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ObjectiveAnaemia is common during pregnancy, and prenatal Fe supplementation is the standard of care. However, the persistence of anaemia despite Fe supplementation, particularly in HIV infection, suggests that its aetiology may be more complex and warrants further investigation. The present study was conducted to examine predictors of incident haematological outcomes in HIV-infected pregnant women in Tanzania.DesignProspective cohort study. Cox proportional hazards and binomial regression models were used to identify predictors of incident haematological outcomes: anaemia (Hb < 110 g/l), severe anaemia (Hb < 85 g/l) and hypochromic microcytosis, during the follow-up period.SettingAntenatal clinics in Dar es Salaam, Tanzania.SubjectsParticipants were 904 HIV-infected pregnant women enrolled in a randomized trial of vitamins (1995–1997).ResultsMalaria, pathogenic protozoan and hookworm infections at baseline were associated with a two-fold increase in the risk of anaemia and hypochromic microcytosis during follow-up. Higher baseline erythrocyte sedimentation rate and CD8 T-cell concentrations, and lower Hb concentrations and CD4 T-cell counts, were independent predictors of incident anaemia and Fe deficiency. Low baseline vitamin D (<32 ng/ml) concentrations predicted a 1·4 and 2·3 times greater risk of severe anaemia and hypochromic microcytosis, respectively, during the follow-up period.ConclusionsParasitic infections, vitamin D insufficiency, low CD4 T-cell count and high erythrocyte sedimentation rate were the main predictors of anaemia and Fe deficiency in pregnancy and the postpartum period in this population. A comprehensive approach to prevent and manage anaemia, including micronutrient supplementation and infectious disease control, is warranted in HIV-infected women in resource-limited settings – particularly during the pre- and postpartum periods. [ABSTRACT FROM PUBLISHER]

Objective: To determine the prevalence trends of HIV‐1 infection among pregnant women seen between 1995 and 2003 at public antenatal clinics (ANC) in the city of Dar es Salaam. Design and settings: Cross‐sectional studies among pregnant women at selected antenatal clinics who were offered HIV testing as part of research and service programmes to prevent vertical transmission of HIV infection and improve pregnancy outcomes. Subjects and methods: Consenting women gave blood for HIV antibody testing using a sequential ELISA protocol. Sociodemographic information was collected using structured interviews. Results: In total, 62% of women attending the antenatal clinics gave informed consent for HIV testing and 51,076 had final confirmed results available for this analysis. Women below 20 years of age had the lowest HIV seroprevalence. The HIV‐1 prevalence declined from 14.2% in 1995 to 10.6% in 2003. Conclusion: There is a definite substantial decline in prevalence of HIV‐1 infection among pregnant women in Dar es Salaam following ongoing interventions, which have been carried out in Tanzania. There is a need to further strengthen these interventions. [ABSTRACT FROM AUTHOR]

Highlights key epidemiological differences between AIDS in African countries and AIDS in the United States. Background conditions that permit and constraint responses to the epidemics; African countries of high and low prevalence; Population distribution and demographic impact; Demographic structure of a high-fertility and a low-fertility population; Differences in the availability of health services; Inadequacy of laboratory equipment needed to meet the Centers for Disease Control and Prevention case definition of AIDS.