Assessment of dietary intake and nutritional status of children (under five years) who are HIV positive attending The Aids Support Organization (TASO) Entebbe

Abstract

BACKGROUND: HIV/AIDS still remains a challenging pandemic worldwide, with Sub-Saharan African being the most affected region. In Uganda, the impact of the disease at household, community and national level has been enormous. A large proportion of HIV positive children less than five years of age are malnourished. HIV infection in children less than five years of age increases energy requirements and affects nutritional status through increase in resting energy expenditure, reduction in food intake, nutrient malabsorption and loss, and complex metabolic alterations that culminate in weight loss and wasting which is common in AIDS. Exclusive breastfeeding during the first 6 months of life has been recommended. Exclusive breastfeeding is more protective than mixed feeding for infant’s survival and development followed by complementary foods in addition to breastfeeding for 24 months.

OBJECTIVES: The aim of this study was to assess the dietary intake and nutritional status of children under five years who were HIV positive. Specifically the study sought to determine factors affecting children’s nutritional status, the effect of the caretakers’ knowledge attitudes and practices on dietary patterns and establish the health related problems associated with HIV/AIDS that may hinder food intake.

METHODS: The total number of children under study was 245. 50.2% were males while 49.8% were females. The methodology undertaken was a cross-sectional study employing both qualitative and quantitative methods. Data was collected using a questionnaire covering background information of the caretakers and children, social economic status, and food consumption patterns/ habits of the children, 24-hr dietary intake, and nutrition knowledge, access to health, and nutrition information. Nutritional status of the children was determined using anthropometric measurements. Epi-Info 2003 statistical package was used to compute Weight-for- age (WAZ), Height-for-age (HAZ), and Weight-for-height (WHZ) z-scores. SPSS version 12.0 was used to present descriptive statistics (Mean, Std. Deviation, and Frequencies). Statistical significance was set at 95% Confidence Interval.

RESULTS: The results revealed that exclusive breastfeeding was positively correlated with nutritional status (r2 = 0.624, P= 0.004). In the study, immunization had a positive impact on HIV/AIDS positive children, where 60.4% completed their immunization. The most frequent illness the children got within the past 30 days prior to the research was nausea (14.4%) and the least was difficult in swallowing/Candida esophagus (6.3%). Majority of the children (72.7%) got side effects from the use of ARV drugs including reduced appetite (27.3%), headaches (18.4%), abdominal pain (15.1%), and heartburn (12.7%). The result also revealed that the total number of children who consumed 3 to 4 meals per day was 77.9% while only 12.7% could afford more than 4 meals per day as recommended by MOH (2003). From the results on nutritional information, 63.3% of the caretakers received information on nutrition and care on HIV positive children from health workers in TASO Entebbe Centre. The information included foods good for the patients, foods that should not be given the patients e.g. alcohol, and consequences of poor or/ and bad feeding, improving children’s nutritional status at household level, hygiene and proper sanitation. The survey also revealed that 13.5% of the children were underweight, 11.3% were stunted and 12.1% were wasted while 63.1% were normal.

CONCLUSION: From the study it was observed that the children did not meet their requirements for zinc, iron and vitamin A and therefore were at high risk of becoming deficient in these micronutrients