Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia

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Abstract

Background

Nutritional care is considered a crucial component of comprehensive care for people living with HIV/AIDS (PLWHA), particularly in resource-limited settings where malnutrition and food insecurity are endemic problems, and low quality monotonous diets are the norm. The findings of this study provide baseline information on dietary diversity and related factors for health care providers so that they will be able to improve nutritional care and support activity. Therefore, the aim of this study was to assess dietary diversity and associated factors among HIV positive adults (18–65 years old) attending antiretroviral therapy (ART) clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia.

Patients and methods

An institution-based cross-sectional study was conducted from November 2015 to February 2016 at the ART clinics of Hiwot Fana and Dilchora Hospitals. Using a systematic random sampling technique, a total of 303 patients were selected from all adults attending the ART clinics. The data were collected with a 95% CI used to show association between dietary diversity and independent factors.

Results

A total of 303 adult HIV positive individuals on ART participated in the study and 62.4% were females. The largest numbers of participants (49.5%) were 30–40 years of age. Eighty-seven (28.7%) participants had low dietary diversity (≤4 food groups). Duration of anti-retroviral treatment was the factor significantly associated with dietary diversity: respondents with a duration of antiretroviral treatment of more than 2 years were almost two times more likely to have high dietary diversity compared with those with less than a year of antiretroviral treatment (adjusted odds ratio =0.490; 95% CI: 0.091, 0.978).

Conclusion

Low dietary diversity was found to be a nutritional problem among HIV positive adults. Duration of antiretroviral treatment was the predictor of low dietary diversity. Therefore, appropriate dietary management of side effects of ART is important.

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Most cited references 19

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Operationalizing dietary diversity: a review of measurement issues and research priorities.

Marie T. Ruel (2003)

Dietary diversity (DD) is universally recognized as a key component of healthy diets. There is still, however, a lack of consensus on how to measure and operationalize DD. This article reviews published literature on DD, with a focus on the conceptual and operational issues related to its measurement in developing countries. Findings from studies of the association between DD and individual nutrient adequacy, child growth and/or household socioeconomic factors are summarized. DD is usually measured using a simple count of foods or food groups over a given reference period, but a number of different groupings, classification systems and reference periods have been used. This limits comparability and generalizability of findings. The few studies that have validated DD against nutrient adequacy in developing countries confirm the well-documented positive association observed in developed countries. A consistent positive association between dietary diversity and child growth is also found in a number of countries. Evidence from a multicountry analysis suggests that household-level DD diversity is strongly associated with household per capita income and energy availability, suggesting that DD could be a useful indicator of food security. The nutritional contribution of animal foods to nutrient adequacy is indisputable, but the independent role of animal foods relative to overall dietary quality for child growth and nutrition remains poorly understood. DD is clearly a promising measurement tool, but additional research is required to improve and harmonize measurement approaches and indicators. Validation studies are also needed to test the usefulness of DD indicators for various purposes and in different contexts.

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Synergism of nutrition, infection, and immunity: an overview

N S Scrimshaw, J SanGiovanni (1997)

Infections, no matter how mild, have adverse effects on nutritional status. The significance of these effects depends on the previous nutritional status of the individual, the nature and duration of the infection, and the diet during the recovery period. Conversely, almost any nutrient deficiency, if sufficiently severe, will impair resistance to infection. Iron deficiency and protein-energy malnutrition, both highly prevalent, have the greatest public health importance in this regard. Remarkable advances in immunology of recent decades have increased insights into the mechanisms responsible for the effects of infection. These include impaired antibody formation; loss of delayed cutaneous hypersensitivity; reduced immunoglobulin concentrations; decreased thymic and splenic lymphocytes; reduced complement formation, secretory immunoglobulin A, and interferon; and lower T cells and T cells subsets (helper, suppressor-cytotoxic, and natural killer cells) and interleukin 2 receptors. The effects observed with single or multiple nutrient deficiencies are due to some combination of these responses. In general, cell-mediated and nonspecific immunity are more sensitive than humoral immunity.

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Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort.

C Wanke, M Zampini, A Mangili … (2006)

Despite major advances in the treatment and survival of patients infected with human immunodeficiency virus (HIV), weight loss and wasting remain common problems. In the HIV-infected population, weight loss is associated with lower CD4+ cell counts and is an independent predictor of mortality. The etiology of weight loss and wasting is complex and multifactorial. We discuss, on the basis of a large longitudinal cohort that examined nutritional status in HIV infection, data on weight loss and wasting from the present clinical era. The definition, prevalence, and significance of HIV-associated weight loss and wasting are summarized. The etiology of weight loss is discussed for 2 main categories: inadequate nutrient intake and altered metabolism. Finally, studies of interventions to treat HIV-associated weight loss and wasting are discussed. This information is intended to raise awareness among health care providers of HIV-infected patients that weight loss and wasting remain important acquired immunodeficiency syndrome-defining conditions, despite the advent of HAART.

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Author and article information

Journal

Journal ID (nlm-ta): HIV AIDS (Auckl)

Journal ID (iso-abbrev): HIV AIDS (Auckl)

Journal ID (publisher-id): HIV/AIDS – Research and Palliative Care

Title: HIV/AIDS (Auckland, N.Z.)

Publisher: Dove Medical Press

ISSN (Electronic): 1179-1373

Publication date Collection: 2018

Publication date (Electronic): 21 May 2018

Volume: 10

Pages: 63-72

Affiliations

[1 ]Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia

[2 ]Department of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia

Author notes

Correspondence: Tesfaye Digaffe, Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia, Tel +251 91 211 1224, Email tdigaffe@ 123456yahoo.com

Article

Publisher ID: hiv-10-063

DOI: 10.2147/HIV.S138638

PMC ID: 5968811

PubMed ID: 29861644

SO-VID: 5a24387b-ddcd-4ca7-ace3-a2bfa240b714

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia

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Abstract

Background

Patients and methods

Results

Conclusion

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Annual Reviews HIV/AIDS: Public Health and Society

Most cited references 19

Operationalizing dietary diversity: a review of measurement issues and research priorities.

Synergism of nutrition, infection, and immunity: an overview

Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort.

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