Food Insecurity, Nutritional Status, and Factors Associated with Malnutrition among People Living with HIV/AIDS Attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia

Abstract

Background In resource limited settings, HIV/AIDS patients lack access to sufficient nutritious foods, which poses challenges to the success of antiretroviral therapy. HIV/AIDS and malnutrition are still major public health problems in Ethiopia. Though measuring nutritional status is an essential part of ART program, little evidence exists on food insecurity and nutritional status of HIV/AIDS patients in Ethiopia. Hence, the study aimed to determine food insecurity and nutritional status and contextual determinants of malnutrition among HIV/AIDS patients in West Shewa Zone, Ethiopia. Methods Institution-based cross-sectional study was conducted among HIV/ADIS patients who have been attending antiretroviral therapy at public health facilities in West Shewa Zone from April to May 2016, Ethiopia. The sample size was 512 and study participants were selected from each facilities using systematic random sampling method. Data were collected using pretested questionnaire by trained data collectors. Data were entered to Epi-Info 3.5.1 for Windows and analyzed using SPSS version 22. Logistic regression analyses were conducted to determine independent factors associated with malnutrition. Results Prevalence of malnutrition was 23.6% (95% CI: 19.7%–27.4%) and prevalence of household food insecurity was 35.2% (95% CI: 31.1%–39.0%). Factors significantly associated with malnutrition among HIV/AIDS patients were unemployment (AOR = 3.4; 95% CI: 1.8–5.3), WHO clinical stages III/IV (AOR = 3.3; 95% CI: 1.8–6.5), CD4 count less than 350 cells/μl (AOR = 2.0; 95% CI: 1.8–4.2), tuberculosis (AOR = 2.3; 95% CI: 1.3–4.9), duration on antiretroviral therapy (AOR = 1.8; 95% CI: 1.2–2.9), and household food insecurity (AOR = 5.3; 95% CI: 2.5–8.3). Conclusions The findings revealed high prevalence of malnutrition and household food insecurity among HIV/AIDS patients attended ART. The negative interactive effects of undernutrition, inadequate food consumption, and HIV infection demand effective cross-sectorial integrated programs and effective management of opportunistic infections like tuberculosis.

Prevalence of malnutrition and associated factors among adult patients on antiretroviral therapy follow-up care in Jimma Medical Center, Southwest Ethiopia

“…Undernutrition was nearly four times and two times more likely among bedridden and ambulatory patients compared to patients who have a working functional status, respectively. Our findings were supported by other studies done in other settings else [6,7,10,11,13,20,21,[24][25][26].…”

“…This is comparable with studies done in different parts of the world [6,7] and Ethiopia [10,21], where undernutrition is more prevalent among the younger adults and overweight is more prevalent among older patients. Additionally, studies also supports the higher proportion of undernutrition among unemployed patients and patients in the lower educational status [11,24,25]. While studies done in Northern and Southern Ethiopia indicated contradicting finding in which undernutrition was higher in older age [11,26].…”

HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis

“…In Ethiopia, the threat of HIV treatment failure is becoming a continuing discussion. This might be due to poor HIV care services, delayed to recognize treatment failure, [34], late initiation of HAART [33], high burden of opportunistic infections [35], lack of appropriate nutritional support [36], ART-associated adverse reaction, [37] and frequent psychological problem [38,39]. Besides, the absence of frequent therapeutic drug monitors and/ or resistance testing while the patient is still on the suspect or failing regimen.…”

Still poor HAART adherence has great impact on HIV/AIDS treatment failure in Ethiopia

“…In Ethiopia threat of HIV treatment failure is becoming appointed discussion. This might be due to implementation of poor HIV care, delaying on recognition of symptom of treatment failure, (35), late initiation of HAART (36), high burden of opportunistic infections (37), lack of well nutritional support (38), ART associated adverse reaction, (39) and frequent psychological problem (40,41) are recorded in Ethiopia. Besides, absence of frequent therapeutic drug monitors and/ or resistance testing while the patient is still on the suspect or failing regimen.…”