59.6%(2)(4). In Tanzania, a study conducted at Dodoma showed the prevalence of anaemia among HIV patients as 59.5% (3). In a similar study done in Mwanza, at Bugando Medical Centre, the prevalence of anaemia among children under 5 years was 77.2%, with mild, moderate and severe anaemia being 16.5%, 33.0%, and 27.7% respectively(4).

1.2 PROBLEM STATEMENT

In patients with HIV, anaemia is a commonly encountered haematologic abnormality that has a significant impact on clinical outcomes and quality of life (QOL)(5). Anaemia affects many patients infected with HIV. Prevalence rates vary depending on the sub-populations of HIV-infected patients studied the stage of the disease and the age of the patient. Anaemia has been shown to have adverse effects on survival, morbidity, disease progression, and QOL. Conversely, the resolution of anaemia has been associated with improvements in survival and QOL. Recent evidence suggests that HAART may alleviate anaemia in individuals with HIV(6) Anaemia is the most common haematological complication in HIV patients and has a significant impact on quality of life, morbidity, and mortality, In multivariate analysis the use of HAART was strongly associated with not having anaemia during 1 year of follow-up, adjusting for patient gender, race, injection drug use history, baseline CD4 and HIV-1 RNA level and anaemia treatment. In conclusion, HAART is an effective treatment for the anaemia of HIV infection. However, little is known about the epidemiology of anaemia in this population in the Tanzanian Lake zone. Therefore, the present study is aimed at assessing the prevalence and pattern of anaemia among patients living with HIV. This study will reveal the rate of anaemia, its distribution and the severity in the various groups of participants to be studied. It is envisaged that the study will provide data for the early detection and timely management of anaemia among these patients, thus helping to prevent anaemia and disease progression, and ultimately improve quality of life(7).

1.3 RATIONALE OF THE STUDY
Information obtained from this study will provide epidemiological data on HIV patients at the CTC and Baylor clinics in Bugando. This information might be useful to policymakers in devising control measures.

1.4 STUDY QUESTION
What are the prevalence, morphological pattern and risk factors of anaemia among patients with HIV attending Baylor and CTC clinics in BMC?

1.5 Objectives


1.5.1 General objective
To determine the prevalence, morphological pattern and risk factors of anaemia among HIV patients attending Baylor and CTC clinics in BMC.

1.5.2 Specific objective

 To determine the prevalence of anaemia among HIV patients attending Baylor and CTC clinics in BMC
 To determine the morphological pattern of anaemia among HIV patients attending Baylor and CTC clinics in BMC
 To determine the Risk factor among HIV patients with anaemia attending CTC and Baylor