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

Figures & data

Table 1 Bivariable Logistic Regression of Socio-Demographic and Economic Factors Among Adult PLHIV and Attending ART at Goba Hospital, Bale Zone, Southeast Ethiopia, March 16 to May 26, 2019

Characteristics	Cases, n (%)	Controls, n (%)	COR (95% CI)	P-value
Age group
18–24	6 (6.7)	9 (5.1)	1.36 (0.43–4.32)	0.598
25–34	24 (27)	68 (38.9)	0.72 (0.36–1.44)	0.355
35–44	37 (41.6)	53 (30.3)	1.43 (0.75–2.76)	0.290
≥45	22 (24.7)	45 (25.7)	1
Sex
Female	58 (65.2)	95 (54.3)	1
Male	31 (34.8)	80 (45.7)	0.64 (0.37–1.10)	0.091 ^*
Residence
Urban	57 (64)	122 (69.7)	1
Rural	32 (36)	53 (30.3)	1.29 (0.75–2.22)	0.352
Ethnicity
Oromo	58 (65.2)	114 (65.1)	1
Amhara	30 (33.7)	58 (33.1)	1.02 (0.59–1.75)	0.952
Others ^a	1 (1.1)	3 (1.8)	0.66 (0.07–6.44)	0.717
Religion
Orthodox	49 (55.1)	111 (63.4)	1
Muslim	31 (34.8)	49 (28)	1.40 (0.82–2.51)	0.209
Protestant	9 (10.1)	15 (8.6)	1.34 (0.56–3.32)	0.500
Marital status
Married	51 (57.3)	108 (61.7)	1
Divorced/separated	13 (14.6)	21 (12)	1.31 (0.61–2.83)	0.489
Widowed	13 (14.6)	20 (11.4)	1.38 (0.64–2.98)	0.418
Single	12 (13.5)	26 (14.9)	0.98 (0.46–2.11)	0.953
Educational status
Formal education	59 (66.3)	138 (78.9)	1
No formal education	30 (33.7)	37(21.1)	1.90 (1.07–3.35)	0.028 ^**
Occupation
Housewife	28 (31.5)	42 (24)	1
Farmer	17 (19.1)	33 (18.9)	0.77 (0.36–1.65)	0.504
Daily laborer	15 (16.9)	34 (19.1)	0.66 (0.31–1.43)	0.295
Merchant	14 (15.7)	30 (17.1)	0.70 (0.32–1.55)	0.379
Jobless	9 (10.1)	22 (12.6)	0.61 (0.25–1.53)	0.293
Gov’t employee	6 (6.7)	14 (8)	0.64 (0.22–1.87)	0.418
Average monthly income in Ethiopian Birr
≤1,000	50 (56.2)	75 (42.9)	1.42 (0.69–2.89)	0.331
1,001–2,000	24 (27)	68 (38.9)	0.75 (0.35–1.63)	0.470
>2,000	15 (16.9)	32 (18.3)	1
Source of drinking water
Piped water	59 (66.3)	127 (72.6)	1
Public tap	27 (30.3)	41 (23.4)	1.42 (0.80–2.52)	0.235
Spring/well	3 (3.4)	7 (4)	0.92 (0.23–3.69)	0.909
Family size
≤3	52 (58.4)	115 (65.7)	1
>3	37 (41.6)	60 (34.3)	1.36 (0.81–2.30)	0.246

Notes:

a Wolaita=1, Tigre=3,

* Significant at P<0.20,

** Significant at P<0.05.

Abbreviation: COR, crude odds ratio.

Table 2 Bivariable Logistic Regression of Nutrition-Related Characteristics Among Adult PLHIV and Attending ART at Goba Hospital, Bale Zone, Southeast Ethiopia, March 16 to May 26, 2019

Characteristics	Cases, n (%)	Controls, n (%)	COR (95% CI)	P-value
Household food insecurity
Food secure	53 (59.6)	147 (84.0)	1
Food insecure	36 (40.4)	28 (16.0)	3.57 (1.99–6.40)	<0.001 ^**
Dietary diversity score
Inadequate	42 (42.7)	63 (36.0)	1.59 (0.95–2.67)	0.079 ^*
Adequate	47 (52.8)	112 (64.0)	1
Dietary counseling
No	31 (34.8)	41 (23.4)	1.75 (0.99–3.01)	0.051 ^*
Yes	58 (65.2)	134 (76.6)	1
Meal frequency
<3/day	11 (12.4)	16 (9.1)	1.40 (0.62–3.16)	0.416
≥3/day	78 (87.6)	159 (90.9)	1
Eating difficulty
No	64 (71.9)	141 (80.6)	1
Yes	25 (28.1)	34 (19.4)	1.62 (0.89–2.94)	0.112 ^*

