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Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: a case control study in Northern Ethiopia

Authors: Negassie Berhe, Desalegn Tegabu, Mekuriaw Alemayehu

Published in: BMC Infectious Diseases | Issue 1/2013

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Abstract

Background

Adherence to antiretroviral treatment is critical for suppression of viral replication, reduced destruction of CD4 cells, prevention of viral resistance, promotion of immune reconstitution and slowed disease progression. This study sought to determine the effect of nutritional factors on adherence to ART among HIV-infected adults on ART.

Methods

Matched case control study design (matched by age and sex) was employed. Data was collected from ART registration chart, pre-tested structured data extraction format, anthropometric measurements and by interview. Conditional logistic regression was used to compute the relevant associations among the variables by STATA version 10.

Results

From 174 paired subjects participated in the study 80 (46%) pair were males and 94 (54%) pair were females on ART for at least one year prior to the survey. The mean age (±SD) for the non-adherent was 38.4 ± 8.1years and for the adherent subjects was 38.5 ± 8.4 years. Malnutrition with BMI less than 18.5 Kg/m2 in the adherent group was 14 (8%) and that of the non-adherent group was 74 (42.5%) which was associated with non-adherence to ART (AOR 10.0, 95%CI 4.3 – 54.7). Inability to get enough and quality food was also associated with non-adherence to ART (AOR 2.1, 95%CI 1.1 – 11.5).

