High magnitude of under nutrition among HIV infected adults who have not started ART in Tanzania-a call to include nutrition care and treatment in the test and treat modelReportar como inadecuado




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BMC Nutrition

, 3:58

Nutritional interventions, policies and public health

Abstract

BackgroundUndernutrition among people living with HIV PLWHIV can be ameliorated if nutrition specific and sensitive interventions are integrated into their HIV care and treatment centers CTC. Integrated care is lacking despite expansion of antiretroviral therapy ART coverage, representing a substantial missed opportunity. This research aims to examine nutritional status and associated risk factors among HIV-positive adults prior to ART initiation in Tanzania in order to characterize existing gaps and inform early integration of nutrition care into CTC.

MethodsWe analyzed data from 3993 pre-ART adults living with HIV enrolled in CTCs within the Trial of Vitamin TOV3 and progression of HIV-AIDS study in Dar es salaam, Tanzania. The primary outcome for this analysis was undernutrition, measured as body mass index BMI below 18.5 kg-m. We conducted descriptive analyses of baseline characteristics and utilized multiple logistic regression to determine independent factors associated with pre-ART undernutrition.

ResultsUndernutrition was prevalent in about 27.7% of pre-ART adults, with a significantly higher magnitude among males compared to females 30% vs. 26.6%, p < 0.025. Severe undernutrition BMI < 16.0 kg-m was prevalent in one in four persons, with a trend toward higher magnitudes among females 26.2% vs. 21.1% p = 0.123. Undernutrition was also more prevalent among younger adults p < 0.001, those with lower wealth quintiles p = 0.003, and those with advanced HIV clinical stage p < 0.001. Pre-ART adults presented with poor feeding practices, hallmarked by low dietary diversity scores and infrequent consumption of proteins, vegetables, and fruits. After adjusting for confounders and important co-variates, pre-ART undernutrition was associated with younger age, low wealth indices, advanced clinical stage, and low dietary diversity.

ConclusionsOne in every four pre-ART PLWHIV presented with undernutrition in Dar es salaam, Tanzania. Risk factors for undernourishment included younger age, lower household income, advanced HIV clinical stage, and lower dietary diversity score. Knowledge of the prevalence and prevailing risk factors for undernutrition among pre-ART PLWHIV should guide targeted, early integration of nutrition interventions into routine HIV care and treatment in high-prevalence, low-income settings such as Tanzania.

KeywordsUndernutrition Antiretroviral therapy Nutrition care And integrated care AbbreviationsABCAfya Bora Consortium

AIDSAcquired immunodeficiency syndrome

ARTAntiretroviral therapy

BMIBody Mass Index

CTCCare and treatment center

ELISAEnzyme-linked immunosorbent assay

HAARTHighly active antiretroviral therapy

HIVHuman Immunodeficiency Virus

MUHASMuhimbili University of Health and Allied Sciences

NIHNational Institute of Health

NIMRNational Institute of Medical Research

PLWHIVPeople living with Human Immuno-deficiency Virus

Sd.Standard deviation

TOV3Trial of Vitamin 3

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Autor: Bruno F. Sunguya - Nzovu K. Ulenga - Hellen Siril - Sarah Puryear - Eric Aris - Expeditho Mtisi - Edith Tarimo - David P

Fuente: https://link.springer.com/







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