Notes:

* Significant at P<0.20,

** Significant at P<0.05.

Table 3 Bivariable Logistic Regression of Psychosocial and Substance Use Characteristics Among Adult PLHIV and Attending ART at Goba Hospital, Bale Zone, Southeast Ethiopia, March 16 to May 26, 2019

Characteristics	Cases, n (%)	Controls, n (%)	COR (95% CI)	P-value
Living condition
Family	70 (78.7)	128 (73.1)	1
Alone	14 (15.7)	34 (19.4)	0.75 (0.38–1.49)	0.418
Parent	5 (5.6)	13 (7.5)	0.70 (0.24–2.05)	0.520
Depression (PHQ score)
No (<5 point)	47 (52.8)	130 (74.3)	1
Yes (≥5 point)	42 (47.2)	45 (25.7)	2.58 (1.51–4.42)	0.001 ^**
Disclosure status
No	29 (32.6)	64 (36.6)	1
Yes	60 (67.4)	111 (63.4)	1.19 (0.69–2.05)	0.522
Current alcohol consumption (in the last 30 days)
No	67 (75.3)	161 (92.0)	1
Yes	22 (24.7)	14 (8.0)	3.78 (1.82–7.82)	0.001 ^**
Alcohol consumption in the last 12 months
No	66 (74.2)	156 (89.1)	1
Yes	23 (25.8)	19 (10.9)	2.86 (1.46–5.61)	0.002 ^**
Current cigarette smoking (in the last 30 days)
No	83 (93.3)	168 (96.0)	1
Yes	6 (6.7)	7 (4.0)	1.74 (0.56–5.33)	0.336
Ever smoking cigarette after starting ART
No	81 (91.0)	163 (93.1)	1
Yes	7 (7.9)	11 (6.3)	1.27 (0.48–3.41)	0.631
Current khat chewing (in the last 30 days)
No	83 (93.3)	168 (96.0)	1
Yes	6 (6.7)	7 (4.0)	1.74 (0.57–5.33)	0.336
Ever khat chewing after starting ART
No	83 (93.3)	165 (94.3)	1
Yes	6 (6.7)	10 (5.7)	1.19 (0.42–3.39)	0.741

Notes:

** Significant at P<0.05.

Abbreviations: ART, antiretroviral therapy; PHQ, Patient Health Questionnaire.

Table 4 Bivariable Logistic Regression of Disease and Treatment Relate Factors Among Adult PLHIV and Attending ART at Goba Hospital, Bale Zone, Southeast Ethiopia, March 16 to May 26, 2019

