Nutritional status of HIV-infected women with tuberculosis in Dar es Salaam, Tanzania

Abstract

HIV-positive women with TB have substantial 24-h deficits in energy and protein intake, report significant food insecurity and gain minimal weight on anti-tuberculosis treatment. Enhanced dietary education together with daily supplementation of 1000 kcal with 40 g protein may be required.

HIV, Tuberculosis, and Food Insecurity in Africa—A Syndemics-Based Scoping Review

“…Reporting of food insecurity was inconsistent across the included articles. Besides the well-validated HFIAS [14,41,46,56,57], authors evaluated food insecurity by diagnosing malnutrition using BMI values [14,47,49,50,[52][53][54]58], mid-upper arm circumference (MUAC) [47][48][49], weight-for-height z-score [48], lean mass index (LMI) [51,52], fat mass index (FMI) [51,52], bioelectrical impedance analyzer (BIA) measurements [51,52], food energy/nutritional intake of macronutrients [43,45,51,54], dietary diversity score [53], weight gain or loss [14,41,51,53,57], clinical symptoms such as kwashiorkor, pellagra, and marasmus [43,45], qualitative reports of food availability [42,55], food sufficiency [42], or presence/absence of nutritional support [43,44,50]. A couple of the studies only reported a narrative description of food insecurity, without stating the measure used [42,44,…”

“…Among studies that used the Household Food Insecurity and Access Scale (HFIAS) to assess food insecurity (n = 5), all reported the presence of food insecurity [14,41,46,47,57] but only one study reported the actual HFIAS score, where the average score was 6 (range: 1-14) [41]. Another study at baseline started with 92% food insecurity at enrollment, which declined to 73% food insecurity, after the nutritional support and TB treatment initiative was administered for 6 months [14].…”

“…Of the 18 included studies, 14 studies reported on HIV (n = 3) [41,[51][52][53], TB (n = 2) [49,55], or both HIV-and TB-related (n = 9) [42][43][44][45][46][47][48]52,53] outcomes, in addition to food insecurity. Health and health-related outcomes reported among individuals co-infected with HIV and TB include morbidity [43,44,48,52], mortality [41,42,45,[51][52][53]55], treatment outcomes (e.g., treatment non-adherence, access to treatment, initiated ART, treatment success, treatment failure, etc.) [42,44,51], weight loss/wasting [46,52,53], opportunistic infection [46,48], TB lung disease [47], and lethargy [49].…”

“…Some studies (n = 7) documented HIV-and TB-related treatment adherence and health behaviors amongst co-infected individuals [14,41,42,44,51,56,57]. Treatment non-adherence was reported as the inconsistent and incorrect use of medication or treatment as prescribed by health providers, and was reported in several studies [14,42,44,51,56,57]; in one study, 31% of the individuals with HIV/AIDS and TB co-infection were reported as non-adherent to treatment [57].…”

“…Treatment non-adherence was reported as the inconsistent and incorrect use of medication or treatment as prescribed by health providers, and was reported in several studies [14,42,44,51,56,57]; in one study, 31% of the individuals with HIV/AIDS and TB co-infection were reported as non-adherent to treatment [57]. Other documented related health behaviors included: if the patient was on treatment (e.g., medications such as ART) and had access to treatment [41,42,44,51]. The presence of food and nutritional support, whether in the form of nutrient-rich food, ready-to-use therapeutic food (RUTF), or a supply of food ingredients, supported high treatment adherence [14].…”