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Prevalence of wasting among HIV positive children under 15 years of age attending ART at public health institutions in Southern Ethiopia
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Background:
Malnutrition is very common in HIV-infected individuals. Even though data from different settings are necessary to tackle it, pieces of evidence are limited especially in the case of the nutritional status of HIV-infected children. Hence, this study aims to assess the nutritional status and associated factors among children on antiretr...
Context in source publication
Similar publications
Background
Antiretroviral therapy (ART) enhances the survival of HIV-infected patients by reducing viral load and increasing CD4. As CD4 count increases, patients are more protected against opportunistic infections. In developing countries including Ethiopia, there were limited studies about the survival benefit of ART particularly no study in Komb...
Citations
... Even after interventions by stakeholders, child mortality from malnutrition remains a major public health concern, especially in developing countries such as Ethiopia. In Ethiopia, different studies [3,8,12,[22][23][24][25][26][27][28][29][30][31] showed the prevalence of under nutrition with great inconsistencies across different geographical regions at different periods of time. Identifying modifiable risk factors for under-nutrition among HIV-infected children is a critical step in identifying potential interventions. ...
... As described in Table 1, among the included studies, 7 were done in the Amhara region [4, 23-25, 27, 31, 38], whereas 2 in Oromia [22,30], 1 in Addis Ababa [39], 2 in Eastern Ethiopia [3,12], 1 in Harari [26], 2 from Sidama [28,29], and 1 in the Southern Nations, Nationalities, and Peoples (SNNP) [8]. Regarding study design and publication year, most studies (87.5%) were cross-sectional, and published from 2012 to 2022, respectively. ...
... As shown in Figs 4 and 5, the occurrence of stunting was significantly associated with opportunistic infections (OI) and child feeding problems. The results of these seven primary studies indicated that stunting was significantly associated with OI [3,8,12,22,24,29,31]. The pooled odds ratio indicated that the likelihood of stunting occurrence was 3.15 times higher among children who were infected with any of the OIs as compared to their counterparts (OR: 3.15, 95%CI: 1.85, 5.33, I2 = 99.3%, ...
Background
Children living with HIV/AIDS are particularly vulnerable to under-nutrition. Under-nutrition associated with HIV/AIDS infection increases the rate of morbidity and mortality in children. To reaffirm a future objective, there needs to be evidence regarding the current national burden of under-nutrition and related factors among children infected with HIV. Hence, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in Ethiopia.
Methods
We searched Ethiopian universities’ online libraries, Google, Google Scholar, PubMed, CINAHL, Cochrane Library, and Scopus to find the primary studies for this review. Publication bias was checked through Egger’s regression test. Heterogeneity among the included studies was assessed using the I² test. The data were extracted using Microsoft Excel and exported to STATA Version 14 statistical software. A random effect meta-analysis model was performed to estimate the pooled prevalence of Under-nutrition.
Results
After reviewing 1449 primary studies, 16 articles met the inclusion criteria and were included in the final meta-analysis. The estimated pooled prevalence of stunting, underweight, and wasting among children living with HIV/AIDS was 32.98% (95% CI: 22.47, 43.50), 29.76% (95% CI: 21.87, 37.66), and 21.16% (95% CI: 14.96, 27.35) respectively.
Conclusions
This study showed that under-nutrition among HIV-infected children in Ethiopia was significantly high. Under-nutrition is more common among HIV-infected children with opportunistic infections, child feeding problems, do not adhere to dietary recommendations, and have diarrhea. The national policies and strategies for ART service- provider centers should maximize their emphasis on reducing under-nutrition among HIV-infected children. Based on this finding, we recommend HIV intervention programs to address nutritional assessment and interventions for HIV-infected children.
Protocol registration
The protocol has been registered in the PROSPERO database with a registration number of CRD-394170.
... The highest prevalence of stunting was reported from a study conducted in Cameron (77.0%) [23], and the lowest was reported from a study conducted in Ethiopia (5.5%) [61]. Similarly, the highest prevalence of underweight was reported from a study in Nigeria (58.6%) [7], and the lowest was from a study in Tanzania (6.8%) [24]. ...
Abstract Background In the developing world, such as the sub-Saharan African region, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to under-nutrition. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in sub-Saharan Africa. Methods The primary studies for this review were retrieved from PubMed/ MEDLINE online, Science Direct, Hinari, web of science, CINHAL, EMBASE, WHO databases, Google, and Google Scholar databases. The articles selected for this meta-analysis were published between 2010 and 2020. The last search date was 18 October 2021. The data was extracted in Microsoft Excel format and exported to STATA Version 14.0. A random effect meta-analysis model was used. Heterogeneity was evaluated by the I2 test. The Egger weighted regression test was used to assess publication bias. Results We retrieved 847 records from these databases. Of which records, 813 were excluded due to different reasons and 34 studies were included in the final analysis. The pooled prevalence of stunting, underweight and wasting in HIV infected children was 46.7% (95% CI; 40.36–53.07, I2 = 98.7%, p
... Antiretroviral therapy (ART) side effects, poor dietary intake, and HIV infection itself are all contributing factors to this issue [5]. Although there have been few studies assessing the nutritional state of children living with HIV in Ethiopia [5][6][7][8][9][10], the majority of these research have been on the general nutritional status, and some have been on stunting [5][6][7][8][9][10]. ...
