Performance of individual dietary diversity score to identify malnutrition among patients living with HIV in Ethiopia

Abstract

There is a lack of uniformity in developing and validating indicators of nutritional status among People Living with Human Immunodeficiency Virus (PLHIV). Experiences from low and middle-income countries are scant, and differences in methodological and analytical approaches affect the comparability and generalizability of findings. Therefore, this study investigated the performance of individual diversity score (IDDS) as a proxy indicator of nutritional status among PLHIV. We conducted a facility-based cross-sectional study among 423 PLHIV who were under Antiretroviral Treatment (ART) at clinics in Bahir-Dar, Ethiopia. We collected data on sociodemographic, dietary, clinical, and anthropometric measures. Dietary intake was assessed using 24-Hour dietary recall. Body Mass Index (BMI) was calculated to assess the nutritional status of study subjects. The receiver operating characteristic (ROC) curve analysis was used to assess the ability of the IDDS and Minimum Dietary Diversity for Women (MDD-W) to detect poor nutritional status. Furthermore, sensitivity, specificity, Predictive Values (PPs), and Likelihood Ratios (LRs) were calculated at different cut-off points. IDDS showed good reliability with Cronbach’s Alpha of 0.76. The Area Under the Curve (AUC) of IDDS was 78.5 (95%CI 73.9–83.4). At the IDDS cut-off of 4, the sensitivity and specificity of IDDS to indicate nutritional status were 88.0% (95%CI 81.0–93.0) and 71.0% (95%CI 66.0–76.0), respectively. The AUC of MDD-W was 74.1%, and at the cut-off of 4 the sensitivity and specificity of MDD-W to indicate undernutrition were 73.0% and 72.0%, respectively. Both IDDS and MDD-W have good accuracy as a proxy indicator for measuring the nutritional status of PLHIV. In the prevention of undernutrition among PLHIV especially in a resource-limited setting, IDDS and MDD-W can be used to assess nutritional status.

COVID-19 fear and its associated correlates among type-2 diabetes patients in Bangladesh: A hospital-based study

“…Similar results were obtained in prior studies conducted in Bangladesh and China (Rahman et al, 2020a;Sujan et al, 2021). There may be more crowded people and greater access to media and health information leading to higher risks of COVID-19-related fear among urban diabetes patients (Huang et al, 2021;World Economic Forum., 2022). Our study also showed that diabetes people who engaged in regular MVPA in recommended level had decreased probability of fear related to COVID-19, compared to those who did not exercise.…”

Nutritional status and its associated factors among commercial female sex workers in Hawassa city, south Ethiopia

“…This study showed that self-reported HIV status was strongly associated with being underweight ( P = 0.000) among CFSWs. Sex workers with positive HIV status had a 21.6-times higher odds ratio to being underweight than HIV-negative CFSWs, which agrees with recent studies ( Hussien et al., 2021 ; Nigusso & Mavhandu-Mudzusi, 2021 ). A higher prevalence of malnutrition among people living with HIV and AIDS (PLWHA) is reported in Ethiopia ( Hussien et al., 2021 ; Nigusso & Mavhandu-Mudzusi, 2021 ), which also observed in this study as a strong predictor of undernutrition among HIV-positive sex workers.…”

“…Sex workers with positive HIV status had a 21.6-times higher odds ratio to being underweight than HIV-negative CFSWs, which agrees with recent studies ( Hussien et al., 2021 ; Nigusso & Mavhandu-Mudzusi, 2021 ). A higher prevalence of malnutrition among people living with HIV and AIDS (PLWHA) is reported in Ethiopia ( Hussien et al., 2021 ; Nigusso & Mavhandu-Mudzusi, 2021 ), which also observed in this study as a strong predictor of undernutrition among HIV-positive sex workers. This finding is also supported by the qualitative part of this study, which found that ‘sexually transmitted infections/STIs’, and HIV are the most common illness among malnourished CFSWs.…”

“…Moreover, the prevalence of malnutrition among people living with HIV and AIDS (PLWHA) was 60% ( Nigusso & Mavhandu-Mudzusi, 2021 ). The prevalence of undernutrition and overweight/obesity was 29.3% and 2.4% among PLWHA in Bahir Dar city, Ethiopia ( Hussien et al., 2021 ). The study reported ( Nigusso & Mavhandu-Mudzusi, 2021 ) that female gender, urban residence, income below 53.2 US dollars (USD), poor asset possession, duration of less than one year on anti-retroviral therapy/ART, and recurrent episodes of opportunistic infections were strongly associated with malnutrition among PLWHA.…”

Prevalence of undernutrition and associated factors among street adolescents in adama town, oromia regional state, Ethiopia, 2023: A cross sectional study

“…The reliability of the overall questionnaires was checked by Cronbach’s α and showed 0.66. The validity and reliability test for tools to screen for depression and dietary diversity score was checked by other studies conducted in Ethiopia and found sensitivity(88%), specificity(78%) and Cronbach’s α = 0.78 for depression and sensitivity(88%), specificity(71%) and Cronbach’s α = 0.76 for dietary diversity score [ 37 , 38 ].…”