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Published in: BMC Nutrition 1/2017

Open Access 01-12-2017 | Research article

Chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital northwest Ethiopia

Authors: Melkitu Fentie, Molla Mesele Wassie, Adino Tesfahun, Kassahun Alemu, Malede Mequanent, Tadesse Awoke Ayele

Published in: BMC Nutrition | Issue 1/2017

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Abstract

Background

Human Immunodeficiency Virus (HIV) infection and chronic energy deficiency are bidirectional and multifaceted. HIV can cause or worsen chronic energy deficiency by increasing energy requirements, reducing food intake and nutrient absorption. Chronic energy deficiency weakens the immune system, increase the susceptibility to infections and worsening the disease impact. Studies on the magnitude and factors associated with chronic energy deficiency among adults living with HIV are limited. The aim of this study was to assess the prevalence of chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital, northwest Ethiopia.

Methods

An institution based cross-sectional study was conducted and systematic random sampling was used to select study subjects. A total of 317 study subjects were enrolled in the study. Structured and pretested questionnaire was used to collect socio-demographic, economic and diet related variables. Weight and height measurement were taken and medical charts were reviewed. Laboratory analysis for CD4 count and anemia was done. Bi-variable and multi-variable logistic regression analyses were used to assess the effect of different factors on chronic energy deficiency.

Results

A total of 317 patients provide complete information with response rate of 99.4%. The overall prevalence of chronic energy deficiency was 18.3% (95%CI: 14.5%–22.7%). The prevalence of mild, moderate and severe chronic energy deficiency was 11.4, 3.5 and 3.5% respectively. No formal education (AOR = 2.05,95%CI:1.01,4.21), being in the WHO clinical stage three and four (AOR = 3.84,95%CI:1.39,10.61) and history of diarrhea in the last two weeks prior to the survey (AOR = 4.43,95%CI:1.83,10.72) were significantly associated with chronic energy deficiency.

