Relationship Between Tuberculosis and Anemia in African Hospitals: Pathophysiology, Clinical Burden, and Management Implications

Muhindo Anitah

Department of Pharmacy Kampala International University Uganda

Email: anitah.muhindo@studwc.kiu.ac.ug

                                                                                     ABSTRACT
Tuberculosis (TB) remains a leading cause of morbidity and mortality in Africa. Anemia is a frequent hematological abnormality among hospitalized TB patients and is increasingly recognized as both a consequence and prognostic marker of disease severity. In African hospitals where TB, HIV co-infection, malnutrition, and parasitic diseases coexist, the burden of TB-associated anemia is substantial. This review synthesizes current evidence on prevalence, mechanisms, risk factors, clinical consequences, diagnostic challenges, and management strategies of anemia among TB patients in African healthcare settings. The predominant mechanism is anemia of chronic inflammation mediated by hepcidin-driven iron sequestration. However, iron deficiency anemia (IDA), HIV-associated bone marrow suppression, helminth infections, micronutrient deficiencies, and anti-TB drug effects contribute significantly. TBassociated anemia correlates with delayed sputum conversion, severe disease, prolonged hospitalization, and increased mortality. Management remains challenging due to diagnostic overlap between IDA and anemia of inflammation (AI), and concerns regarding iron supplementation in active infection. Context-specific protocols integrating TB care with anemia screening, nutritional assessment, and HIV management are urgently needed. Addressing anemia may improve TB outcomes and reduce inpatient mortality in African hospitals.

Keywords: Tuberculosis, Anemia, Africa, Hepcidin, HIV co-infection, Inflammation, Iron metabolism, Hospital outcomes.

CITE AS: Muhindo Anitah (2026). Relationship Between Tuberculosis and Anemia in African Hospitals: Pathophysiology, Clinical Burden, and Management Implications. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 11(3):16-20.
https://doi.org/10.59298/IDOSR/JBBAF/2026/1131620