Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania
Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania
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DOI：
10.1093/jn/130.8.1950
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发表时间：
2000-08-01
影响因子：
4.2
通讯作者：
Fawzi, WW
中科院分区：
文献类型：
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作者：
Antelman, G;Msamanga, GI;Fawzi, WW
这项横断面研究的目的是确定坦桑尼亚达累斯萨拉姆人类免疫缺陷病毒 (HIV) 阳性孕妇贫血的危险因素。对参加一项关于补充维生素对 HIV 感染的影响的临床试验的 1064 名女性的基线数据进行了检查，以确定贫血的潜在决定因素。平均血红蛋白 (Hb) 水平为 94 g/L，严重贫血 (Hb < 85 g/L) 的患病率为 28%； 83% 的女性 Hb < 110 g/L。缺铁和传染病似乎是贫血的主要原因。与体重指数 (BMI) > 24 kg/m(2) 的女性相比，体重指数 (BMI) < 19 kg/m(2) 的女性与严重贫血存在显着的独立关联[比值比 (OR) 3.13，95% 置信区间 (CI)：1.37-7.14）；与没有寄生虫的女性相比，疟疾寄生虫密度> 1000/mm(3)（OR 2.70，CI：1.58-4.61）；怀孕早期吃土（OR 2.47，CI：1.66-3.69）； CD4+ 细胞计数 < 200/μL 与 CD4+ 细胞计数 > 500/μL 相比（OR 2.70，CI：1.42-5.12）；与视黄醇水平 > 1.05 μmol/L 的女性相比，血清视黄醇水平 < 70 μmol/L（OR 2.45，CI：1.44-4.17）。该人群中与严重贫血相关的最重要的危险因素是可以预防的。公共卫生建议包括提高怀孕期间补铁和疟疾管理的有效性，以及提供健康教育信息，提高人们对怀孕期间吃土可能造成的不良营养后果的认识。
The objective of this cross-sectional study was to identify risk factors for anemia among human immunodeficiency virus (HIV)-positive pregnant women in Dar es Salaam, Tanzania. Baseline data from 1064 women enrolled in a clinical trial on the effect of vitamin supplementation in HIV infection were examined to identify potential determinants of anemia. The mean hemoglobin (Hb) level was 94 g/L, and the prevalence of severe anemia (Hb < 85 g/L) was 28%; 83% of the women had Hb < 110 g/L. iron deficiency and infectious disease appeared to be the predominant causes of anemia. Significant independent associations with severe anemia were observed for women with body mass index (BMI) < 19 kg/m(2) compared with women with BMI > 24 kg/m(2) [odds ratio (OR) 3.13, 95% confidence interval (CI): 1.37-7.14); malaria parasite densities > 1000/mm(3) (OR 2.70, CI: 1.58-4.61) compared with women with no parasites; eating soil during early pregnancy (OR 2.47, CI: 1.66-3.69); CD4+ cell count < 200/mu L compared with CD4+ count > 500/mu L (OR 2.70, CI: 1.42-5.12); and serum retinol levels < 70 mu mol/L (OR 2.45, CI: 1.44-4.17) compared with women with retinol levels > 1.05 mu mol/L. The most significant risk factors associated with severe anemia in this population are preventable. Public health recommendations include increasing the effectiveness of iron supplementation and malaria management during pregnancy, and providing health education messages that increase awareness of the potentially adverse nutritional consequences of eating soil during pregnancy.