scholarly journals Food access and diet quality independently predict nutritional status among people living with HIV in Uganda

2012 ◽  
Vol 16 (1) ◽  
pp. 164-170 ◽  
Author(s):  
Suneetha Kadiyala ◽  
Rahul Rawat

AbstractObjectiveAlthough undernutrition is recognized as a risk factor for mortality among people living with HIV (PLWHIV), even among those initiating antiretroviral therapy, few studies have explored the underlying determinants of undernutrition. The objectives of the present study were to: (i) examine the independent association between household food security, individual diet quality and nutritional status; and (ii) determine if any association between food security and nutritional status is mediated through diet quality.DesignCross-sectional baseline survey.SettingGulu and Soroti districts, Uganda.SubjectsNine hundred and two PLWHIV recruited into a study evaluating the impact of a food assistance programme supported by the World Food Programme.ResultsFood security and diet quality were measured using the Household Food Insecurity Access Scale (HFIAS) and the Individual Dietary Diversity Score (IDDS), respectively. Multivariate regression results demonstrated that HFIAS and IDDS independently predict BMI (P < 0·01) and mid upper-arm circumference (P < 0·05). The adjusted odds ratio of being underweight (BMI < 18·5 kg/m2) among individuals living in severely food-insecure households was 1·92 (P < 0·0 0 1); individuals consuming a highly diverse diet had an adjusted odds ratio of being underweight of 0·56 (P < 0·05) compared with those consuming a diet of low diversity. Similar results were observed when mid upper-arm circumference and wasting were modelled as outcomes. Using path analysis, we observed that the indirect effect of food insecurity on BMI mediated through dietary diversity is negligible, and mostly a result of the direct effect of food insecurity on BMI.ConclusionsOur results provide an empirical basis for focused efforts on improving food access and diet quality among PLWHIV. Addressing the broader structural determinants of food security of people infected and affected by HIV is crucial.

2019 ◽  
Author(s):  
REKIKU Fikre ABEBE ◽  
Tamrayhu seyoum

Abstract Abstract Introduction: Globally 78 million peoples have been infected with HIV/AIDS. Ethiopia has one of the largest populations of HIV infected people in the sub-Saharan region of Africa. The relationship between HIV epidemic and food security situation in Ethiopia is complex. Hence, it is likely that the epidemic will contribute to worsening widespread food insecurity. The aim of study was to assess the level of food security and associated factors among adult people living with HIV /AIDS attending ART Clinic in Hospitals of Hawassa city Administration. Methodology: Thisinstitutional based cross-sectional study was conducted from October to December 2017. Systematic sampling technique was used to select a total of 532 study participant. Data entry was done with EPI-info version 3.5.3 and transferred into SPSS Version 20. Crude with adjusted odds ratio with 95% confidence interval at p- value < 0.05were computed to examine statistical significance. Results:Based on food security assessment core module scale 360 (67.3%) People living with HIV/AIDSwere food insecure. People living with HIV/AIDSwho disclose HIV status were 3.9 (AOR=3.902, 95% CI (1.238, 12.301) times more likely to be food secured compared with their counterparts.Similarly, those who were with high and medium dietary diversity were about 5 times more likely to be house hold food insecure compared to those with low dietary diversity AOR= 4.990(2.488,10.05), AOR= 4.696(1.54,14.36), respectively. Conclusions:Food Security status among People living with HIV/AIDSon ART in Hawassa town was low. Dietary diversity, household size, and disclosing HIV status were found to be significant predictors of food security. Key words: Food security, food insecurity ,Adult living with HIV/AIDS.


