Food security and dietary diversity are associated with health related quality of life after 6 months of follow up among people living with HIV in Accra, Ghana

Abstract

With the efficacy of antiretroviral therapy, people living with HIV (PLWH) are surviving longer and improving their health related quality of life (HRQol) has become an important long-term HIV treatment and management indicator. HRQol has been associated with various factors, including food insecurity (FI). The objective of this prospective study was to examine the association between FI and dietary diversity (HDDS) and HRQol among PLWH in Accra, Ghana. We recruited 152 PLWH from the HIV clinics of six district hospitals Accra, Ghana and utilized a prospective cohort study design with data collection at baseline, three and six months after recruitment for this study. Participants completed questionnaires measuring HRQol, FI and HDDS. Repeated measures ANOVA was used to analyze the associations between FI and HRQol as well as HDDS and HRQol separately and then together. Being food secure [0.035 (95% CI = 0.005, 0.065)] and having a high dietary diversity score [0.029 (95% CI = 0.004, 0.053)] were independently associated with an improvement in quality of life scores over time after adjusting for other covariates and each other. Interventions to improve dietary diversity and food security among PLWH have the potential to improve nutritional status as well as HRQol.

Food Security in Ghanaian Urban Cities: A Scoping Review of the Literature

“…The studies were all conducted in urban or peri-urban settings in Ghana. The distribution of the included studies by the geographical regions of Ghana are as follows; twenty-four studies in Greater Accra [ 20 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ], eight studies in Ashanti Region [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ], three studies in the Northern region [ 22 , 59 , 60 ], and two studies each in the Central region [ 61 , 62 ], Western region [ 21 , 63 ], Eastern [ 64 , 65 ]. Volta [ 66 ] and Brong Ahafo [ 67 ] regions contributed one study each, while two studies were conducted in two or more regions [ 49 , 68 ].…”

“…Food utilisation was reported in seven studies [ 21 , 29 , 31 , 32 , 60 , 67 , 69 ]; three in the Greater Accra Region [ 29 , 31 , 32 ], one each in Northern [ 60 ], Western [ 21 ] and Brong Ahafo [ 67 ] regions. Authors of one these seven studies [ 69 ] did not indicate in which specific Ghana region the study was conducted.…”

“…In the study conducted in the Western region, the authors reported that energy-dense street foods were more frequently purchased and consumed by residents [ 21 ]. In the Sackey et al [ 29 ] study in the Greater Accra region assessing food security and dietary diversity issues, fish compared to meat consumption was frequently observed. After following the study participants over time, the authors reported that the pattern of fish and meat consumption did not change.…”

“…After following the study participants over time, the authors reported that the pattern of fish and meat consumption did not change. More people were consuming fish compared with meat consistently [ 29 ]. In another study in the Greater Accra region that examined urban household characteristics and dietary diversity, Dake et al [ 32 ] reported that the low socio-economic class group were consumed less fruits and vegetables compared to their higher economic class counterparts.…”

“…Perceived food insecurity was scarcely studied, with only five studies reporting on this domain of food security [ 29 , 30 , 49 , 65 , 69 ]. Of these studies, two studies were conducted in the Greater Accra region [ 29 , 30 ], and one from the Eastern region [ 65 ]. Two studies [ 49 , 69 ] were conducted in multiple urban cities.…”