Anaemia in the context of pregnancy and HIV/AIDS: A case of Pumwani Maternity Hospital in Nairobi, Kenya

Abstract

Anemia is a major public health problem in Africa affecting over 80% of women in
many countries. It is more common during pregnancy due to the increased demand for
iron at different stages of pregnancy. In Kenya, one out of every two mothers is
affected by some form of anemia. Human immunodeficiency virus (HIV) and
acquired immune deficiency syndrome (AIDS) among expectant women further
increase risk of anemia prevalence and severity. This study was to determine the
socio-economic characteristics, dietary pattern of pregnant women and investigate the
relationship between iron deficiency anemia (IDA) and HIV/AIDS in pregnancy. A
case-control study was conducted in Pumwani Maternity Hospital in Nairobi Kenya.
The HIV status was ascertained through HIV-antibody tests using Determine, Uni-
Gold and Tie-Breaker reagents. Cases of 57 seropositive and controls of 57
seronegative pregnant women were randomly and co-currently selected. Their
hemoglobin (Hb), demographic, socio-economic characteristics were determined. A
24-hour dietary recall and food frequency were used to determine the food
consumption pattern. Results showed that both cases and controls were from low
socio-economic status and consumed monotonous diets of plant origin particularly
Ugali, a paste made from maize flour and kales vegetables locally known as
Sukumawiki. Fruits were rarely consumed. The meals were mainly consumed three
times in a day with snacks consumed by an insignificant number of women. With
exception of pre-eclampsia, other pregnant-related problems including headache,
dizziness, loss of appetite, heartburn and vomiting were more predominant among the
cases than in the controls. Iron deficiency anemia was more prevalent and severe
among the cases (prevalence=68%, mean Hb=9.551g/dl) than the controls
(prevalence=26.3 %, mean Hb=11.974g/dl). The relative risk of being anemic was
about two times higher for HIV-infected as of the uninfected pregnant women,
(Relative risk=2.33). It is concluded that pregnant women from low socio-economic
status consume diets with iron of low biological value, have low Hb and are generally
anemic. Moreover, HIV-infected pregnant women have lower Hb and are two times
more likely to be anemic than the uninfected. The HIV/AIDS infection is therefore
associated with low Hb and higher anemia prevalence and severity among pregnant
women. There is, therefore, a need for pre-natal nutrition care system that emphasizes
improved consumption of essential nutrients including iron of high biological value
and implementation of interventions tailored to check anemia prevalence and severity
among pregnant women within the context of HIV/AIDS pandemic and low socioeconomic
settings.

Keywords: anemia, HIV/AIDS, pregnancy, hemoglobin, iron

African Journal of Food, Agriculture, Nutrition and Development Vol. 9 (2) 2009: pp. 748-763