2019 ◽  
Author(s):  
Adugna Oluma ◽  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Werku Etafa ◽  
Ginenus Fekadu

Abstract Background : Food insecurity and HIV/AIDS are intertwined in a vicious cycle through nutritional, mental health, and behavioral pathways. Food insecurity is a potentially important barrier to the success of antiretroviral treatment, increased hospitalizations, and higher morbidity among HIV-infected individuals in resource-poor settings particularly in sub-Saharan Africa including Ethiopia. Therefore, the purpose of this study was to assess the prevalence of food insecurity and its associated factors among adult people living with HIV/AIDS on follow up receiving ART at public hospitals of wollega zone, west Ethiopia. Methods : An institutional-based cross-sectional study design was conducted on a sample of 428 among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of wollega zones. Data was collected using the Household Food Insecurity Access Scale and dietary diversity scale by interviewer-administered questionnaires. The data was checked, cleaned and entered into Epi data version 3.1 and then exported into Statistical Package for the Social Sciences (SPSS) window version 21 for analysis. Descriptive statistics - cross-tabulation frequency table, mean, standard deviation, percentage, were employed. Bivariate and multiple logistic regression analyses were used with AOR at CI 95% and p<0.05 were used. Result: The overall prevalence of food insecurity among PLWHA receiving ART therapy was 68.8% which was partitioned as mild (23.32%), moderate (29.09%) and severe (16.35%) food in secured. Being single [AOR=3.507(1.377, 8.934)], illiterate [AOR=5.234(1.747, 15.686)], cigarette smoking [AOR=3.577(2.104, 6.081)], presence of anemia (AOR=2.650(1.563, 4.493)] and inadequate dietary diversity [AOR=2.870(1.088, 7.569)] were predictors of food insecurity. Conclusion : The prevalence of food insecurity was relatively high. Educational status, marital status, cigarette smoking, presence of anemia, opportunistic infection and inadequate dietary diversity were the major significant factors affecting food insecurity. We recommended Wollega Zonal Health Bureaus to effectively intervene in behavioral modification and health information dissemination (HID) which is the key strategies to improve food security.


2020 ◽  
Author(s):  
Sebean Mayimbo ◽  
Clara Maphosa Haruzivishe ◽  
Concepta Kwaleyela ◽  
Phoebe Bwembya ◽  
Ellen Chirwa ◽  
...  

Abstract Background One of the easiest and effective ways of predicting under nutrition is to use the Dietary Diversity Score (DDS) and the mid-upper arm circumference (MUAC). The dietary diversity score is a qualitative measure of food consumption reflecting an individual’s access to different food items and therefore is a proxy indicator of the nutritional status. The aim of the study was to assess whether the DDS and MUAC can be used to assess the nutritional status of pregnant women attending antenatal. Methods A cross-sectional survey was conducted at Chilenje level I Hospital in a township located in Lusaka city, Lusaka province. The study employed quantitative methods to collect and analyse data on the dietary patterns and if this can be used to assess the nutritional status of individuals 24 hours preceding the survey. Health facilities were selected using random sampling method and systematic sampling method was used to select a sample of 299 pregnant women. An interview schedule was used to collect data. Logistic regression was used to establish associations between DDS and MUAC. Results In this study, 44% of the women were in the lowest dietary diversity category, which indicates inadequate nutrient intake, 31% in the medium category and 24% in the high intake. Maternal weight was associated with a 0.08 cm increase in MUAC (95% CI; 0.74 – 0.93) and this was statistically significant. Marital status and age (95% CI; 0.83 – 0.93) were significantly associated with an increase in MUAC in the univariate analysis but when adjusted for other confounders this was not significant (95% CI; 0.81 – 1.00). Consumption of organ meat was associated with a 0.21cm increase in MUAC (95% CI; 0.04 - 0.97). Conclusion The study results indicated that 44% of the women had inadequate nutrient intake, indicating that the dietary diversity score can be used to predict malnutrition in pregnant women. The mid upper was negatively correlated with the 24hour dietary diversity score implying that we might not rely on this measurement to assess the nutritional status. Key words Dietary Diversity Score, Malnutrition, Mid Upper Arm Circumference, Pregnant women, Antenatal.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e047314
Author(s):  
Iyanuoluwa Oyedeji Oyetunji ◽  
Alastair Duncan ◽  
Sharmilah Booley ◽  
Janetta Harbron