Conclusions

Malnutrition, inability to get enough and/or quality food and consumption pattern which is less than three meals per day were significantly associated with non-adherence to ART. Therefore, the capacity to effectively manage the food and nutrition implications of ART adherence is a critical factor in the success of antiretroviral therapy in resource limited settings.
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Literature
1.
go back to reference WHO, UNICEF, UNAIDS, GLOBALHIV/AIDSRESPONSE: Epidemic update and health sector progress towards Universal Access. 2011 WHO, UNICEF, UNAIDS, GLOBALHIV/AIDSRESPONSE: Epidemic update and health sector progress towards Universal Access. 2011
3.
go back to reference Federal HIV/AIDS Prevention and Control Office (HAPCO): Ethiopia Country Progress Report on HIV/AIDS Response, 2012. 2012, Addis Ababa, Ethiopia Federal HIV/AIDS Prevention and Control Office (HAPCO): Ethiopia Country Progress Report on HIV/AIDS Response, 2012. 2012, Addis Ababa, Ethiopia
4.
go back to reference United Stated Agency for International Development (UNAIDS): HIV, Food Security and Nutrition; UNAIDS Policy Brief. 2008 United Stated Agency for International Development (UNAIDS): HIV, Food Security and Nutrition; UNAIDS Policy Brief. 2008
5.
go back to reference Steel G, Nwokike J, Joshi MP: Development of a Multi-Method Tool to Measure ART Adherence in Resource-Constrained Settings: The South Africa Experience. RPM Plus. 2007 Steel G, Nwokike J, Joshi MP: Development of a Multi-Method Tool to Measure ART Adherence in Resource-Constrained Settings: The South Africa Experience. RPM Plus. 2007
6.
go back to reference Weiser SD, Tuller DM, Frongillo EA, Senkungu J, Mukiibi N, Bangsberg DR: Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PLoS One. 2010, 5 (4): e10340-10.1371/journal.pone.0010340.CrossRefPubMedPubMedCentral Weiser SD, Tuller DM, Frongillo EA, Senkungu J, Mukiibi N, Bangsberg DR: Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PLoS One. 2010, 5 (4): e10340-10.1371/journal.pone.0010340.CrossRefPubMedPubMedCentral
7.
go back to reference Hardon AP, Akurut D, Comoro C, Ekezie C, Irunde HF, Gerrits T: Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa. AIDS Care. 2007, 19 (5): 658-665. 10.1080/09540120701244943.CrossRefPubMed Hardon AP, Akurut D, Comoro C, Ekezie C, Irunde HF, Gerrits T: Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa. AIDS Care. 2007, 19 (5): 658-665. 10.1080/09540120701244943.CrossRefPubMed
8.
go back to reference Louise C, Ivers LC, Cullen KA, Freedberg KA, Block S, Coates J, Webb P: HIV/AIDS, Undernutrition and Food Insecurity. Clin Infect Dis. 2009, 49 (7): 1096-1102. 10.1086/605573.CrossRef Louise C, Ivers LC, Cullen KA, Freedberg KA, Block S, Coates J, Webb P: HIV/AIDS, Undernutrition and Food Insecurity. Clin Infect Dis. 2009, 49 (7): 1096-1102. 10.1086/605573.CrossRef
9.
go back to reference Mills E, Nachega JB, Buchan I, Orbinski J, Attaran A, Singh S: Adherence to Antiretroviral Therapy in Sub-Saharan Africa and North America. JAMA. 2006, 296 (6): 679-690. 10.1001/jama.296.6.679.CrossRefPubMed Mills E, Nachega JB, Buchan I, Orbinski J, Attaran A, Singh S: Adherence to Antiretroviral Therapy in Sub-Saharan Africa and North America. JAMA. 2006, 296 (6): 679-690. 10.1001/jama.296.6.679.CrossRefPubMed
10.
go back to reference Talam NC, Gatongi P, Rotich J, Kimaiyo S: Factors affecting antiretroviral drug adherence among HIV/AIDS adult patients attending HIV/AIDS clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya. East Afr J Public Health. 2008, 5 (2): 74-78.PubMed Talam NC, Gatongi P, Rotich J, Kimaiyo S: Factors affecting antiretroviral drug adherence among HIV/AIDS adult patients attending HIV/AIDS clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya. East Afr J Public Health. 2008, 5 (2): 74-78.PubMed
12.
go back to reference Abiy S: Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration. Addis Ababa University [Internet]. 2007, Available from: http://hdl.handle.net/123456789/861 Abiy S: Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration. Addis Ababa University [Internet]. 2007, Available from: http://​hdl.​handle.​net/​123456789/​861
13.
