World Journal of Nutrition and Health
ISSN (Print): 2379-7819 ISSN (Online): 2379-7827 Website: http://www.sciepub.com/journal/jnh Editor-in-chief: Srinivas NAMMI
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World Journal of Nutrition and Health. 2015, 3(2), 35-40
DOI: 10.12691/jnh-3-2-2
Open AccessArticle

Nutritional Status of HIV-infected Adolescents Enrolled into an HIV-care Program in Urban and Rural Uganda: A Cross-sectional Study

Francis Lwanga1, 2, , Rhoda K. Wanyenze1, 3, Joseph KB Matovu1, 4, Teddy Chimulwa2 and Christopher G. Orach4

1Makerere University School of Public Health-Centers for Disease Control (MakSPH-CDC) Fellowship Program, Kampala Uganda

2The AIDS Support Organization (TASO), Kampala Uganda

3Makerere University School of Public Health, Department of Disease Control and Environmental Health, Kampala Uganda

4Makerere University School of Public Health, Department of Community Health and Behavioral Sciences, Kampala Uganda

Pub. Date: April 26, 2015

Cite this paper:
Francis Lwanga, Rhoda K. Wanyenze, Joseph KB Matovu, Teddy Chimulwa and Christopher G. Orach. Nutritional Status of HIV-infected Adolescents Enrolled into an HIV-care Program in Urban and Rural Uganda: A Cross-sectional Study. World Journal of Nutrition and Health. 2015; 3(2):35-40. doi: 10.12691/jnh-3-2-2

Abstract

Malnutrition is a major threat to the health of HIV infected individuals and is associated with increased risks of morbidity and mortality. We assessed the nutritional status of HIV-infected adolescents enrolled into HIV care program in Uganda. We carried out across-sectional study. Data were collected on 205 adolescents aged 10-19 years attending The AIDS Support Organization (TASO) HIV care services in Uganda. All adolescents attending an adolescent clinic day in the respective TASO centers were enrolled into the study. Nutritional status was assessed using BMI-for-Age (BAZ) and Height-for-age (HAZ) as measures of thinness and stunting respectively. Standard deviation (SD) scores (Z scores) were applied to determine the nutritional status. Adolescents whose BAZ and HAZ was ≤-3SD were considered severely undernourished; those ≤-2SD were considered malnourished while those > -2SD were well-nourished. Statistical analysis was done using STATA statistical software package. The prevalence of stunting was 36.2% (72/199) with 11.1% (22/199) of adolescents being severely stunted. The risk factors for stunting included being male (AOR: 4.0; 95% CI: 1.81- 7.02) and residence in rural settings (AOR: 6.0; 95% CI 2.70-12.16). Eighteen percent of the adolescents (36/200) were thin, 8% (16/200) being severely thin. The prevalence of stunting and thinness was high among the HIV infected adolescents. Male adolescents and residing in rural settings are important risk factors of malnutrition among the HIV infected adolescents. There is need for development of comprehensive care and support systems including adequate nutritional care and support for HIV infected adolescents.

Keywords:
adolescence stunting thinness HIV rural urban Uganda

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References:

[1]  Rose A.M, Hall CS, Martinez-Alier N. Aetiology and Management of Malnutrition in HIV-positive Children. January 9, 2014.
 
[2]  Bachou, H, T Thorkild, R Downing, and J Tumwine. Severe malnutrition with and without HIV-1 infection in hospitalised children in Kampala, Uganda: differences in clinical features, haematological findings and CD4+ cell counts. Nutrition Journal 2006 5:27.
 
[3]  Joint United Nations Programme on HIV/AIDS. UNAIDS report on the global AIDS epidemic 2013.
 
[4]  World Health Organization HIV and adolescents: Guidance for HIV testing and counseling and care for adolescents living with HIV: recommendations for a public health approach and considerations for policy-makers and managers. 2013 Geneva, 27, Switzerland.
 
