Determinants of Undernutrition Among Adult People on Antiretroviral Therapy in Goba Hospital, Southeast Ethiopia: A Case–Control Study

Abstract

Background:

Nutritional status affects effectiveness and adherence to antiretroviral therapy, survival status, and quality-of-life in people living with human immunodeficiency virus. Prevalence of undernutrition among HIV infected people in Ethiopia ranges from 12.3% to 55.6%.

Objective:

To identify determinants of undernutrition among adult people on antiretroviral therapy in Goba Hospital, Southeast Ethiopia.

Methods:

A facility-based case–control study was conducted on 276 study participants from March 16 to May 26, 2019. Nutritional status was determined by body mass index (BMI), where BMI<18.5 kg/m² was defined as malnutrition. A pretested structured questionnaire was used to collect data by face-to-face interview. Data were entered into Epi-data version 4.4 and then exported to SPSS version 23 for analyses. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor. P-value<0.05 was considered statistically significant and AORs at 95% CIs was used to assess the strength of association.

Results:

The response rate of participants was 97% among cases and 95% among controls. Nearly two-thirds (65%) of cases and 54.3% of controls were females. Factors significantly associated with undernutrition were household food insecurity (AOR=3.24, 95% CI=1.72–6.08), depression (AOR=2.07, 95% CI=1.16–3.72), current alcohol consumption (AOR=3.80, 95% CI=1.71–8.43), and non-adherence to antiretroviral therapy (AOR=2.61, 95% CI=1.28–5.30).

Conclusion:

Household food insecurity, depression, current alcohol consumption, and non-adherence to ART were associated with undernutrition. Strengthening the strategies and programs that target food assistance besides therapeutic interventions, addressing problems related to adherence of ART, incorporating psychosocial information about depression and substance use during counseling provided by healthcare providers for PLHIV and further longitudinal study were recommended.

Keywords:

• undernutrition
• HIV
• antiretroviral therapy
• case control
• Ethiopia

Data Sharing Statement

Data will be available upon reasonable request.

Ethics Approval

Ethical clearance was obtained from the Institutional Review Board (IRB) of Institute of Health, Jimma University (Ref.No./IHRPGD/596/2019) in accordance with Helsinki declarations for studies involving human subjects. Permission to conduct the study was taken from Bale Zone Health Bureau and Goba Referral Hospital. Written informed consent was obtained from each participant after explaining the purpose of the study. Participants were told that they had the full right to participate or not, discontinue the interview or measurement at any time, and they were also informed that all the data obtained from them would be kept confidential using codes instead of any personal identifiers.

Acknowledgments

We are thankful to Jimma University Institute of Health for their support. We are grateful to all the participants of the study for kindly giving their time to participate in this study. Additionally, we would like to acknowledge the Goba Hospital Medical Director, ART clinic staff, data collectors, and supervisor who devoted their valuable time and cooperate for the successful completion of this study.

Author contributions

All authors made substantial contributions to the conception and design, acquisition of data, or analyses and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed on the journal to which the article will be submitted; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Funding

This research received no specific finance from any funding agency.

Disclosure

The authors declare that they have no competing interests.