Food insecurity and undernutrition in treated HIV patients a (post-) conflict setting: A cross sectional study from Goma, Eastern Democratic Republic of Congo

Abstract

Objective: To assess the prevalence of food insecurity and its impact on nutritional status among HIV infected patients on antiretroviral therapy in a conflict and post conflict setting.Design: Cross-sectional study.Setting: This Goma multicenter cross-sectional study was carried out from February 1 st to March 3 rd , 2016.Subjects: Data on nutritional status among 583 HIV-infected patients on ART were measured using Body Mass Index as a proxy. Food insecurity was the primary independent variable and was measured using the Household Food Insecurity Access Scale. The prevalence of under nutrition and food insecurity was also estimated. A logistic regression model was used to identify the relationship between under nutrition and food insecurity, adjusted for other covariates. Results:The prevalence of food insecurity in the study group was 91.3% (95% CI: 89.0 -93.6%). The prevalence of undernutrition was 24.1% (95% CI: 20.6-27.6%).Nineteen percent of respondents were non-adherent (95% CI: 15.9% -22.3%). Only two percent have received a nutritional support during the previous month. Being household food insecure (AOR = 4.47, 95% CI: 1.35 -14.78) and living in a household with low socio-economic status (AOR = 2.02, 95% CI: 1.10 -3.69) were significantly associated with under nutrition. Conclusion:This study measured a high prevalence of food insecurity in Goma. The study highlight the negative impact of food insecurity on undernutrition and how the situation is exacerbated by the presence of HIV.Further studies are suggested to assess nutritional status with a high validity (sensitivity & specificity) way in HIV-infected patient on ART in this setting. Congo, remains unacceptably high. A major contributing factor is that over 800 million people remain chronically undernourished globally, and the HIV epidemic largely overlaps with populations already experiencing low diet quality and quantity. Malnutrition, and more specific under nutrition, is generally associated with increased mortality among HIV infected individuals initiating Antiretroviral Therapy (ART) [1,2].

Undernutrition and associated factors among HIV-Infected adults receiving ART at Health centers, Lega Tafo and Surrounding, Ethiopia, 2021

“…The nding of the study showed household food insecurity was signi cantly associated with under nutrition. This nding was consistent with study conducted in Humera hospital, West shewa zone ( ve times) and Goma (14). Similarly, nearly the same report from Study conducted in Bale Goba (22) and study conducted in Asella Town (44).…”

“…HIV-infected persons are at higher risk for undernutrition, and certain conditions can magnify the risk, such as anorexia, di culty swallowing or painful swallowing, malabsorption and diarrhea, altered metabolism of nutrients, increased utilization of nutrients, and greater loss of nutrients (4). Not only this but also, there are many factors associated with HIV/AIDS undernutrition among them household food insecurity, lack of nutritional counseling, educational status, and economic status are evidenced by many studies (6,10,14,15).…”

“…In addition, adherence to ART drugs is low in undernourished HIV/AIDS patients (13).HIV-infected persons are at higher risk for undernutrition, and certain conditions can magnify the risk, such as anorexia, di culty swallowing or painful swallowing, malabsorption and diarrhea, altered metabolism of nutrients, increased utilization of nutrients, and greater loss of nutrients (4). Not only this but also, there are many factors associated with HIV/AIDS undernutrition among them household food insecurity, lack of nutritional counseling, educational status, and economic status are evidenced by many studies (6,10,14,15).Many studies were conducted on HIV/AIDS patients but since the dispute undernutrition is unanswered and still there is a lack of information in the Ethiopian context further investigation will be needed. Again, there is a difference between malnutrition and undernutrition but most of the studies use malnutrition and undernutrition interchangeably as the same term.…”

Estimativa de oferta de vitamina D em Programas dirigidos à população HIV/AIDS

“…A vulnerabilidade da população que convive com o vírus HIV à Insegurança Alimentar é alta, devido ao próprio curso da patologia que se apresenta com achados clínicos como: náuseas crônicas, alteração do paladar, perda de apetite, dificuldades em mastigar e/ou deglutir, diarréias...que levam à redução da ingestão e/ou má absorção concorrendo para deficiência de micronutritentes (Akilimali et al, 2016). Em relação a isso, no estágio precoce da doença é observado o comprometimento do status nutricional de vitaminas, como complexo B em especial a vitamina B12, ácido fólico e minerais como zinco, selênio dentre outros (Pavarina, 2008;Matthew, 2004;Batista, et al, 2021).…”

“…Estudos observacionais também confirmam que indivíduos portadores do vírus HIVaids apresentam uma rotina alimentar inadequada, caracterizada pela alta ingestão de açúcar, gordura saturada e sódio, além da ingestão insuficiente de fibras, frutas, vegetais e cereais integrais (Tanaka et al,2015). A baixa quantidade e qualidade dos alimentos compromete o estado nutricional com deficiência de macro e micronutrientes precipitando, inclusive, a ocorrência de infecções oportunistas, prejudicando a adesão ao tratamento antirretroviral (TARV), agravando a imunodepressão e criando um círculo vicioso (Akilimali et al, 2016;Soares, 2015).…”