... Antiretroviral therapy (ART) side effects, poor dietary intake, and HIV infection itself are all contributing factors to this issue [5]. Although there have been few studies assessing the nutritional state of children living with HIV in Ethiopia [5][6][7][8][9][10], the majority of these research have been on the general nutritional status, and some have been on stunting [5][6][7][8][9][10]. ...
Background
Malnutrition associated with HIV infection is a complex condition, with HIV-positive children having a higher mortality rate than HIV-negative children, resulting in significant morbidity and mortality in children. Data from a variety of situations are needed to counter this, but the evidence is limited, especially for the nutritional status of HIV-infected children. Therefore, this study aims to assess the magnitude of underweight and factors associated with it in children receiving antiretroviral therapy.
Methods
An institutional-based cross-sectional study was conducted among HIV-positive children in South Gondar, Northwest Ethiopia. Data were collected using an interviewer-administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values ˂0.05 in multivariable logistic regression were considered as statistically significant factors.
Results
Of 406 participants, 379 participant were included in the study, which corresponds to a response rate of 93.3%. About one-third (36.4%) of the caregivers were not first relatives and 162 (42.7%) were unable to read and write. Of the study participants, 101 (26.6%) had a CD4 count below the normal threshold. Ninety (23.7%) of those questioned did not follow any nutritional advice from health care workers. In this study, the prevalence of underweight was 106 (28%). In the multivariable analysis being younger age, having low CD4 count, having recurrent diarrhea, and having poor adherence to dietary advice was significantly associated with being underweight.
Conclusion
This study found that the prevalence of underweight among HIV-positive children in south Gondar is significantly high. Therefore, HIV-positive pediatrics who are young, have low CD4 counts, have recurrent diarrhea, and do not adhere to dietary recommendations need to detect and monitor nutritional problems promptly.
Background: Undernutrition (Body Mass Index < 18.5 kg/m2) is a common problem and a major cause of hospital admission for patients living with HIV. Though sub-Saharan Africa is the most commonly affected region with HIV and malnutrition, a meta-analysis study that estimates the prevalence and correlates of undernutrition among adults living with HIV has not yet been conducted. The objective of this study was to determine the pooled prevalence of undernutrition and associated factors among adults living with HIV/AIDS in sub-Saharan Africa.
Methods: Studies published in English were searched systematically from databases such as PubMed, Google Scholar, and gray literature, as well as manually from references in published articles. Observational studies published from 2009 to November 2021 were included. The data extraction checklist was prepared using Microsoft Excel and includes author names, study area, publication year, sample size, prevalence/odds ratio, and confidence intervals. The results were presented and summarized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standard. Heterogeneity was investigated using the Q test, I2, 2, and predictive interval. STATA version 17 was used to analyze the data. A meta-analysis using a random-effects model was used to determine the overall prevalence and adjusted odds ratio. The study has been registered in PROSPERO with a protocol number of CRD42021268603.
Results: In this study, a total of 44 studies and 22,316 participants were included. The pooled prevalence of undernutrition among adult people living with HIV (PLWHIV) was 23.72% (95% CI: 20.69–26.85). The factors associated with undernutrition were participants' age (AOR = 0.5, 95% CI: 0.29–0.88), gender (AOR = 2.08, 95% CI: 0.22-20.00), World Health Organization (WHO) clinical stage (AOR = 3.25, 95% CI: 2.57–3.93), Cluster of Differentiation 4 (CD4 count) (AOR = 1.94, 95% CI: 1.53-2.28), and duration of ART (AOR = 2.32, 95% CI: 1.6-3.02).
Conclusion: The pooled prevalence of undernutrition among adult PLWHIV in sub-Saharan Africa remained high. WHO clinical stage, CD4 count, duration of ART treatment, age, and sex were found to be the factors associated with undernutrition. Reinforcing nutrition counseling, care, and support for adults living with HIV is recommended. Priority nutritional screening and interventions should be provided for patients with advanced WHO clinical stages, low CD4 counts, the male gender, younger age groups, and ART beginners.
Keywords: Undernutrition, Adults, HIV/AIDS, and sub-Sahara Africa
