Malnutrition: Prevalence and its associated factors in People living with HIV/AIDS, in Dilla University Referral Hospital

Abstract

BackgroundLiteratures on prevalence and factors associated with malnutrition among peoples living with HIV/AIDS are limited in Ethiopia and not well documented either. The proper implementation of nutritional support and its integration with the routine highly active antiretroviral therapy package demands a clear picture of the magnitude and associated factors of malnutrition. The objective of this study is, therefore, to assess the prevalence and factors associated with malnutrition among peoples living with HIV/AIDS.MethodsInstitution based cross sectional study was conducted in Dilla University referral Hospital including adult HIV patients who were in highly active anti retroviral therapy. Interview administered questionnaires were used to collect data on socio demographic factors. Besides, HIV related clinical information was extracted from anti retro viral therapy data base and clinical charts. The nutritional status of the patients was determined by Body Mass Index (BMI) where BMI < 18kg/m2 was defined as malnutrition according to World Health Organization (WHO). Binary logistic regression was used to assess association between different risk factors and malnutrition. Confidence interval of 95% was considered to see the precision of the study and the level of significance was taken at α <0.05.ResultsA total of 520 patients were included in the analysis. The overall prevalence of malnutrition was 12.3% (95% CI 9.5–15.0). After full control of all variables; unemployment (OR = 3.61, 95% CI: 3.6 − 7.76), WHO clinical stage four (OR = 12.9, 95% CI: 2.49− 15.25), gastrointestinal symptoms (OR = 5.3, 95% CI: 2.56 − 10.78) and previous (one) opportunistic infection (OR = 3.1, 95% CI 2.06 − 5.46), and two & above previous opportunistic infections (OR = 4.5, 95% CI: 3.38 − 10.57) were significantly associated with malnutrition. However, moderately poor economic condition was found to be protective factor for malnutrition (OR = 0.4, 95% CI: 0.14 − 0.95).ConclusionUnemployment, WHO clinical AIDS stage four, one & more number of previous opportunistic infections and gastrointestinal symptoms were found to be important risk factors for malnutrition among People Living with HIV/AIDS. From this study it has been learnt that nutritional programs should be an integral part of HIV/AIDS continuum of care. Furthermore, it needs to improve household income of PLHIV with employment opportunity and to engage them in income generating activities as well.

Chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital northwest Ethiopia

“…In this study, those who had history of diarrhea in the last two weeks were 4.43 times at risk of having chronic energy deficiency than their counter parts. This findings consistent with the study conducted in Dilla(AOR = 3.40) [36] but not in a study done in Butajira and Humera [20,40].…”

“…Similarly, a study conducted in Nepal and Dilla revealed that Illiterate people were 2.3 and 3.5 times more likely to be chronic energy deficient as compared to people who can read and write respectively [34,36]. A meta-analysis done among women living with HIV in SSA also supports this finding [13].…”

“…Studies from Nepal (AOR = 2.09), Hosanna (AOR = 5.23) and Dilla (AOR = 12.9) also showed similar findings [34,36,41]. When the disease stage advances over time, the occurrence of CED is inevitable due to the occurrence and synergetic effect of different opportunity infections which increases their catabolic state, energy demand and loss of both macro and micronutrients by decreasing the intake and absorption of nutrients.…”

“…Educational status, WHO clinical stage and having diarrhea in the last two weeks were significantly associated with chronic energy deficiency. The overall prevalence of chronic energy deficiency in this study was similar with the studies done in Nepal and Singapore [34,35], Tanzania [17] and Ethiopian studies done in Butajira, Dilla, Addis Abeba and Dembia [19][20][21]36]. But it was lower than the findings from Iran, China, Brazil, Botswana, Bahirdar, Humera and Gondar [14,18,31,[37][38][39][40].…”

Diagnósticos de enfermagem e seus componentes em pacientes com a síndrome da imunodeficiência adquirida

“…It is also important to point out that the HIV has mechanisms that affect specifically the nutritional status of individuals by increasing the energy demand and interfering in the absorption and metabolism of the nutrients. (18) The consumption of illegal drugs, alcohol, and tobacco is seen by some authors as a risk factor for developing opportunistic infections in patients with AIDS. Oral candidiasis and hairy leukoplakia are some examples of these infections.…”