IntroductionCardiovascular diseases (CVDs) are the single greatest contributor to global mortality. The successful introduction and scale-up of antiretroviral therapy (ART) delivered a reduction in HIV mortality. Consequently, an association was found between the scale-up of ART and an increased prevalence of comorbidities among people living with HIV (PLWH) such as hypertension and dyslipidaemia. A higher quality diet can delay the onset of comorbidities related to HIV infection. Diet quality and its methods of assessment are not fully established among PLWH. This review will identify the diet quality and food insecurity indices that have been used among PLWH and how these constructs are associated with risk of developing CVD.Methods and analysisThe frameworks recommended by Arksey and O’Malley and the Joanna Briggs Institute’s manual for conducting scoping reviews will be adopted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines will be used for reporting. A search strategy was developed using keywords related to the topic. A preliminary MEDLINE (via PubMed) search was conducted on 11 November 2020 to develop a comprehensive search strategy. The final search will be conducted on PubMed, EbscoHost, Scopus, Web of Science and Cochrane Library databases. Titles and abstracts of retrieved records will be screened independently by two reviewers. Data will be extracted from records that meet the inclusion criteria using a predesigned charting tool. Discrepancies in decisions made by reviewers will be resolved by consensus or the decision of a third reviewer. Extracted data will be presented in tables or charts. A descriptive summary of the charts or tables will follow.Ethics and disseminationEthical approval is not required for a scoping review. Findings will inform other studies currently underway and will be presented at conferences and published in peer-reviewed journals.Registration numberhttps://osf.io/7k3ja.


2020 ◽  
Author(s):  
Fisaha Tesfay ◽  
Anna Ziersch ◽  
Sara Javanparast ◽  
Lillian Mwanri

Abstract Background Food insecurity is one of the major contributors to poor attainment of nutritional recovery among people living with HIV who are enrolled in nutritional programs. Nevertheless, nutritional programs in HIV care settings implemented in many countries are not designed to address food insecurity. This study in Tigray region Ethiopia examined relapse of undernutrition, and in particular how food insecurity had an impact on effectiveness of the nutritional program, specifically relapse of undernutrition after nutritional recovery Methods This study employed mixed-methods approach involving quantitative and qualitative methods. In the quantitative part, hospital records were collected of 1757 adults and 236 children living with HIV who were enrolled in the nutritional program. Logistic and cox-regression analysis were used to analyse the data. In the qualitative study, data was collected through in-depth interviews with 20 adults, 15 caregivers of children living with HIV, and 13 health providers and program managers. Thematic framework analysis was used to analyse the qualitative data. Results Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed. Lower educational status (primary and secondary), no membership of a community HIV support group, ambulatory and bedridden functional status, longer periods on ART (more than 24 months), presence of an opportunistic infection and poor baseline nutritional status were associated with relapse. Furthermore, those from rural areas, who did not attend formal education, were employed and had bedridden functional status, anaemia and worst nutritional status were likely to have more frequent episodes of relapse than their counterparts. Findings of the qualitative study also highlighted that poverty, poor livelihood, and food insecurity were the fundamental challenges to the effectiveness of nutritional programs in HIV care including relapse. Household food insecurity contributed to the selling and sharing of the nutritional supports and negatively impacted program effectiveness by contributing to relapse of undernutrition. Conclusions Unless nutritional programs take into consideration the underlying determinants of food insecurity in the design, implementation, and funding of nutritional programs in HIV care, the success of the nutritional programs like those implemented in Ethiopia will be undermined.


2019 ◽  
Author(s):  
REKIKU FIKRE ◽  
Tamirayehu Seyoum habtwelde

Abstract Abstract Objective Food security and adequate nutrition are fundamental to HIV treatment. There is emerging evidence that patients who begin ART without adequate nutrition have lower survival rates. The relationship between HIV epidemic and food security situation in Ethiopia is complex. Hence, it is likely that the epidemic will contribute to worsening widespread food insecurity. The aim of study was to assess the level of food security and associated factors among adult people living with HIV /AIDS attending ART Clinic in Hospitals of Hawassa city Administration 2018. Results: Based on food security assessment core module scale 360 (67.3%) people living with HIV/AIDS were food insecure. People living with HIV/AIDS who disclose HIV status were 3.9 (AOR=3.902, 95% CI (1.238, 12.301) times more likely to be food secured compared with their counterparts. Subjects with Low Dietary diversity were 4.69 times less likely to be food secured than those with high dietary diversity AOR=4.696, 95% CI (1.536, 14.356). Key words: Food security, disclosures, Household size, Hawassa town.


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