scholarly journals Malnutrition as predictor of survival from anti-retroviral treatment among children living with HIV/AIDS in Southwest Ethiopia: survival analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abdu Oumer ◽  
Mina Edo Kubsa ◽  
Berhanu Abebaw Mekonnen

Abstract Background Approximately 70% of HIV positive people live in Africa where food insecurity and under nutrition are endemic. However the impact of malnutrition on treatment outcome is not clear. This study assessed the effect of under nutrition on Anti-Retroviral Therapy treatment outcome among pediatric age group living with HIV/AIDS in Public Hospitals, Southwest Ethiopia. Method A retrospective cohort study was conducted on records of 242 pediatric children in Guraghe zone Public Hospitals. Also median, mean, standard deviation and interquartile range were calculated. Life table, hazard function and survival function were plotted. Log rank test with 95% confidence interval of mean survival time was done. The nutritional status data were managed via WHO Anthros plus and BMI for age Z score was calculated. To assess effects of nutritional status on mortality, both Bivariate and multivariate cox proportional hazard regression was conducted with crude (CHR) and adjusted hazard ratio (AHR) (95% confidence interval and p value). P value of less than 0.05 was used as cut off point to declare statistical significance. Results A total of 243 records of pediatric ART records with mean age of 11.6 (± 3.8 years) were reviewed. About 178 (73.3%) have got therapeutic feeding on the course of ART treatment. Whereas significant number of children, 163 (67.1%) reported to had eating problems. A total of 13 (5.3%) children were dead with incidence density of 11.2 deaths per 1000 person years. There is significantly higher survival time among well nourished (11.1 years with 95% CI: 10.8 to 11.4) as compared to underweight children (9.76 with 95% CI: 9.19 to 10.32 years). Underweight children had almost three fold increase incidence of death (AHR = 3.01; 95% CI: 0.80–11.4). Similarly children with anemia had higher incidence of death than children without anemia (AHR = 1.55; 95% CI: 0.49–4.84). Conclusions Low nutritional status at the start of ART evidenced by underweight and anemia were found to be predictors of survival among HIV positive children. There should be improved, sustained and focused nutritional screening, care and treatment for children on ART follow up.

2009 ◽  
Vol 13 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Elizabeth Nafula Kuria

AbstractObjectiveTo establish the food consumption, dietary habits and nutritional status of people living with HIV/AIDS (PLWHA) and adults whose HIV status is not established.DesignCross-sectional descriptive survey.SettingThika and Bungoma Districts, Kenya.SubjectsA random sample of 439 adults; 174 adults living with HIV/AIDS and 265 adults whose HIV/AIDS status was not established in Thika and Bungoma Districts.ResultsMajority of PLWHA consume foods that are low in nutrients to build up the immune system and help maintain adequate weight, and there is little variety in the foods they consume. More adults who are HIV-positive are undernourished than those whose status is not established. Of the HIV-positive adults, those with a BMI of ≤18·5 kg/m2 were 23·6 % (Thika 20·0 % and Bungoma 25·7 %) while of the adults whose status is not established those with BMI ≤ 18·5 kg/m2 were 13·9 % (Thika 9·3 % and Bungoma 16·7 %).ConclusionsAdults who are HIV-positive are more likely to be undernourished than those whose status is not established, as there is a significant difference (P = 0·000) between the nutritional status (BMI) of PLWHA and those whose HIV/AIDS status is not established. PLWHA consume foods that are low in nutrients to promote their nutritional well-being and health.


2021 ◽  
Author(s):  
Nigusie Shifera ◽  
Abebaw Molla ◽  
Gebremeskel Mesafint ◽  
Simegnew Gichew ◽  
Rahel Matiyas ◽  
...  

Abstract Background: Almost 1.9 billion adults worldwide are overweight or obese, while 462 million are underweight. These are primarily found in countries with low and middle-incomes, like Ethiopia. Under nutrition is the frequent health problem among peoples living with HIV/AIDS, however no large-scale research, including a number of health facilities has been conducted in Ethiopia. So this study aimed to assess the nutritional status and under nutrition related factors among HIV/AIDS patients attending ART follow-up in public hospitals of Bench Sheko zones, south west, Ethiopia.Methods: In November/2020, a cross-sectional facility study design was carried out in all public hospitals in the Bench Sheko zone. To pick the study participants, a systematic sampling technique was used. Data were collected via face-to-face interviews and entered into Epi-data 3.1, then exported to SPSS version 24 for statistical analysis. In order to identify the candidate and independent determinants of under-nutrition, bivariate and multivariable logistic regression analyses were carried out respectively. Independent determinants of under-nutrition were measured using adjusted odds ratio with their corresponding 95% confidence level at P-value of < 0.05 cut of point.Results: A total of four hundred two adult HIV-positive patients who were attending in ART clinics were participated with 98% response rate. The proportion of under nutrition (BMI<18.5 kg/m2), normal nutrition (BMI 18.5–24.9 kg/m2) and overweight or obese (BMI ≥25 kg/m2) patients were 29.2% [95% CI: (24.6-33.5)], 61.2% [95% CI: (56.5-66.3)], and 9.6% [95% CI: (6.6-12.9)] respectively. Out of under nutrition patients, severe malnutrition (BMI<16 kg/m2) accounted of 5.6%. Factors food insecurity [AOR: 3.26, 95% CI: (1.79-5.92)], poor ART adherence [AOR: 4.22, 95% CI: (1.47-12.14)], CD4 cell count ≤ 200 [AOR: 5.73, 95% CI: (2.45-13.13)], and substance user [AOR: 4.11, 95% CI: (2.31-7.30)] was independent factors of under nutrition.Conclusion: This study found that the prevalence of malnutrition was high compared to other settings. The government should also pay due attention to improving the treatment of HIV/AIDS by offering nutritional support services in hospitals. Moreover policymaker and heath care professionals consider the effects of these factors for nutrition while providing ART service.