Conclusion

The prevalence of chronic energy deficiency among adults living with HIV was medium public health problem. Educational status, WHO clinical stage, and history of diarrhea in the last two weeks prior to the survey were risks for chronic energy deficiency. Integration of nutritional management with HAART, early diagnosis and treatment of diarrheal disease would be supreme important.
Literature
1.
go back to reference WHO. Global health observatory data, HIV/AIDS. 2016. WHO. Global health observatory data, HIV/AIDS. 2016.
2.
go back to reference Stuart G, Lawrence H, Jackson R. HIV/AIDS, Food and nutrition security: impacts and actions. 2001. Stuart G, Lawrence H, Jackson R. HIV/AIDS, Food and nutrition security: impacts and actions. 2001.
3.
go back to reference WHO. Regional office for Africa, Ethiopia/HIV/AIDS. 2014. WHO. Regional office for Africa, Ethiopia/HIV/AIDS. 2014.
4.
go back to reference FANTA. HIV/AIDS:A guide for nutrition, care and support. 2001. FANTA. HIV/AIDS:A guide for nutrition, care and support. 2001.
5.
go back to reference Piwoz E, Preble E. HIV/AIDS and nutrition: a review of the literature and recommendations for nutritional care and support in sub-Saharan Africa. 2000. Piwoz E, Preble E. HIV/AIDS and nutrition: a review of the literature and recommendations for nutritional care and support in sub-Saharan Africa. 2000.
6.
go back to reference Zachariah R, Fitzgerald M, Massaquoi M, Pasulani O, Arnould L, Makombe S. Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi. AIDS. 2006;20(18):2355–60. Zachariah R, Fitzgerald M, Massaquoi M, Pasulani O, Arnould L, Makombe S. Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi. AIDS. 2006;20(18):2355–60.
7.
go back to reference Sztam K, Fawzi W, Duggan C. Macronutrient supplementation and food prices in HIV treatment. J Nutr. 2010;140(1):96–9. Sztam K, Fawzi W, Duggan C. Macronutrient supplementation and food prices in HIV treatment. J Nutr. 2010;140(1):96–9.
8.
go back to reference Anabwani G, Navario P. Nutrition and HIV/AIDS in sub-Saharan Africa: an overview of nutrition. Nutrition. 2005;21(1):96–9. Anabwani G, Navario P. Nutrition and HIV/AIDS in sub-Saharan Africa: an overview of nutrition. Nutrition. 2005;21(1):96–9.
9.
go back to reference Alison T. Guide to Screening for food and nutrition services among adolescents and adults living with HIV. Food and Nutrition technical Assistance project (FANTA). 2010. http://www.fantaproject.org. Accessed June 2016. Alison T. Guide to Screening for food and nutrition services among adolescents and adults living with HIV. Food and Nutrition technical Assistance project (FANTA). 2010. http://​www.​fantaproject.​org. Accessed June 2016.
10.
go back to reference Mangili A, Murman D, Zampini A, Wanke C. Nutritionand HIV infection: review of weight loss and wasting in the era of HAART. Clin Infect Dis. 2006;42(6):836–42.CrossRefPubMed Mangili A, Murman D, Zampini A, Wanke C. Nutritionand HIV infection: review of weight loss and wasting in the era of HAART. Clin Infect Dis. 2006;42(6):836–42.CrossRefPubMed
11.
go back to reference WHO, UNAIDS, UNICEF. GLOBAL HIV/AIDS Response Epidemic Update and Health Sector Progress towards Universal Access. Progress Report. 2011. WHO, UNAIDS, UNICEF. GLOBAL HIV/AIDS Response Epidemic Update and Health Sector Progress towards Universal Access. Progress Report. 2011.
12.
go back to reference John R, Douglas C. Nutritional aspects of HIV-associated wasting in sub-Saharan Africa. Am J Clin Nutr. 2010;94(4):1138S–42S. John R, Douglas C. Nutritional aspects of HIV-associated wasting in sub-Saharan Africa. Am J Clin Nutr. 2010;94(4):1138S–42S.
13.
go back to reference Olalekan AU. Prevalence and pattern of HIV-related malnutrition among women in sub-Saharan Africa: a meta-analysis of demographic health surveys. BMC Public Health. 2008;8:226. Olalekan AU. Prevalence and pattern of HIV-related malnutrition among women in sub-Saharan Africa: a meta-analysis of demographic health surveys. BMC Public Health. 2008;8:226.
14.
go back to reference Andrade C, Jesus R, Andrade T, Oliveira N, Nabity S, Ribeiro G. Prevalence and characteristics associated with malnutrition at hospitalization among patients with acquired immunodeficiency syndrome in Brazil. 2012. Andrade C, Jesus R, Andrade T, Oliveira N, Nabity S, Ribeiro G. Prevalence and characteristics associated with malnutrition at hospitalization among patients with acquired immunodeficiency syndrome in Brazil. 2012.
15.