go back to reference Tiyou A, Belachew T, Alemseged F, Biadgilign S: Food Insecurity and Associated Factors among HIV-infected individuals receiving highly active antiretroviral therapy in Jimma zone. Southwest Ethiop Nutr J. 2012, 11: 51- Tiyou A, Belachew T, Alemseged F, Biadgilign S: Food Insecurity and Associated Factors among HIV-infected individuals receiving highly active antiretroviral therapy in Jimma zone. Southwest Ethiop Nutr J. 2012, 11: 51-
14.
go back to reference Cantrell RA, Sinkala M, Megazinni K, Lawson-Marriott S, Washington S, Chi BH: A Pilot Study of Food Supplementation to Improve Adherence to Antiretroviral Therapy Among Food-Insecure Adults in Lusaka, Zambia. JAIDS J Acquir Immune Defic Syndr. 2008, 49 (2): 190-195. 10.1097/QAI.0b013e31818455d2. OctCrossRefPubMed Cantrell RA, Sinkala M, Megazinni K, Lawson-Marriott S, Washington S, Chi BH: A Pilot Study of Food Supplementation to Improve Adherence to Antiretroviral Therapy Among Food-Insecure Adults in Lusaka, Zambia. JAIDS J Acquir Immune Defic Syndr. 2008, 49 (2): 190-195. 10.1097/QAI.0b013e31818455d2. OctCrossRefPubMed
15.
go back to reference Rawat R, Kadiyala S, McNamara PE: The impact of food assistance on weight gain and disease progression among HIV-infected individuals accessing AIDS care and treatment services in Uganda. BMC Publ Health. 2010, 10: 316-10.1186/1471-2458-10-316. Jun 7CrossRef Rawat R, Kadiyala S, McNamara PE: The impact of food assistance on weight gain and disease progression among HIV-infected individuals accessing AIDS care and treatment services in Uganda. BMC Publ Health. 2010, 10: 316-10.1186/1471-2458-10-316. Jun 7CrossRef
17.
go back to reference Tigray Regional Health Bureau: Tigray Regional Health Bureau First quarter report of 2004 E.C, 2012: Mekelle. In. Mekelle. 2012 Tigray Regional Health Bureau: Tigray Regional Health Bureau First quarter report of 2004 E.C, 2012: Mekelle. In. Mekelle. 2012
18.
go back to reference Idindili B, Jullu B, Mugusi F, Tanner M: A case–control study of factors associated with non-adherent to antiretroviral therapy among HIV infected people in Pwani Region, eastern Tanzania. Tanzan J Health Res. 2012, 14 (3): 1-12.CrossRef Idindili B, Jullu B, Mugusi F, Tanner M: A case–control study of factors associated with non-adherent to antiretroviral therapy among HIV infected people in Pwani Region, eastern Tanzania. Tanzan J Health Res. 2012, 14 (3): 1-12.CrossRef
19.
go back to reference Amico KR, Simoni J, Wilson I, Malow RM, Devieux J, Deschamps A: Monitoring Patient Adherence: Recommendations from and for Practice. 2009 Amico KR, Simoni J, Wilson I, Malow RM, Devieux J, Deschamps A: Monitoring Patient Adherence: Recommendations from and for Practice. 2009
20.
go back to reference Kroenke K, Spitzer R, Williams J: The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral Kroenke K, Spitzer R, Williams J: The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral
21.
go back to reference Sullivan K: Determining an Individual’s Anemia Status based on Hemoglobin Levels. 2001 Sullivan K: Determining an Individual’s Anemia Status based on Hemoglobin Levels. 2001
22.
go back to reference Eyuel T, Worku A: Assessment of antiretroviral treatment outcome in public hospitals, South Nations Nationalities and Peoples Region, Ethiopia. Ethiop J Health Dev. 2011, 25 (2): 102-109. Eyuel T, Worku A: Assessment of antiretroviral treatment outcome in public hospitals, South Nations Nationalities and Peoples Region, Ethiopia. Ethiop J Health Dev. 2011, 25 (2): 102-109.
23.
24.
go back to reference Byron E, Gillespie S, Nangami M: Integrating nutrition security with treatment of people living with HIV: lessons from Kenya. Food Nutr Bull. 2008, 29 (2): 87-97. JunCrossRefPubMed Byron E, Gillespie S, Nangami M: Integrating nutrition security with treatment of people living with HIV: lessons from Kenya. Food Nutr Bull. 2008, 29 (2): 87-97. JunCrossRefPubMed
25.
go back to reference Lyimo R, de Bruin M, van den Boogaard J, Hospers H, van der Ven A, Mushi D: Determinants of antiretroviral therapy adherence in northern Tanzania: a comprehensive picture from the patient perspective. BMC Publ Health. 2012, 12: 716-10.1186/1471-2458-12-716. Aug 30CrossRef Lyimo R, de Bruin M, van den Boogaard J, Hospers H, van der Ven A, Mushi D: Determinants of antiretroviral therapy adherence in northern Tanzania: a comprehensive picture from the patient perspective. BMC Publ Health. 2012, 12: 716-10.1186/1471-2458-12-716. Aug 30CrossRef
