Malnutrition: Prevalence and associated factors among people living with HIV attending HIV Clinic in Arua Hospital

Abstract

Background: In Uganda, nutrition is integrated into the essential package of care, treatment and support for people living with HIV/AIDS, however, effective intervention and strategies for improving nutritional intake are still lacking. Literature on prevalence and factors associated with malnutrition among People Living with HIV (PLHIV) are limited. The study therefore established the magnitude and factors associated with malnutrition; also and determined the prevalence of malnutrition among PLHIV. The results of the study could inform the development of strategies for nutrition interventions in care and support services and also determine the extent to which PLHIV in care and treatment services may need nutrition care services, Objectives: To determine the prevalence and factors associated with malnutrition among adults PLHIV attending HIV clinic in Arua regional referral hospital. Methods: A health facility based cross-sectional study with qualitative and quantitative data collection methods were conducted between August and September 2017 among 225 adults PLHIV in Arua hospital. Study participants were selected using systematic sampling. Malnutrition was measured using Body Mass Index (BMI) and the prevalence of malnutrition among adults PLHIV was calculated as percentage of PLHIV who had BMI < 18.5kgm2 over the whole sample size of 225. Quantitative data were collected using an interviewer administered questionnaire. Qualitative data were collected through key informant interviews using a topic guide and was analyzed by thematic analysis using a top-down approach basing on the question topic guide. Quantitative data were analyzed using STATA version 12®. Multivariable logistic regression was used to determine factors associated with malnutrition and to estimate odds ratios, 95% confidence intervals and p-values of independent predictors associated with malnutrition Results A total of 225 PLHIV were included in the study. The overall prevalence of malnutrition was 15.6% (95% CI: 11.40- 20.90). After adjusting for sex, marital status, religion, land ownership, size of land, level of education, monthly income, waiting time in health facility; we noted that WHO clinical stage two (AOR=4.48; 95% CI: 2.54-13.07) and travelling more than three kilometers to get services (AOR=5.03; 95% CI: 1.98-8.68) were associated with higher odds of malnutrition in PLHIV. Being older (above 35years) was protective against malnutrition, (AOR=0.275; 95% CI: 0.11-0.69). Conclusion Traveling more than 3 km to the hospital and WHO clinical staging two were significantly associated with higher odds of malnutrition in PLHIV while age of 35 year or more was associated with lower odds of malnutrition.