go back to reference Bhimavarapu R, Chitra KP, Ramasway M. Nutritional Status and Serum Zinc Levels in HIV infected individuals compared to control subjects Undergoing Anti Retro Viral Therapy(ART). J Pharm Sci Res. 2010;2(11):745–51. Bhimavarapu R, Chitra KP, Ramasway M. Nutritional Status and Serum Zinc Levels in HIV infected individuals compared to control subjects Undergoing Anti Retro Viral Therapy(ART). J Pharm Sci Res. 2010;2(11):745–51.
16.
go back to reference Folasire O, Folasire A, Sanusi R. Measures of nutritional status and quality of life in adult people living with HIV/AIDS at a Tertiary Hospital in Nigeria. Food Nutr Sci. 2015;6(4):412.CrossRef Folasire O, Folasire A, Sanusi R. Measures of nutritional status and quality of life in adult people living with HIV/AIDS at a Tertiary Hospital in Nigeria. Food Nutr Sci. 2015;6(4):412.CrossRef
17.
go back to reference Ritte S, Kessy A. Social factors and lifestyle attributes associated with nutritional status of people living with HIV/AIDS attending care and treatment clinics in Ilala district, Dar es Salaam. East African journal of public health. 2014;9(1):33–8. Ritte S, Kessy A. Social factors and lifestyle attributes associated with nutritional status of people living with HIV/AIDS attending care and treatment clinics in Ilala district, Dar es Salaam. East African journal of public health. 2014;9(1):33–8.
18.
go back to reference Nnyepi M. The risk of developing malnutrition in people living with HIV/AIDS: Observations from six support groups in Botswana. South Afr J Clin Nutr. 2009;22(2). Nnyepi M. The risk of developing malnutrition in people living with HIV/AIDS: Observations from six support groups in Botswana. South Afr J Clin Nutr. 2009;22(2).
19.
go back to reference Fufa H, Umeta M, Taffesse S, Mokhtar N, Aguenaou H. Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa. Ethiopia. 2009;30(3):227–32. Pubmed. Fufa H, Umeta M, Taffesse S, Mokhtar N, Aguenaou H. Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa. Ethiopia. 2009;30(3):227–32. Pubmed.
20.
go back to reference Gedle D, Gelaw B, Muluye D, Mesele M. Prevalence of malnutrition and Its associated factors among adult people living with HIV/AIDS receiving anti-retroviral therapy at Butajira Hospital, Southern Ethiopia. BMC Nutrition. 2015;1(1):5.CrossRef Gedle D, Gelaw B, Muluye D, Mesele M. Prevalence of malnutrition and Its associated factors among adult people living with HIV/AIDS receiving anti-retroviral therapy at Butajira Hospital, Southern Ethiopia. BMC Nutrition. 2015;1(1):5.CrossRef
21.
go back to reference Anbesaw M, Tadesse A, Mekonen A, Amare T. Undernutrition and associated factorsamong adults living with human immune deficiency virus in dembia district, northwest Ethiopia. Archives of Public Health. 74(1):33. Anbesaw M, Tadesse A, Mekonen A, Amare T. Undernutrition and associated factorsamong adults living with human immune deficiency virus in dembia district, northwest Ethiopia. Archives of Public Health. 74(1):33.
22.
go back to reference MOH, FDRE. National Guidelines for HIV/AIDS and Nutrition. 2008. MOH, FDRE. National Guidelines for HIV/AIDS and Nutrition. 2008.
23.
go back to reference Getu D, Fassil T. Biostatistics lecture note for health science students. 2005. Getu D, Fassil T. Biostatistics lecture note for health science students. 2005.
24.
go back to reference CSA. Ethiopian demographic and health survey. 2011. CSA. Ethiopian demographic and health survey. 2011.
25.
go back to reference Rutstein S, Johnson K. The DHS wealth index. DHS comparative reports. 2004. Rutstein S, Johnson K. The DHS wealth index. DHS comparative reports. 2004.
26.
go back to reference Ginna K, Terri B, Marie C. Guidelines formeasuring household and individual dietary diversity. 2013. Ginna K, Terri B, Marie C. Guidelines formeasuring household and individual dietary diversity. 2013.
28.
go back to reference BIOBANK U. Height measurement manual. 2011. BIOBANK U. Height measurement manual. 2011.
29.
go back to reference WHO. Global Database on Body Mass Index. World Health Organization. 2012. WHO. Global Database on Body Mass Index. World Health Organization. 2012.
30.
go back to reference WHO, CDC. World wide prevalence of Anemia. 1993-2005. WHO, CDC. World wide prevalence of Anemia. 1993-2005.
31.
go back to reference Daniel M, Mazengia F, Birhanu D. Nutritional status and associated factors among adult HIV/AIDS clients in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Sci J Public Health. 2013;1(1):24–31.CrossRef Daniel M, Mazengia F, Birhanu D. Nutritional status and associated factors among adult HIV/AIDS clients in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Sci J Public Health. 2013;1(1):24–31.CrossRef
33.
go back to reference WHO. Nutrition Landscape Information System (NLIS). Country Profile Indicators Interpretation Guide. 2010. WHO. Nutrition Landscape Information System (NLIS). Country Profile Indicators Interpretation Guide. 2010.
