A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya

Dibari, Filippo; Bahwere, Paluku; Gall, Isabelle Le; Guerrero, Saúl; Mwaniki, Dennis; Seal, Andrew

doi:10.1017/s1368980010003435

Cited by 37 publications

(93 citation statements)

References 12 publications

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“…Among the identified confounders, it can be speculated that throat sores reduce the swallowing capacity of the patients. A qualitative study on the compliance of the use of P-RUTF achieved a similar conclusion [23]. In SAM patients, cases of swallowing difficulty need to be detected early by medical staff and ideally addressed with appropriate in-patient care using therapeutic milk formulas (F75 and F100) [31].…”

Section: The Acceptability Of Sms-rutfhmentioning

confidence: 82%

“…The most common commercial brand of RUTF is Plumpy'nut [17], which was designed for pediatric use and is the only one that has been clinically tested in several different studies [3,[18][19][20][21][22]. In wasted adults, a number of factors have been shown to reduce compliance with Plumpy'nut including the taste of this pediatric formulation [23]. Moreover, the micronutrient densities in Plumpy'nut might not be appropriate for the needs of wasted adults with HIV/TB.…”

Section: Introductionmentioning

confidence: 99%

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Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Dibari

Bahwere

Huerga³

et al. 2013

Nutrition

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Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods Objective: To develop a method for determining the acceptability and safety of ready-to-use therapeutic foods (RUTF) before clinical trialing. Acceptability was defined using a combination of three consumption, nine safety, and six preference criteria. These were used to compare a soy/ maize/sorghum RUTF (SMS-RUTFh), designed for the rehabilitation of human immunodeficiency virus/tuberculosis (HIV/TB) wasted adults, with a peanut-butter/milk-powder paste (P-RUTF; brand: Plumpy'nut) designed for pediatric treatment. Methods: A cross-over, randomized, controlled trial was conducted in Kenya. Ten days of repeated measures of product intake by 41 HIV/TB patients, >18 y old, body mass index (BMI) 18-24 kg$m À2 , 250 g were offered daily under direct observation as a replacement lunch meal. Consumption, comorbidity, and preferences were recorded. Results: The study arms had similar age, sex, marital status, initial BMI, and middle upper-arm circumference. No carryover effect or serious adverse events were found. SMS-RUTFh energy intake was not statistically different from the control, when adjusted for BMI on day 1, and the presence of throat sores. General preference, taste, and sweetness scores were higher for SMS-RUTFh compared to the control (P < 0.05). Most consumption, safety, and preference criteria for SMS-RUTFh were satisfied except for the average number of days of nausea (0.16 versus 0.09 d) and vomiting (0.04 versus 0.02 d), which occurred with a higher frequency (P < 0.05). Conclusion: SMS-RUTFh appears to be acceptable and can be safely clinically trialed, if close monitoring of vomiting and nausea is included. The method reported here is a useful and feasible approach for testing the acceptability of ready-to-use foods in low income countries. MSF Field Research

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Section: The Acceptability Of Sms-rutfhmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Dibari

Bahwere

Huerga³

et al. 2013

Nutrition

Self Cite

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“…Our results show that the potential nutritional supplements were perceived to be food by the majority of participants and therefore, if well accepted, they might be also shared as any other food. Sharing of supplements in foodinsecure settings has also been indicated by others (17)(18)(19) , which suggests the need to revise the approach to food assistance for PLHIV in food-insecure settings. To discourage this practice among Malawian food-insecure households, several authors have suggested considering counselling activities in health-care facilities and/or integrating HIV care in safety net programmes (7) .…”

Section: Discussionmentioning

confidence: 94%

Preferences for food and nutritional supplements among adult people living with HIV in Malawi

Rodas-Moya

Kodish²,

Manary³

et al. 2015

Public Health Nutr.

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“…These include gender, urbanization, cost of food, irregular follow up by primary care giver, poor patient-health giver relations, lack of information or not well understood information, level of education, tendency to eat out and lack of self-discipline [2,20,23]. In Kenya, non-adherence to treatment has been associated with among other things, poverty, since 46% of Kenyans live on less than a dollar per day and may not afford the recommended diet [29] taste of the food, diet monotony and sharing of food rations with other family members [11]. Studies in Kenya have shown non-adherence even when patients acknowledged that they had received dietary advice and could as well afford the recommended dietor were given food rations [3,28], implying that there could exist underlying reasons for nonadherence in such cases.…”

Section: Introductionmentioning

confidence: 99%

Key Factors on the Spotlight as Predictors of Dietary Adherence Among Patients Living with Type 2 Diabetes

Musee¹,

Okeyo²,

Odiwuor³

2016

EJPM

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Abstract:There is a rise in prevalence of Type 2 diabetes in Kenya, and an increase in related complications, which lead to disability and death. Diet modification oriented for this group of patients includes recommendations to control blood sugar, lipid levels and pressure which are vital in lowering risk and complications development in the management of Type 2 diabetes. Studies indicate that adherence to diet therapy is weak in the midst of diet recommendations and patients' education. There seems to be limited literature in developing countries as to the most critical factors in the prediction mix of adherence. This article attempts to display the competitiveness between socio-demographic and patient education related factors in the context of adherence. Across sectional analysis of a sample of 240 eligible diabetics was used and their dietary behaviour evaluated using a pre-tested dietary habit assessment survey tool with socio-demographic and patient-focus education factors. Linear regression preceded by principle axis factoring to categories adherences was executed. The results indicated that diet characterized by control of lipid levels was influenced by diet accessible within distance from home (β=0.211, t=2.053, ρ=0.041), while diet to control blood sugar and pressure was influenced by diet accessible from the workplace (β=0.193, t=2.027, ρ=0.044), occupation status (β=0.162, t=2.051, ρ=0.042), age (β=0.178, t=2.238, ρ=0.026), marital status (β=0.208, t=2.731, ρ=0.007) and diet found in the locality or surrounding environment (β=0.277, t=3.034, ρ=0.003). In conclusion, adherence enhancement seems to draw reference to education sessions focused on challenges faced by the unmarried, age specifics, occupation, setting specifics.

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A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya

Abstract: Objective: To understand factors affecting the compliance of malnourished,

Cited by 37 publications

References 12 publications

Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Preferences for food and nutritional supplements among adult people living with HIV in Malawi

Key Factors on the Spotlight as Predictors of Dietary Adherence Among Patients Living with Type 2 Diabetes

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