Prevalence of protein energy malnutrition in HIV-infected under five children and the effects of highly active antiretroviral therapy on their nutritional status in Nigeria

Abstract

Aim: To determine the prevalence of malnutrition among HIV- infected under-five children and effect of highly active antiretroviral therapy (HAART) on the nutritional status. Method: This cross-sectional and descriptive study was conducted among under-fives presenting at the Paediatric HIV clinic in a tertiary centre in Nigeria. HIV positive children aged less than five years, who were on HAART and whose parents/caregivers gave consent were included. Odds ratios (ORs) and their 95% confidence intervals (CIs) were determined in a multivariate logistic regression analysis and p-values of <0.05 were considered significant. Result: A total of 92 HIV positive children comprising 52 (56.5%) males and 40 (43.5%) females were recruited, giving a ratio of 1.3:1. Children who were more than 48 months of age were (46.7%), while (9.8%) were aged 24 months or less. The mean age of the children was 44.5+12.9 months, while that of the male and female children were 43.9 +13.1 months and 45.2+12.6 months, respectively, and their age difference was statistically insignificant. The prevalence of undernutrition was 40.2% with a significantly higher proportion of them being male children (P= 0.02) while 1.1% of the children was overweight. The prevalence of severe wasting, severe underweight and severe stunting were 2.1, 3.3 and 17.4% respectively. A total of 12 (13.0%) were wasted, 14 (15.2%) were underweight, and 26 (28.3%) were stunted. Children who received HAART for more than 12 months were less likely to be wasted (P=0.02). Multivariate logistic regression also showed that being a male increased the risk of being underweight (OR=2.55, 95%CL=1.06-6.16) and stunted (OR=2.67, 95%CL=1.32-5.40). Conclusion: Malnutrition remains a problem of children living with HIV even while they are on HAART. The longer duration of HAART is significantly associated with better nutritional status.