Prevalence and morphological types of anaemia and hookworm infestation in the medical emergency ward, Mulago Hospital, Uganda.

INTRODUCTION Anaemia is common worldwide, although the burden is highest in developing countries where nutrient deficiencies and chronic infections are prevalent. OBJECTIVE To determine the prevalence and morphological types of anaemia and assess the hookworm burden among patients in the medical emergency ward at Mulago national referral hospital, Uganda. METHODS In a cross-sectional descriptive study 395 patients were recruited by systematic random sampling and their socio-demographic characteristics and clinical details collected. A complete blood count and peripheral film examination were done and stool examined for hookworm ova. STATISTICAL ANALYSIS Data were processed using Epi-Info version 6 and Stata version 9. The chi-square test was used for categorical variables and Student's t-test for non-categorical variables. Multiple logistic regression was used to determine factors predictive of anaemia. RESULTS Of the patients 255 (64.6%) had anaemia. The prevalence was higher among males (65.8%) than females (63.7%). Fatigue (odds ratio (OR) 2.1, confidence interval (CI) 1.37 - 3.24), dizziness (OR 1.64, CI 1.07 - 2.44), previous blood transfusion (OR 2.83, CI 1.32 - 6.06), lymphadenopathy (OR 2.99, CI 1.34 - 6.66) and splenomegaly (OR 5.22, CI 1.78 - 15.28) were significantly associated with anaemia. Splenomegaly, low body mass index (BMI) (<19) and being HIV positive were independently associated with anaemia. The commonest type of anaemia was hypochromic microcytic (34.1%). Only 10.6% of anaemic patients had hookworm infestation. CONCLUSIONS In our study the prevalence of anaemia (64.6%) was very high. Splenomegaly, HIV infection and low BMI were independently associated with anaemia. The commonest type of anaemia was microcytic hypochromic (34.1%). There was a low prevalence of hookworm infestation.

[1]  I. Bates,et al.  Anaemia: A Useful Indicator of Neglected Disease Burden and Control , 1997, PLoS medicine.

[2]  M. Tonelli,et al.  Impact of anemia on hospitalization and mortality in older adults. , 2006, Blood.

[3]  W. Fawzi,et al.  Anemia Is an Independent Predictor of Mortality and Immunologic Progression of Disease Among Women With HIV in Tanzania , 2005, Journal of acquired immune deficiency syndromes.

[4]  I. Adam,et al.  Prevalence and risk factors for anaemia in pregnant women of eastern Sudan. , 2005, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[5]  C. Whitty,et al.  Treatable factors associated with severe anaemia in adults admitted to medical wards in Blantyre, Malawi, an area of high HIV seroprevalence. , 2005, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[6]  Luigi Ferrucci,et al.  Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. , 2004, Blood.

[7]  C. Obonyo,et al.  Anemia and malaria at different altitudes in the western highlands of Kenya. , 2004, Acta tropica.

[8]  S. Kariuki,et al.  Prevalence and severity of anemia and iron deficiency: cross-sectional studies in adolescent schoolgirls in western Kenya , 2004, European Journal of Clinical Nutrition.

[9]  A. Dicko,et al.  Risk factors for malaria infection and anemia for pregnant women in the Sahel area of Bandiagara, Mali. , 2003, Acta tropica.

[10]  F. Scheutz,et al.  Postnatal anaemia: neglected problems and missed opportunities in Uganda. , 2003, Health policy and planning.

[11]  J. Cook,et al.  Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Côte d'Ivoire. , 2001, The American journal of clinical nutrition.

[12]  W. Fawzi,et al.  Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania. , 2000, The Journal of nutrition.

[13]  R. Moore,et al.  Human immunodeficiency virus infection, anemia, and survival. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  A. Collins,et al.  Hematocrit level and associated mortality in hemodialysis patients. , 1999, Journal of the American Society of Nephrology : JASN.

[15]  U. Svanberg,et al.  Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania. , 1998, The American journal of clinical nutrition.

[16]  P. Sullivan,et al.  Epidemiology of anemia in human immunodeficiency virus (HIV)-infected persons: results from the multistate adult and adolescent spectrum of HIV disease surveillance project. , 1998, Blood.

[17]  K. Charlton,et al.  Iron, folate and vitamin B12 status of an elderly South African population , 1997, European Journal of Clinical Nutrition.

[18]  R. Stoltzfus,et al.  Hemoquant determination of hookworm-related blood loss and its role in iron deficiency in African children. , 1996, The American journal of tropical medicine and hygiene.

[19]  R. Hayes,et al.  The impact of human immunodeficiency virus on mortality of patients treated for tuberculosis in a cohort study in Zambia. , 1995, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[20]  H. Nell,et al.  The haematological and biochemical changes in severe pulmonary tuberculosis. , 1989, The Quarterly journal of medicine.

[21]  P. Coelho,et al.  Evaluation of Kato's quantitative method through the recovery of Schistosoma mansoni eggs added to human feces. , 1970, The Journal of parasitology.

[22]  R. Sturrock Hookworm studies in Uganda: investigations at Teboke in Lango District. , 1966, East African medical journal.