Prevalence and determinants of anemia among HIV-positive children in central Uganda: A cross sectional study

TL;DR

This study examines how common anemia is among HIV-positive children in Uganda and identifies factors linked to it, including iron deficiency.

Contribution

The study provides new insights into anemia prevalence and its determinants in HIV-positive children in a low-income setting.

Findings

57.3% of HIV-positive children in the study had anemia.

Iron deficiency anemia accounted for 54.1% of anemic cases.

Factors like education level of caretakers and HIV stage were significantly associated with anemia.

Abstract

Anemia remains a critical public health issue, especially in low-resource settings like Uganda, with severe consequences especially in HIV-positive children. Limited research has been conducted in low-income settings especially about anaemia in HIV-Positive children. This study aimed to determine the prevalence and factors associated with anemia among HIV positive children at Kayunga Regional Referral Hospital. In addition to assess iron deficiency anemia using Mentzer index.

This was a hospital based cross-sectional study conducted at KRRH. 384 HIV-positive children aged 6 months to 12 years attended the KRRH ART clinic between November 2024 to January 2025 were enrolled.Data was collected using structured questionnaires,information regarding their sociodemographic, medical and laboratory was obtained asking care giver or reviewing the medical record. Anthropometric measurements were done and interpreted compared to the WHO z-scores and obtained blood sample for CBC and analyzed.

Anemia was defined based on age-specific hemoglobin thresholds: < 11.0 g/dL for children aged 6–59 months, < 11.5 g/dL for those aged 5–11 years, and <12.0 g/dL for children aged 12–14 years. Iron deficiency anemia was diagnosed with MI > 13. Logistic regression in STATA was done to determine the factors that were significantly associated with anaemia.

Majority of the children (63.5%) were over 5 years of age and 52.9% were male and 57.3% had anemia with 95% confidence interval of 52.3–62.2%. The predominant severity category of anemia was moderate (48.6%). Multivariable analysis showed that caretakers who stopped in primary, having more than four siblings, being in current HIV stages 2 or 3, any history of hospital admission in the preceding six months, and being severely stunted, wasted, or experiencing concurrent stunting and wasting were independently associated with anemia among children infected with HIV (P-value < 0.05 for all). Iron deficiency anemia accounted for 54.1% of all children with anemia.

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