[5]  Uganda Nutrition Action Plan. Scaling up Multi-Sectoral Efforts to Establish a Strong Nutrition Foundation for Uganda’s Development, 2011. Available at: http://www.unicef.org /Uganda/Nutrition_Plan_2011.pdf.
 
[6]  Ministry of Health-Uganda Policy Guidelines on Infant and Young Child Feeding. 2009 Available at: https://extranet.who.int/nutrition/gina/sites/default/files/UGA%202009%20IYCF%20Guidelines.pdf.
 
[7]  Stang, J., Story, M. In Guidelines for Adolescent Nutrition Services. Available at: http://www.epi.umn.edu/let/pubs/img/adol_preface_materials.pdf.
 
[8]  Christine M. McDonald, Karim P. Manji, Roland Kupka et al. Stunting and Wasting are Associated with Poorer Psychomotor and Mental Development in HIV-Exposed Tanzanian Infants 2012 J. Nutr. 143: 204-214,
 
[9]  Christine J. McGrath; Michael H. Chung; Barbra A. Richardson; Sarah Benki Nugent; Danson Warui and Grace C. John-Stewart. Younger age at HAART initiation is associated with more rapid growth reconstitution, AIDS 2011 28; 25(3): 345-355.
 
[10]  Shalini Duggal, Tulsi Das Chugh, and Ashish Kumar Duggal. HIV and Malnutrition: Effects on Immune System. Clinical and Developmental Immunology Vol. 2012, Article ID784740.
 
[11]  FANTA-2. The Analysis of the Nutrition Situation in Uganda. Food and Nutrition Technical Assistance II Project (FANTA-2) 2010, Washington, DC: AED.
 
[12]  Rosalind S.G. Nutritional Assessment; A Laboratory Manual; Oxford University Press 1993: New York, NY, USA.
 
[13]  World Health Organization. Global Database on Child Growth and Malnutrition; WHO: 1997 Geneva, Switzerland.
 
[14]  Francis Lwanga, Barbara Eva Kirunda and Christopher Garimoi Orach. Intestinal Helminth Infections and Nutritional Status of Children Attending Primary Schools in Wakiso District, Central Uganda. Int. J. Environ. Res. Public Health 2012. 9, 2910-2921.
 
[15]  Banerjee T. Pensi T. Banerjee D. Grover G (2010). Impact of HAART on survival, weight gain and resting energy expenditure in HIV-1-infected children in India. Annals of Tropical Paediatrics 2010, 30:27-37.
 
[16]  William Checkley, Leonardo D. Epstein, Robert H. Gilm an, Lilia Cabrera and Robert E. Black. Effects of Acute Diarrhea on Linear Growth in Peruvian Children. Am J Epidemiol 2003; 157:166-175.
 
[17]  Rashida A. Ferrand; Ruedi Luethy; Filda Bwakura; Hilda Mujuru; Robert F. Miller and Elizabeth L Corbett. HIV Infection Presenting in Older Children and Adolescents: A Case Series from Harare, Zimbabwe. Clinical Infectious Diseases 2007; 44:874-8.
 
[18]  C.Padmapriyadarsini; N.Pooranagangadevi; K.Chandrasekaran and Sudha Subramanyan. Prevalence of Underweight, Stunting, and Wasting among Children Infected with Human Immunodeficiency Virus in South India. Vol. 2009.
 
[19]  L C de Barros Ramalho, E M Goncalves, W R G de Carvalho, G Guerra-Junior, M Centeville, F H Aoki, A M Morcillo, M M dos Santos Vilela and M T N da Silva. Abnormalities in body composition and nutritional status in HIV-infected children and adolescents on antiretroviral therapy. International Journal of STD & AIDS 2011; 22: 453-456.
 
[20]  Stephen M. Apadi. Growth failure in HIV-infected children. Consultation on Nutrition and HIV/AIDS in Africa: Evidence, lessons and recommendations for action. 2005. [http://www.who.int/nutrition/topics/Paper_4_Growth_failure_bangkok.pdf].
 
