Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe

Background Sub-Saharan Africa suffers from a high burden of undernutrition, affecting 23.2% of its population, and in 2015 constituted 69% of the estimated people living with Human Immunodeficiency Virus (HIV) globally. Zimbabwe, in Southern African has a HIV prevalence of 14.7%, but malnutrition (u...

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Published in:BMC nutrition 2017-01, Vol.3 (1), p.1, Article 15
Main Authors: Takarinda, Kudakwashe C, Mutasa-Apollo, Tsitsi, Madzima, Bernard, Brilliant Nkomo, Chigumira, Ancikaria, Banda, Mirriam, Muti, Monica, Harries, Anthony D, Owen Mugurungi
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Acquired immune deficiency syndrome
AIDS
Antiretroviral drugs
Body mass index
HIV
Human immunodeficiency virus
Nutrition
Womens health
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creator Takarinda, Kudakwashe C
Mutasa-Apollo, Tsitsi
Madzima, Bernard
Brilliant Nkomo
Chigumira, Ancikaria
Banda, Mirriam
Muti, Monica
Harries, Anthony D
Owen Mugurungi
description Background Sub-Saharan Africa suffers from a high burden of undernutrition, affecting 23.2% of its population, and in 2015 constituted 69% of the estimated people living with Human Immunodeficiency Virus (HIV) globally. Zimbabwe, in Southern African has a HIV prevalence of 14.7%, but malnutrition (under- and over-nutrition) in this population has not been characterized. A nationally representative survey was therefore conducted to determine malnutrition prevalence and associated factors among HIV-positive adults (≥15 years) enrolled at antiretroviral therapy (ART) clinics in Zimbabwe. Methods Height and weight measurements were taken for all enrolled participants who had attended their scheduled clinic review visits. Malnutrition was determined using body mass index (BMI) calculations and classified as undernutrition ( 350 cells/mL[aOR = 4.85 (95% CI, 1.03-22.77)]. Conclusion Zimbabwe faces two types of nutritional disorders; undernutrition and overweight / obesity, in its HIV-infected population, both of which are associated with increased morbidity and mortality. This may reflect a shift in the pattern of HIV/AIDS from being a highly fatal infectious disease to a chronic manageable condition.
doi_str_mv 10.1186/s40795-017-0132-8
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Zimbabwe, in Southern African has a HIV prevalence of 14.7%, but malnutrition (under- and over-nutrition) in this population has not been characterized. A nationally representative survey was therefore conducted to determine malnutrition prevalence and associated factors among HIV-positive adults (≥15 years) enrolled at antiretroviral therapy (ART) clinics in Zimbabwe. Methods Height and weight measurements were taken for all enrolled participants who had attended their scheduled clinic review visits. Malnutrition was determined using body mass index (BMI) calculations and classified as undernutrition (&lt;18.5 kg/m2), normal (18.5-24.9 kg/m2) or over-nutrition (≥25 kg/m2). Multivariate-adjusted odds ratios (aOR) were used to assess factors associated with undernutrition and over-nutrition. Results Of 1,242 HIV-positive adults interviewed, 849 (69%) were female and median age was 41 years (IQR, 34-49). The majority (93%) were on ART with a median treatment duration of 3 years (IQR, 1.1-4.3) and 581 (56%) had advanced HIV disease and a median CD4 cell count of 348 cells/uL (IQR, 174-510) at their last scheduled visit. There were 776 (63.6%) who had a normal BMI, 122 (10%) who had under-nutrition (1.4%-severe; 1.5%-moderate; 7.1%-mild) and 322 (26.4%) who had over-nutrition (18.4%-overweight; 8%-obesity). Females and those of older age (35-44 years and ≥45 years) versus 15-24 years were less likely to have undernutrition. Those reporting difficulty in accessing food in the past month [aOR = 1.67 (95%CI, 1.10-2.55)] and who had advanced HIV disease [aOR = 2.25 (95% CI, 