Nutrition risk and validation of an HIV disease-specific nutrition screening tool in Ghana

Figures & data

Table 1: Rapid Nutrition Screening for HIV disease (RNS-H)^9,23

Within the past 12 months I have worried whether my food would run out before I got money to buy more (1 point)

2. Within the past 12 months the food I bought just didn’t last and I didn’t have money to get more (1 point)

3. BMI*:

1. < 18.5 (3 points)

2. 18.5–24.9 (0 points)

3. 25–29.9 (1 point)

4. ≥ 30 (2 points)

4. I have been diagnosed with HIV within the past 6 months (3 points)

When diagnosed? ______________

5. I have one or more of the following conditions: diabetes, heart disease, high blood pressure (2 points) Check all that apply:

_____ diabetes_____ heart disease _____ high blood pressure _____ lipodystrophy

6. I have lost more than 10 pounds over the past 6 months without trying (3 points)

7. I have one of the following: difficulty swallowing, nausea with vomiting, poor appetite or chronic diarrhoea (2 points). Check all that apply:

_____ difficulty swallowing _____ nausea with vomiting _____ poor appetite _____ chronic diarrhoea

0–3 points  1. Normal nutrition status 4–6 points  2. At nutrition risk 7–17 points  3. High nutrition risk

*BMI = (weight in pounds / (height in inches x height in inches)) x 703.

Table 2: Academy/ASPEN malnutrition criteria¹⁰

Indicator	Chronic illness		Acute illness
	Moderate	Severe	Moderate	Severe
Energy intake	< 75% of energy needs for > 7 days	≤ 50% of energy needs for ≥ 5 days	< 75% of energy needs for ≥ 1 month	≤ 75% of energy needs for ≥ 1 month
Weight loss	1–2% 1 week 5%  1 month 7.5%  3 months	> 2%  1 week > 5%  1 month > 7.5%  3 months	5%  1 month 7.5% 3 months 10%  6 months 20%  1 year	> 5%  1 month > 7.5%  3 months > 10% 6 months >20%  1 year
Loss of subcutaneous fat	Mild	Moderate	Mild	Severe
Muscle mass	Mild	Moderate	Mild	Severe
Fluid accumulation	Mild	Moderate to severe	Mild	Severe
Grip strength	N/A	Measurably reduced	N/A	Measurably reduced

Table 3: Most common nutrition-related complications

Complication	Female (n = 36)	Male (n = 15)	Total
Food insecurity	13 (36.1%)	5 (33.3%)	18 (35.3%)
Poor appetite	12 (33.3%)	5 (33.3%)	17 (33.3%)
10+ pounds weight loss	10 (27.8%)	4 (26.7)	14 (27.5%)
Hypertension	5 (13.9%)	3 (20%)	8 (15.7%)
Diarrhoea	4 (11.1%)	2 (13.3%)	6 (11.8%)
Nausea/vomiting	4 (11.1%)	0 (0%)	4 (7.8%)
Dysphagia	3 (8.3%)	0 (0%)	3 (5.9%)
High cholesterol	1 (2.8%)	0 (0%)	1 (2%)
Coronary artery disease	0 (0%)	0 (0%)	0 (0%)
Diabetes mellitus	0 (0%)	0 (0%)	0 (0%)

Table 4: Nutrition status assigned by screening tool and dietitian assessment

Nutrition status	Female	Male	Total
Screening tool:
Not at risk	16 (44.4%)	7 (46.7%)	23 (45.1%)
At risk	14 (38.9%)	4 (26.7%)	18 (35.3%)
At high risk	6 (16.7%)	4 (26.7%)	10 (19.6%)
Dietitian assessment:
Not at risk	14 (38.9%)	6 (40.0%)	20 (39.2%)
At risk	11 (30.6%)	4 (26.7%)	15 (29.4%)
At high risk	11 (30.6%)	5 (33.3%)	16 (31.4%)

Wright L, Epp J. Development and validation of a HIV disease-specific nutrition screening tool. Top Clinic Nutr. Manuscript accepted for publication.

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Academy of Nutrition and Dietetics. Nutrition care process. (2017). [Cited 2019 March 15] https://www.eatrightpro.org/practice/practice-resources/nutrition-care-process.

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