Determination of eligibility to antiretroviral therapy in resource limited settings using total lymphocyte counts, hemoglobin and body mass index among HIV positive patients

Background: Acquired Immunodeficiency Syndrome is a serious public health problem in Ethiopia. CD4+ T cell count testing is the standard method for determining eligibility for antiretroviral therapy. However, automation for CD4+ T cell count is not widely available in sub-Saharan Africa including Ethiopia.Objective: This study was to determine eligibility for antiretroviral therapy in resource-limited settings using total lymphocyte counts, hemoglobin and body mass index among HIV positive patients.Materials and methods: CD4+ T cell count was determined using Becton Dickinson FACS count analyzer. Total lymphocyte count and hemoglobin concentration were measured by a Cell Dyne 1800 hematology analyzer and body mass index was determined. Correlation of total lymphocyte count, hemoglobin and body mass index with CD4+ T cell count was determined by Pearson’s correlation coefficient and p-value.Results: The correlation between CD4+ T cell count and Total Lymphocyte Count (TLC) was not strong, but the association between CD4+ T cell count and TLC was highly significant and correlation between CD4+ T cell counts with hemoglobin were very weak. The sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of TLC using threshold value of 1000 cells/mm3 for CD4+ T cell counts <350 cells/mm3 were 3% , 94%, 17% and 71%, respectively. Total lymphocyte count threshold of 1750 cells/mm3 were the better predictor of CD4+ T cell counts of <350 cells/mm3 when compared to < 200 cells/mm3.Conclusion: TLC showed weak correlation with CD4+ T cell counts but the association between CD4+ T cell count with TLC was significant (p<0.0001). The TLC threshold of 1750 cells/mm3 were the most accurate predictors of CD4+ T cell counts of <350 cells/mm3. Therefore, the significant association of TLC with CD4+ T cell count may suggest that TLC could be used as marker for CD4+ T cell count in determining anti-retroviral treatment initiation when CD4+ T cell count is not available particularly in rural settings where laboratory facilities are lacking

Prevalence of anemia and its associated factors among pregnant women receiving antenatal care at Aymiba Health Center, northwest Ethiopia

Fikir Asrie Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Introduction: Anemia is a global public health problem in both developing and developed countries; ~1.62 billion people suffer from anemia, and pregnant women are the most susceptible to it. The main aim of the present study was to assess the prevalence of anemia and associated risk factors among pregnant women receiving antenatal care at Aymiba Health Center, northwest Ethiopia.Methods and materials: An institution-based cross-sectional study was conducted at Aymiba Health Center from January to March 2015. Hemoglobin level and intestinal parasitic infections in pregnant women were assessed. Sociodemographic data were collected using a structured questionnaire. The data were entered and analyzed using the SPSS version 20. Odds ratio, p<0.05, and binary logistic regression were used to assess the association of pregnant women’s sociodemographic characteristics with their hemoglobin levels and the prevalence of anemia.Results: The mean with ±2 standard deviation of hemoglobin value was 12±1.3 (95% confidence interval [CI] =11.9–12.5), and the prevalence of anemia from a total of 206 study subjects was 52 (25.2%). Of this anemic group, 50 (24%) were in the second and third trimesters. Anemia was significantly associated with rural residence and intestinal parasitic infections (adjusted odds ratio [AOR] =9.17, 95% CI =2.15–40, p<0.001) and (AOR =55.091, 95% CI =6.88–441.19, p<0.001), respectively.Conclusion: In the present study, the prevalence of anemia was lower than in previous studies conducted in various countries, including Ethiopia. More studies are needed regarding the importance of regular maternal care and health education promotion programs, which have the potential to play a more significant role in health care. Keywords: hemoglobin, pregnancy, antenatal care, Aymiba, Ethiopi