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

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. 748-76