[21]  Aranka Anema, Nicholas Vogenthaler, Edward A. Frongillo, Suneetha Kadiyala, and Sheri D. Weiser. Food Insecurity and HIV/AIDS: Current Knowledge, Gaps, and Research Priorities. Current Medicine Group LLC 2009. ISSN 1548-3568., 6:224-231.
 
[22]  Steven Hirschfeld. Dysregulation of Growth and Development in HIV-Infected Children. J. Nutr. 1996. 126: 2641S-2650S.
 
[23]  Bijal Shah, Louise Walshe, Dattary G. Saple, Shruti H. Mehta, Jeetender P. Ramnani, R. D. Kharkar, Robert C. Bollinger and Amita Gupta. Adherence to Antiretroviral Therapy and Virologic Suppression among HIV-Infected Persons Receiving Care in Private Clinics in Mumbai, India. HIV/AIDS 2007. CID:44, 1235.
 
[24]  Ajay K. Sethi, David D. Celentano, Stephen J. Gange, Richard D. Moore, and Joel E. Gallant Association between Adherence to Antiretroviral Therapy and Human Immunodeficiency Virus Drug Resistance. HIV/AIDS 2003. CID:37, 1112.
 
[25]  Uganda Bureau of Statistics (UBOS) and ICF International Inc. 2012. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS and Calverton, Maryland: ICF International Inc.
 
[26]  Uganda Bureau of Statistics and the World Food Programme. A comprehensive food security and vulnerability analysis (CFSVA) 2013. [http://documents.wfp.org/stellent/groups/public/documents/ena/wfp257002.pdf].
 
[27]  Ingunn Marie, S.E.; Thorkild, T.; Wamani, H.; Karamagi, C.; Tumwine, J.K Determinants of infant growth in Eastern Uganda: A community-based cross-sectional study. BMC Public Health 2008.
 
[28]  The World Health organization. Health for the World’s Adolescents. A second chance in the second decade. Geneva 27, Switzerland 2014. [http://apps.who.int/adolescent/second-decade/files/1612_MNCAH_HWA_Executive_Summary.pdf].
 
[29]  Santolaria-Fernández FJ, Gómez-Sirvent JL, González-Reimers CE, Batista-López JN, Jorge-Hernández JA, Rodríguez-Moreno F, Martínez-Riera A, Hernández-García MT Nutritional assessment of drug addicts. Drug Alcohol Depend, 1995; 38(1):11-8.
 
[30]  Lien A. Quach, Christine A Wanke, Christopher H. Schmid, Sherwood L. Gorbach, D. Mkaya Mwamburi, Kenneth H. Mayer, Donna Spiegelman and Alice M. Tang. Drug Use and Other Risk Factors Related to Lower Body Mass Index among HIV-Infected Individuals. Drug Alcohol Depend. 2008; 95(0).
 
[31]  Ene-Obong H, Ibeanu V, Onuoha N, Ejekwu A. Prevalence of overweight, obesity, and thinness among urban school-aged children and adolescents in southern Nigeria. Food Nutr Bull. 2012 Dec; 33(4): 242-50.
 
[32]  Ponce Cedric Fouejeu Wamba, Julius Enyong Oben, and Katherine Cianflone. Prevalence of Overweight, Obesity, and Thinness in Cameroon Urban Children and Adolescents. Journal of Obesity 2013, ID 737592.
 
[33]  Philippa M Musoke and Pamela Fergusson. Severe malnutrition and metabolic complications of HIV-infected children in the antiretroviral era: clinical care and management in resource-limited settings. Am J Clin Nutr 2011; 94(suppl):1716S-20S.
 
[34]  Fergusson P, Tomkins A. HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg, 2009. 103(6):541-8.
 
[35]  Eduardo Villamor, Lara Misegades, Maulidi R Fataki, Roger L Mbise and Wafaie W Fawzi. Child mortality in relation to HIV infection, nutritional status, and socio-economic background. IJE 2005. vol. 34 no. 1; 34 :61-68.
 
[36]  Taye B, , Enquselassie F. The impact of malnutrition in survival of HIV infected children after initiation of antiretroviral treatment (ART). J 2010; 48(1):1-10.