34.
go back to reference Thapa R, Amatya A, Pahari D, Bam K, Newman M. Nutritional status and its association with quality of life among people living with HIV attending public anti-retroviral therapy sites of Kathmandu Valley, Nepal. AIDS Res Ther. 2015;12(1):14.CrossRefPubMedPubMedCentral Thapa R, Amatya A, Pahari D, Bam K, Newman M. Nutritional status and its association with quality of life among people living with HIV attending public anti-retroviral therapy sites of Kathmandu Valley, Nepal. AIDS Res Ther. 2015;12(1):14.CrossRefPubMedPubMedCentral
35.
go back to reference Paton N, Sangeetha S, Earnest A, Bellamy R. The impact of malnutrition on survival and the CD4 count response in HIV‐infected patients starting antiretroviral therapy. HIV Medicine. 2006;7(5):323–30.CrossRefPubMed Paton N, Sangeetha S, Earnest A, Bellamy R. The impact of malnutrition on survival and the CD4 count response in HIV‐infected patients starting antiretroviral therapy. HIV Medicine. 2006;7(5):323–30.CrossRefPubMed
36.
go back to reference Hailemariam S, Bune G, Ayele H. Malnutrition: prevalence and its associated factors in People living with HIV/AIDS, in Dilla University Referral Hospital. Arch Public Health. 2013;71(1):13.CrossRefPubMedPubMedCentral Hailemariam S, Bune G, Ayele H. Malnutrition: prevalence and its associated factors in People living with HIV/AIDS, in Dilla University Referral Hospital. Arch Public Health. 2013;71(1):13.CrossRefPubMedPubMedCentral
37.
go back to reference Khalili H, Soudbakhsh A, Hajiabdolbaghi M, Dashti-Khavidaki S, Poorzare A, Saeedi A. Nutritional status and serum zinc and selenium levels in Iranian HIV infected individuals. BMC Infect Dis. 2008;8(1):165.CrossRefPubMedPubMedCentral Khalili H, Soudbakhsh A, Hajiabdolbaghi M, Dashti-Khavidaki S, Poorzare A, Saeedi A. Nutritional status and serum zinc and selenium levels in Iranian HIV infected individuals. BMC Infect Dis. 2008;8(1):165.CrossRefPubMedPubMedCentral
38.
go back to reference Hu W, Jiang H, Chen W, Deng B, Wang W. Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China. Asia Pac J Clin Nutr. 2011;20(4):544.PubMed Hu W, Jiang H, Chen W, Deng B, Wang W. Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China. Asia Pac J Clin Nutr. 2011;20(4):544.PubMed
39.
go back to reference Wasie B, Kebede Y, Yibrie A. Nutritional status of adults living with HIV/AIDS at the University of Gondar Referral Hospital, Northwest Ethiopia. Ethiop J Health Biomed Sci. 2014;3(1). Wasie B, Kebede Y, Yibrie A. Nutritional status of adults living with HIV/AIDS at the University of Gondar Referral Hospital, Northwest Ethiopia. Ethiop J Health Biomed Sci. 2014;3(1).
40.
go back to reference Hadgu T, Worku W, Tetemke D, Berhe H. Undernutrition among HIV positive women in Humera hospital, Tigray, Ethiopia, 2013. BMC Public Health. 2013;13(1):943.CrossRefPubMedPubMedCentral Hadgu T, Worku W, Tetemke D, Berhe H. Undernutrition among HIV positive women in Humera hospital, Tigray, Ethiopia, 2013. BMC Public Health. 2013;13(1):943.CrossRefPubMedPubMedCentral
41.
go back to reference Mekuria A, Habtamu J. Malnutrition and associated factors among adult individuals receiving highly active antiretroviral therapy in health facilities of Hosanna Town, Southern Ethiopia. Open Access Library Journal. 2015;2. Mekuria A, Habtamu J. Malnutrition and associated factors among adult individuals receiving highly active antiretroviral therapy in health facilities of Hosanna Town, Southern Ethiopia. Open Access Library Journal. 2015;2.
42.
go back to reference Crush J, Frayne B, Grant M. The regional network on HIV/AIDS, livelihoods and food security. 2006. Crush J, Frayne B, Grant M. The regional network on HIV/AIDS, livelihoods and food security. 2006.
43.
go back to reference Patwari AK. Diarrhoea and malnutrition interaction. 1999. Pubmed. Patwari AK. Diarrhoea and malnutrition interaction. 1999. Pubmed.
44.
go back to reference Benta AA, James C, Elizabeth K. Effect of mother’s education on child’s nutritional status in the slums of Nairobi. 2012. Benta AA, James C, Elizabeth K. Effect of mother’s education on child’s nutritional status in the slums of Nairobi. 2012.
Metadata
Title
Chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital northwest Ethiopia
Authors
Melkitu Fentie
Molla Mesele Wassie
Adino Tesfahun
Kassahun Alemu
Malede Mequanent
Tadesse Awoke Ayele
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Nutrition / Issue 1/2017
Electronic ISSN: 2055-0928
DOI
https://doi.org/10.1186/s40795-017-0129-3

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