Incidence and predictors of anemia among children with antiretroviral therapy at health facilities in Southern Ethiopia: A retrospective follow-up study.

Objectives: Anemia is a prevalent hematological disorder in children infected with human immunodeficiency virus who are receiving antiretroviral therapy. Anemia is increasingly prevalent among children undergoing antiretroviral treatment; however, studies on the incidence and predictors of anemia in this population within Ethiopia remain limited. Therefore, this study aimed to determine the incidence of anemia and its predictors among children who were enrolled in antiretroviral therapy at health facilities in the Wolaita Zone, South Ethiopia, 2022.

Methods: A facility-based retrospective cohort study was conducted among 352 medical records at health facilities in the Wolaita Zone from February 2022 to January 2023. The medical records were selected using the stratified cluster sampling method. The data were entered into EpiData and analyzed using STATA version 14. The Cox proportional hazard regression model was used. Finally, predictors with p < 0.05 were stated as statistically significant factors. The results were presented using text, tables, and figures.

Results: The overall incidence rate of anemia among children was 4.29 (95% confidence interval: 3.46-5.34) per 100 person-years. Being female sex (adjusted hazard ratio = 1.79, 95% confidence interval: 1.29-2.47), advanced disease stage (adjusted hazard ratio = 2.26, 95% confidence interval: 1.26-4.06), a zidovudine-based regimen (adjusted hazard ratio = 2.07, 95% confidence interval: 1.16-3.69), and being stunted (adjusted hazard ratio = 3.37, 95% confidence interval: 2.06-5.50) were the predictors of anemia.

Conclusion: The incidence of anemia in the study setting was relatively low. Females, children at advanced World Health Organization clinical stages, those who were stunted, and those who initiated with a zidovudine-based regimen were the predictors of anemia. Healthcare providers should give special attention to children who are at an advanced disease stage, who were stunted, and who are taking a zidovudine-based regimen.