2016 ◽  
Vol 28 (1) ◽  
pp. 53-68
Author(s):  
Nkosiyazi Dube ◽  
Linda Harms Smith

There is a dilemma regarding HIV/AIDS disclosure to children born and living with HIV/AIDS in residential settings. Since the advent and accessibility of Anti-Retroviral Therapy, most children born HIV positive live longer and have healthier lives. Some of these children find themselves in Need of Care due to abandonment, orphanhood and neglect or abuse, and are placed in alternative care such as a Child and Youth Care Centre (CYCC). Social Service Workers are then faced with this dilemma around disclosure of their HIV status, due to the complexities around the consequences of such a disclosure, and the absence of clear policies in this regard. The study explored the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living in a CYCC in Ekurhuleni, South Africa. The findings indicate that HIV status disclosure is a complex but essential process as it reinforces children’s ability to adhere to medication and dispels anxiety and suspicion within themselves around their status. Recommendations relate to community education and awareness programmes, policy and practice changes and makes suggestions for future research.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022221 ◽  
Author(s):  
Menkeoma Laura Okoli ◽  
Samuel Alao ◽  
Somtochukwu Ojukwu ◽  
Nnadozie C Emechebe ◽  
Asuelimen Ikhuoria ◽  
...  

BackgroundDespite the availability and knowledge of various contraceptive methods, consistent utilisation in women living with HIV/AIDS (WLWHA) within the reproductive age group remains below the Sustainable Development Goals (SDGs) and Family Planning 2020 goals. This study examines the association between sociodemographic factors and contraceptive use including the effect of clustering tendencies of these factors on contraceptive usage among WLWHA in Kenya.MethodsWeighted multivariate logistic regression models were conducted to determine the association of sociodemographic factors on contraception use among WLWHA using the 2008–2009 Kenya Demographic Health Survey. Spatial autocorrelation techniques were used to explore clustering tendencies of these factors on contraception utilisation. Our study population included 304 HIV positive women, aged 15–49 years.ResultsAmong 304 HIV-positive women in our study population, 92 (30.3%) reported using one method of contraception. Contraceptive use was significantly associated with wealth and education after adjustment for other sociodemographic variables. Women classified as having low and middle wealth index were less likely to use contraceptives (OR=0.17, 95% CI 0.07 to 0.43; OR=0.33, 95% CI 0.11 to 0.98, respectively) compared with women classified as having high wealth index. Similarly, women with primary education only were less likely to use contraceptives compared with women with secondary or higher education (OR=0.42, 95% CI 0.18 to 0.98). Spatial autocorrelation revealed significant positive clusters with weak clustering tendencies of non-contraceptive use among different levels of wealth index and education within different regions of Kenya.ConclusionThese findings underscores the need for intervention programmes to further target socially disadvantaged WLWHA, which is necessary for achieving the SDGs.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kefyalew Dagne Gizachew ◽  
Yigrem Ali Chekol ◽  
Elyas Admasu Basha ◽  
Shiferaw Abeway Mamuye ◽  
Abate Dargie Wubetu

Abstract Background Suicide is the act of intentionally causing one's own death. HIV/AIDS continues to be associated with an under-recognized risk for suicidal behavior. Suicidal behavior among people living with HIV/AIDS is not only a predictor of future attempted suicide and completed suicide, but it is also associated with poor quality of life and poor adherence with antiretroviral therapy. Objective The aim of this study was to assess the prevalence of suicidal ideation and attempt and associated factors among people living with HIV/AIDS in selected public hospitals of Amhara region, central Ethiopia. Methods Institutional based cross-sectional study design was employed. The study was conducted in four public hospitals in North Shewa Zone from May to December 2017. Study population comprised all HIV-infected individuals from Antiretroviral Therapy (ART) clinic. A total of 348 study subjects were recruited using systematic random sampling and 326 completed the interview. Suicidality module from Composite International Diagnostic Interview (CIDI) was modified to assess suicidal behavior. Crude and adjusted OR was analyzed using logistic regression and the level of significance of association was determined at P value < 0.05. Result A total of 326 (93.7%) study subjects were interviewed. The magnitude of suicidal ideation and attempt was found to be 16% and 7.1%, respectively. Low monthly income, living alone, suicidal thought before knowing seropositive status, family history of suicide, experiencing mild and moderate-to-severe depression and anxiety symptoms, being gossiped sometimes in the last 12 months of the study period due to HIV status and ever use of khat (a psychoactive substance) was statistically significant associated factor with suicidal ideation. And low monthly income, experiencing mild and moderate-to-severe depression and anxiety symptoms, being gossiped sometimes and often in the previous 12 months of the study period due to HIV status and using alcohol currently were significantly associated factors with suicidal attempt. Conclusion Suicidal ideation and attempt among people living with HIV/AIDS (PLWHA) in this study were higher than prevalence in the general population. This shows suicidal ideation and attempt is a mental health concern of PLWHA and it needs great attention in Ethiopia.


Sign in / Sign up

Export Citation Format

Share Document