Prevalence, feeding practices, and factors associated with undernutrition among HIV-exposed uninfected children aged 6 to 18 months in Bushenyi district, western Uganda: A cross-sectional study

Abstract

Background HIV-exposed children are vulnerable to undernutrition. Understanding the prevalence and factors with undernutrition remains essential for developing effective strategies to reduce the impact of malnutrition among this vulnerable population. Methods This was a cross sectional, descriptive and analytical study to determine the prevalence, feeding practices, and factors associated with undernutrition among HIV-exposed uninfected children aged 6 to 18 months in Bushenyi District. The study involved 245 mother-child pairs attending four highly active antiretroviral treatment (HAART) clinics. Data was collected from April to June 2021. Questionnaire interviews were used to obtain factors associated with undernutrition. A digital weighing scale, stadiometer and mid-upper-arm circumference (MUAC) tape were used for anthropometry. Undernutrition was defined by either a length-for-age or a weight-for-length or a weight-for-age below − 2 SD based on the 2006 World Health Organization growth standards. Data were entered and analysed using IBM SPSS 27.0 statistics for windows. The prevalence of undernutrition and indicators for feeding practices were determined as proportion, whereas binary logistic regression was used to determine factors associated with undernutrition. A p-value < 0.05 was considered for statistical significance at multivariable level. Results Of the 245 participants, 48(19.6%) had undernutrition. The prevalence of stunting, wasting and underweight was 11%, 5.3% and 6.5% respectively. Most study participants 176(71.8%) were initiated on breastfeeding during their first hour of life, and 185(75.5%) were exclusively breastfed for 6 months. However, 93(38%) of them did not receive an acceptable meal frequency and 188 (76.7%) did not have an acceptable dietary diversity score during the last 24 hours. Only 15(6.1%) continued breastfeeding after 1 year of age. The majority of mothers 162(66.1%) were advised on feeding practices. Low birthweight [p = 0,03; aOR 2.94(1.23–7.03)], history of illness in the past two weeks [p = 0,02; aOR 2.35(1.13–4.91)], maternal viral load of ≥ 1000 copies/µL [p = 0,03; aOR 3.12(1.10–8.89)], maternal undernutrition [p = 0,003; aOR 4.05(1.61–10.20)], and mixed feeding [p = 0,04; aOR 1.35(0.06–2.73)] were factors significantly associated with undernutrition. Conclusion The prevalence of undernutrition among HIV-exposed uninfected children was relatively high in this study. It demonstrates the need for routine nutritional assessment of HIV-exposed uninfected children.

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