1.34-3.77)] were more likely to have undernutrition. Being overweight or obese was more likely in females [aOR = 3.86 (95% CI, 2.72-5.48)], in those age ≥45 years [aOR = 2.24 (95% CI,1.01-5.04)], those with higher wealth quintile and those with CD4 &gt; 350 cells/mL[aOR = 4.85 (95% CI, 1.03-22.77)]. Conclusion Zimbabwe faces two types of nutritional disorders; undernutrition and overweight / obesity, in its HIV-infected population, both of which are associated with increased morbidity and mortality. This may reflect a shift in the pattern of HIV/AIDS from being a highly fatal infectious disease to a chronic manageable condition.</description><identifier>ISSN: 2055-0928</identifier><identifier>EISSN: 2055-0928</identifier><identifier>DOI: 10.1186/s40795-017-0132-8</identifier><language>eng</language><publisher>London: BioMed Central</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Antiretroviral drugs ; Body mass index ; HIV ; Human immunodeficiency virus ; Nutrition ; Womens health</subject><ispartof>BMC nutrition, 2017-01, Vol.3 (1), p.1, Article 15</ispartof><rights>Copyright BioMed Central 2017</rights><rights>2017. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2598-1ab6e3152f44f479b481aa9043311900587ab2789c5f8a265153dc4d8606743</citedby><cites>FETCH-LOGICAL-c2598-1ab6e3152f44f479b481aa9043311900587ab2789c5f8a265153dc4d8606743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2577738161?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,25733,27903,27904,36991,44569</link.rule.ids></links><search><creatorcontrib>Takarinda, Kudakwashe C</creatorcontrib><creatorcontrib>Mutasa-Apollo, Tsitsi</creatorcontrib><creatorcontrib>Madzima, Bernard</creatorcontrib><creatorcontrib>Brilliant Nkomo</creatorcontrib><creatorcontrib>Chigumira, Ancikaria</creatorcontrib><creatorcontrib>Banda, Mirriam</creatorcontrib><creatorcontrib>Muti, Monica</creatorcontrib><creatorcontrib>Harries, Anthony D</creatorcontrib><creatorcontrib>Owen Mugurungi</creatorcontrib><title>Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe</title><title>BMC nutrition</title><description>Background Sub-Saharan Africa suffers from a high burden of undernutrition, affecting 23.2% of its population, and in 2015 constituted 69% of the estimated people living with Human Immunodeficiency Virus (HIV) globally. Zimbabwe, in Southern African has a HIV prevalence of 14.7%, but malnutrition (under- and over-nutrition) in this population has not been characterized. A nationally representative survey was therefore conducted to determine malnutrition prevalence and associated factors among HIV-positive adults (≥15 years) enrolled at antiretroviral therapy (ART) clinics in Zimbabwe. Methods Height and weight measurements were taken for all enrolled participants who had attended their scheduled clinic review visits. Malnutrition was determined using body mass index (BMI) calculations and classified as undernutrition (&lt;18.5 kg/m2), normal (18.5-24.9 kg/m2) or over-nutrition (≥25 kg/m2). Multivariate-adjusted odds ratios (aOR) were used to assess factors associated with undernutrition and over-nutrition. Results Of 1,242 HIV-positive adults interviewed, 849 (69%) were female and median age was 41 years (IQR, 34-49). The majority (93%) were on ART with a median treatment duration of 3 years (IQR, 1.1-4.3) and 581 (56%) had advanced HIV disease and a median CD4 cell count of 348 cells/uL (IQR, 174-510) at their last scheduled visit. There were 776 (63.6%) who had a normal BMI, 122 (10%) who had under-nutrition (1.4%-severe; 1.5%-moderate; 7.1%-mild) and 322 (26.4%) who had over-nutrition (18.4%-overweight; 8%-obesity). Females and those of older age (35-44 years and ≥45 years) versus 15-24 years were less likely to have undernutrition. Those reporting difficulty in accessing food in the past month [aOR = 1.67 (95%CI, 1.10-2.55)] and who had advanced HIV disease [aOR = 2.25 (95% CI, 1.34-3.77)] were more likely to have undernutrition. Being overweight or obese was more likely in females [aOR = 3.86 (95% CI, 2.72-5.48)], in those age ≥45 years [aOR = 2.24 (95% CI,1.01-5.04)], those with higher wealth quintile and those with CD4 &gt; 350 cells/mL[aOR = 4.85 (95% CI, 1.03-22.77)]. Conclusion Zimbabwe faces two types of nutritional disorders; undernutrition and overweight / obesity, in its HIV-infected population, both of which are associated with increased morbidity and mortality. 