Prevalence and morphologic types of anemia among adult patients admitted to the meidcal emergency ward in mulago hospital.

Abstract

INTRODUCTION: Anaemia is a common condition worldwide although the burden is highest in the developing countries where nutrient deficiencies and chronic infections are prevalent. The tends in prevalence and causes of anaemia are changing with the changing prevalence of infectious diseases including HIV. It has been established that anaemia increases mortality and morbidity if not properly addressed. OBJECTIVE: To determine the prevalence and morphologic types of anaemia among adult patients admitted to the medical emergency ward in mulago hospital. DESIGN: Cross sectional descriptive study STUDY SETTING: Mulago hospital, medical emergency ward PARTICIPANTS: Patients aged 18 years and above, admitted to the medical emergency ward from September 2007 to mid January 2008 were recruited by systematic random sampling of every 5th patient until a sample size of 395 was attained. MEASUREMENTS: Basic socio-demographic characteristics and clinical details of the patients were collected using a questionnaire. 3mls of blood were drawn for a complete blood count and peripheral film examination. Stool was collected and examined for hookworm ova. STATISTICAL ANALYSIS: Data was processed using EPI-INFO version 6 and STATA version 9 computer software packages and summarized using frequency tables and bar graphs. The Chi-squared test was used for categorical variables and the student’s t-test for non-categorical variables. Multiple logistic regression was used to determine factors independently associated with anaemia. RESULTS: Two hundred fifty five (64.6%) patients had anaemia. The prevalence was higher among males (65.8%) than females (63.7%). Fatigue (OR 2.1, C1 1.37-3.24), dizziness (OR 1.64, C1 1.07-2.22), Previous blood transfusion (OR 2.83, c1 1.32-6.06), lymphadenopathy (OR 2.99, C1 1.34-6.66) and splenomegally (OR 5.22, C1 1.78-15-28) were significantly associated with anemia. Splenomegally, low BMI (<19) and being HIV positivewere independently associated with anemia on logistic regression. The commonest type of anemia was the hypochromic microcytic type (34.1%). Only 10.6%) of the anaemic patients had hookworm infestation and it may not be a major contributor to anaemia. CONCLUSIONS: The prevalence of anaemia (64.6%) among patients admitted to the medical emergency ward in mulago hospital is very high. Splenomegally, HIV infection and low body mass index are independently associated with anaemia. The commonest type of anaemia was microcytic hypochromic (34.1%). There is a low prevalence of hookworm infestation amongst patients with anaemia admitted to the medical emergency ward in mulago hospital. Hookworm infestation may therefore not be a major contributor to anaemia in these patients.