26.
go back to reference Senkomago V, Guwatudde D, Breda M, Khoshnood K: Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda. AIDS Care. 2011, 23 (10): 1246-1253. 10.1080/09540121.2011.564112. OctCrossRefPubMed Senkomago V, Guwatudde D, Breda M, Khoshnood K: Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda. AIDS Care. 2011, 23 (10): 1246-1253. 10.1080/09540121.2011.564112. OctCrossRefPubMed
27.
go back to reference Nyanzi-Wakholi B, Lara A, Munderi P, Gilks C, Dart Trial Team: The charms and challenges of antiretroviral therapy in Uganda: the DART experience. AIDS Care. 2012, 24 (2): 137-142.PubMed Nyanzi-Wakholi B, Lara A, Munderi P, Gilks C, Dart Trial Team: The charms and challenges of antiretroviral therapy in Uganda: the DART experience. AIDS Care. 2012, 24 (2): 137-142.PubMed
28.
go back to reference Ivers LC, Chang Y, Gregory Jerome J, FreedbergK A: Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: a prospective observational cohort study. AIDS Res Ther. 2010, 7: 33-10.1186/1742-6405-7-33. Aug 26CrossRefPubMedPubMedCentral Ivers LC, Chang Y, Gregory Jerome J, FreedbergK A: Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: a prospective observational cohort study. AIDS Res Ther. 2010, 7: 33-10.1186/1742-6405-7-33. Aug 26CrossRefPubMedPubMedCentral
29.
go back to reference Peter O, Andrew K, Curtis C, Will S, Aranka A, Edward M: Adherence to antiretroviral therapy among a conflict-affected population in Northeastern Uganda: a qualitative study. AIDS. 2008, 22: 1882-1884. 10.1097/QAD.0b013e3283112ba6.CrossRef Peter O, Andrew K, Curtis C, Will S, Aranka A, Edward M: Adherence to antiretroviral therapy among a conflict-affected population in Northeastern Uganda: a qualitative study. AIDS. 2008, 22: 1882-1884. 10.1097/QAD.0b013e3283112ba6.CrossRef
30.
go back to reference Sanjobo N, Frich JC, Fretheim A: Barriers and facilitators to patients’ adherence to antiretroviral treatment in Zambia: a qualitative study. SAHARA J. 2008, 5 (3): 136-143. 10.1080/17290376.2008.9724912.CrossRefPubMed Sanjobo N, Frich JC, Fretheim A: Barriers and facilitators to patients’ adherence to antiretroviral treatment in Zambia: a qualitative study. SAHARA J. 2008, 5 (3): 136-143. 10.1080/17290376.2008.9724912.CrossRefPubMed
31.
go back to reference Mangili A, Murman DH, Zampini AM, Wanke CA, MayerK H: 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. Clin Infect Dis. 2006, 42 (6): 836-842. 10.1086/500398.CrossRefPubMed Mangili A, Murman DH, Zampini AM, Wanke CA, MayerK H: 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. Clin Infect Dis. 2006, 42 (6): 836-842. 10.1086/500398.CrossRefPubMed
32.
go back to reference Serrano C, Laporte R, Ide M, Nouhou Y, Truchis P, Rouveix E: Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country. Asia Pac J Clin Nutr. 2010, 19 (1): 68-75.PubMed Serrano C, Laporte R, Ide M, Nouhou Y, Truchis P, Rouveix E: Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country. Asia Pac J Clin Nutr. 2010, 19 (1): 68-75.PubMed
33.
go back to reference Danel C, Moh R, Chaix M-L, Gabillard D, Gnokoro J, Diby C-J: Two-Months-off F-M-oARItRoR, Compared with Continuous Therapy: A Randomized Trial Involving West African Adults. J Infect Dis. 2009 Jan 1;199(1):66–76.: Two-Months-off, Four-Months-on Antiretroviral Regimen Increases the Risk of Resistance, Compared with Continuous Therapy: A Randomized Trial Involving West African Adults. J Infect Dis. 2009, 199 (1): 66-76. 10.1086/595298. Jan 1CrossRefPubMed Danel C, Moh R, Chaix M-L, Gabillard D, Gnokoro J, Diby C-J: Two-Months-off F-M-oARItRoR, Compared with Continuous Therapy: A Randomized Trial Involving West African Adults. J Infect Dis. 2009 Jan 1;199(1):66–76.: Two-Months-off, Four-Months-on Antiretroviral Regimen Increases the Risk of Resistance, Compared with Continuous Therapy: A Randomized Trial Involving West African Adults. J Infect Dis. 2009, 199 (1): 66-76. 10.1086/595298. Jan 1CrossRefPubMed
Metadata
Title
Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: a case control study in Northern Ethiopia
Authors
Negassie Berhe
Desalegn Tegabu
Mekuriaw Alemayehu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-233

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