Characteristics		Cases, n (%)	Controls, n (%)	COR (95% CI)	P-value
WHO clinical stage
Stage I		51 (57.3)	110 (62.9)	1
Stage II		15 (16.9)	30 (17.1)	1.08 (0.53–2.18)	0.833
Stage III		14 (15.7)	21 (12.0)	1.44 (0.68–3.05)	0.345
Stage IV		9 (10.1)	14 (8.0)	1.39 (0.56–3.41)	0.477
CD4 cell count
<200 cell/μL		15 (16.9)	24 (13.7)	1.80 (0.82–3.96)	0.144 ^*
200–500 cell/μL		49 (55.0)	79 (45.1)	1.79 (1.00–3.18)	0.049 ^**
>500 cell/μL		25 (28.1)	72 (41.1)	1
ART Regimen
AZT+3TC+EFV		6 (6.7)	9 (5.1)	1
AZT+3TC+NVP		12 (13.55	24 (13.7)	0.75 (0.22–2.60)	0.650
TDF+3TC+NVP		15 (16.9)	33 (18.9)	0.68 (0.21–2.26)	0.532
TDF+3TC+EFV		51 (57.3)	105 (60.0)	0.73 (0.25–2.14)	0.568
Second line		5 (5.6)	4 (2.3)	1.88 (0.35–9.98)	0.461
Duration of ART
<12 months		3 (3.4)	10 (5.7)	0.51 (0.14–1.93)	0.322
12–36 months		29 (32.6)	68 (38.9)	0.73 (0.42–1.25)	0.248
>36 months		57 (64.0)	97 (55.4)	1
Adherence to ART
Adherent		64 (71.9)	153 (87.4)	1
Non-adherent		25 (28.1)	22 (12.6)	2.72 (1.43–5.17)	0.002 ^**
Opportunistic infections (in the past 6 months)
Tuberculosis	No	78 (87.6)	167 (95.4)	1
	Yes	11 (12.4)	8 (4.6)	2.94 (1.14–7.61)	0.026 ^**
Chronic diarrhea	No	83 (93.3)	168 (96)	1
	Yes	6 (6.7)	7 (4)	1.74 (0.56–5.33)	0.336
Oral candidiasis	No	84 (94.4)	170 (97.1)	1
	Yes	5 (5.6)	5 (2.9)	2.02 (0.57–7.18)	0.275
Oral thrush/ulcer	No	85 (95.5)	170 (97.1)	1
	Yes	4 (4.5)	5 (2.9)	1.60 (0.42–6.11)	0.492
Pneumocystis carinii	No	87 (97.8)	171 (97.7)	1
Pneumonia (PCP)	Yes	2 (2.2)	4 (2.3)	0.98 (0.18–5.47)	0.984
Anemia status
Normal		56 (62.9)	128 (73.1)	1
Anemic		33 (37.1)	47 (26.9)	1.61 (0.93–2.77)	0.089 ^*

Notes:

* Significant at P<0.20,

** Significant at P<0.05.

Table 5 Factors Associated with Undernutrition in Adult PLHIV Attending ART at Goba Hospital, Bale, Southeast Ethiopia, March 16 to May 26, 2019

Characteristics	Cases, n (%)	Controls, n (%)	COR (95% CI)	AOR (95% CI)
Sex
Female	58 (65.2)	95 (54.3)	1
Male	31 (34.8)	80 (45.7)	0.64 (0.37-1.10)	0.58 (0.32-1.05)
Educational status
Formal education	59 (66.3)	138 (78.9)	1
No formal education	30 (33.7)	37 (21.1)	1.90 (1.07–3.35)
Household food insecurity
Food secure	53 (59.6)	147 (84)	1	1
Food insecure	36 (40.4)	28 (16)	3.57 (1.99–6.40)	3.24 (1.72–6.08) ^**
Dietary diversity score
Inadequate	42 (47.2)	63 (36)	1.59 (0.95–2.67)
Adequate	47 (52.8)	112 (64)	1
Dietary counseling
No	31 (34.8)	41 (23.4)	1.75 (0.99–3.01)
Yes	58 (65.2)	134 (76.6)	1
Eating difficulty
No	64 (71.9)	141 (80.6)	1
Yes	25 (28.1)	34 (19.4)	1.62 (0.89–2.94)
Depression (PHQ score)
No (<5 points)	47 (52.8)	130 (74.3)	1	1
Yes (≥5 points)	42 (47.2)	45 (25.7)	2.58 (1.51–4.42)	2.07(1.16–3.72) ^*
Alcohol consumption in the last 12 months
No	66 (74.2)	156 (89.1)	1
Yes	23 (25.8)	19 (10.9)	2.86 (1.46–5.6i)
Current alcohol consumption (in the last 30 days)
No	67 (75.3)	161 (92)	1	1
Yes	22 (24.7)	14 (8)	3.78 (1.82–7.82)	3.80 (1.71–8.43) ^**
CD4 cell count
<200 cell/μL	15 (16.9)	24 (13.7)	1.80 (0.82–3.96)
200–500 cell/μL	49 (55)	79 (45.1)	1.79 (1.00–3.18)
>500 cell/μL	25 (28.1)	72 (41.1)	1
Adherence to ART
Adherent	64 (71.9)	153 (87.4)	1	1
Non-adherent	25 (28.1)	22 (12.6)	2.72 (1.43–5.17)	2.61 (1.28–5.30) ^**
Tuberculosis
No	78 (87.6)	167 (95.4)	1
Yes	11 (12.4)	8 (4.6)	2.94 (1.14–7.61)
Anemia status
Normal	56 (62.9)	128 (73.1)	1
Anemic	33 (37.1)	47 (26.9)	1.61 (0.93–2.77)

Notes:

* P<0.05,

** P<0.01.