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Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>BMC nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takarinda, Kudakwashe C</au><au>Mutasa-Apollo, Tsitsi</au><au>Madzima, Bernard</au><au>Brilliant Nkomo</au><au>Chigumira, Ancikaria</au><au>Banda, Mirriam</au><au>Muti, Monica</au><au>Harries, Anthony D</au><au>Owen Mugurungi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe</atitle><jtitle>BMC nutrition</jtitle><date>2017-01-01</date><risdate>2017</risdate><volume>3</volume><issue>1</issue><spage>1</spage><pages>1-</pages><artnum>15</artnum><issn>2055-0928</issn><eissn>2055-0928</eissn><abstract>Background Sub-Saharan Africa suffers from a high burden of undernutrition, affecting 23.2% of its population, and in 2015 constituted 69% of the estimated people living with Human Immunodeficiency Virus (HIV) globally. Zimbabwe, in Southern African has a HIV prevalence of 14.7%, but malnutrition (under- and over-nutrition) in this population has not been characterized. A nationally representative survey was therefore conducted to determine malnutrition prevalence and associated factors among HIV-positive adults (≥15 years) enrolled at antiretroviral therapy (ART) clinics in Zimbabwe. Methods Height and weight measurements were taken for all enrolled participants who had attended their scheduled clinic review visits. Malnutrition was determined using body mass index (BMI) calculations and classified as undernutrition (&lt;18.5 kg/m2), normal (18.5-24.9 kg/m2) or over-nutrition (≥25 kg/m2). Multivariate-adjusted odds ratios (aOR) were used to assess factors associated with undernutrition and over-nutrition. Results Of 1,242 HIV-positive adults interviewed, 849 (69%) were female and median age was 41 years (IQR, 34-49). The majority (93%) were on ART with a median treatment duration of 3 years (IQR, 1.1-4.3) and 581 (56%) had advanced HIV disease and a median CD4 cell count of 348 cells/uL (IQR, 174-510) at their last scheduled visit. There were 776 (63.6%) who had a normal BMI, 122 (10%) who had under-nutrition (1.4%-severe; 1.5%-moderate; 7.1%-mild) and 322 (26.4%) who had over-nutrition (18.4%-overweight; 8%-obesity). Females and those of older age (35-44 years and ≥45 years) versus 15-24 years were less likely to have undernutrition. Those reporting difficulty in accessing food in the past month [aOR = 1.67 (95%CI, 1.10-2.55)] and who had advanced HIV disease [aOR = 2.25 (95% CI, 1.34-3.77)] were more likely to have undernutrition. Being overweight or obese was more likely in females [aOR = 3.86 (95% CI, 2.72-5.48)], in those age ≥45 years [aOR = 2.24 (95% CI,1.01-5.04)], those with higher wealth quintile and those with CD4 &gt; 350 cells/mL[aOR = 4.85 (95% CI, 1.03-22.77)]. Conclusion Zimbabwe faces two types of nutritional disorders; undernutrition and overweight / obesity, in its HIV-infected population, both of which are associated with increased morbidity and mortality. This may reflect a shift in the pattern of HIV/AIDS from being a highly fatal infectious disease to a chronic manageable condition.</abstract><cop>London</cop><pub>BioMed Central</pub><doi>10.1186/s40795-017-0132-8</doi><oa>free_for_read</oa></addata></record>
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subjects Acquired immune deficiency syndrome
AIDS
Antiretroviral drugs
Body mass index
HIV
Human immunodeficiency virus
Nutrition
Womens health
title Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe
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