Determinants for Effective Nutritional Counselling on Prognosis of Moderate Acute Malnutrition in Paediatric HIV/AIDS Positive Patients Conducted at Hoima Regional Referral Hospital, Uganda
Abstract
This study evaluated the determinants of effective nutritional counselling on the prognosis of moderate acute malnutrition in Paediatric HIV/AIDS patients at Hoima Regional Referral Hospital. This study used pre- and post-study design, which measured the occurrence of an outcome of interest using specific values in a group of participants before and after the intervention; it was conducted among 157 paediatric HIV/AIDS patients at Hoima RRH, western Uganda. Data were obtained from all the participants using a questionnaire, and focus group discussion was analysed using Stata 17. The findings reveal that of the 157 paediatric HIV/AIDS patients studied, 67.5% improved after nutritional counselling. Paediatric HIV/AIDS patients aged ≥ 60 months (p = 0.009), caretakers whose occupations other than peasantry (p = 0.021), and attendance to ≥ 3 nutritional counselling sessions (p = 0.004) were associated with a higher likelihood of improvement after nutritional counselling with a significant increase in Body Mass Index of (p = 0.007). Thus, the majority of Paediatric HIV/AIDS patients indicated a significant improvement in prognosis after nutritional counselling and being aged ≥ 60 months, having an attendance of ≥ 3 sessions and having a caretaker’s occupation other than peasantry determined the effectiveness of nutritional counselling. The study concludes that there is a need to routinely refer Paediatric HIV/AIDS patients with moderate acute malnutrition for nutritional counselling
Downloads
References
Aggarwal R., Ranganathan P. (2019). Study designs: Part 4 - Interventional studies. Perspect Clin Res. 2019 Jul-Sep;10(3):137-139. doi: 10.4103/picr.PICR_91_19.
Ashley Crossman (2018). Understanding Purpose sampling; An overview of its method and applications.
Audian, A. K., Zotor, F. B., Amuna, P. and Ellah, B. (2015). Feeding among the HIV infected patients in Sub Saharan Africa: Impact on Treatment Adherence and Weight gain. Proc Nutr Soc (1-9.)
Aziiza, N., Per-Ole, I and Margret, K. (2018). Realisation of the Right to adequate food and nutritional status of land evictees: a case for mothers/caregivers and their children in rural central Uganda. BMC
Batana, Y., Cockburn, J., Kasirye I., Tiberti, L. and Ahaibwe, G. (2014). Situation Analysis of Child Poverty and Deprivation in Uganda. SSRN Electronic Journal; doi: 10.2139/ssrn.2463210.
Benzekri, N., Sambou, J., Diaw, B., El, HS., Sall, F., Niang, A, et al. (2015). High prevalence of food insecurity and malnutrition among HIV-infected adults in Senegal, West Africa. PLos ONE; 10: e0141819.
Bhutta, ZA., Das, JK., Walker, N., Rizvi, A., Campbell, H and others (2013). “Interventions to Address Deaths from Childhood Pneumonia and Diarrhea Equitably; What Works and at What Cost?” The Lancet381 (9875):1417-29
Bradley, CF., Bavon, M., Jean, L., Faustin, K., Carol, G and Frieda, B. (2011). Barriers to and facilitators of adherence to pediatric antiretroviral therapy in a sub-Saharan setting: insights from a qualitative study. PMID: 21823909, PMCID: PMC4530354, DOI: 10.1089/apc.2011.0083
Braun, V., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. Sage.
Calixte Ida Penda et al., (2018) Malnutrition among HIV infected children under 5 years of age at the Laquintinie hospital Douala, Cameroon. The Pan African Medical Journal doi: 10.11604/pamj.2018.30.91.15832
David, C., Linda, A., Dina, M.H., Siew, M.F., Rawiwan, H., Pagakrong, L., Lam, V. N., Torsak, B., Viet, C.D., Kumarul, A.R. and Azar, K. (2016). Antiretroviral Therapy in Severely Malnourished, HIV-Infected Children in Asia. The Pediatric Infectious disease journal; 35(5): e144e151.
Delelegn, Y.G., Kokeb, T.H., Ermiyas, M.K. and Robel, T.Z. (2018). Food Insecurity, Nutritional Status and Factors Associated with Malnutrition among PLWHA attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia. Biomedical Research International: Volume 2018. Article ID 19135534, 9 pages.
Delvarianzadeh, M., Khosravi, F. & Taghavi, N. (2017). Factors affecting nutritional counselling on malnutrition as failure to thrive (FTT) in children under 2years of age in Shahroud, Iran in 2015, Health Scope; 6(3): e14176. Doi: 10.5812/jhealthscope.14176. doi: https://doi.org/10.1101/2021.01.16.21249861
Edem, M., Tette, A., Eric, K.S. & Edmund, T. (2015). Factoring affecting malnutrition in children and uptake of interventions to prevent the condition. BMC Pediatrics, 15 Article number:189
Endris, N., Asefa, H. and Dube, L. (2015). Prevalence of Malnutrition Associated Factors among Children in Rural Ethiopia. BioMed Research International, Vol (3):1-6
Ersilia, B. Simona, D.L., Dyna, T. & Cristina, M.M. (Feb, 2012). Nutritional Rehabilitation of HIV-Exposed Infants in Malawi: Results from the Drug Resources Enhancement against AIDS and Malnutrition Program, International Journal of Environmental Research and Public Health: 9(2):421-34
Food and Nutrition Technical Assistance III Project (FANTA) - (2016) Nutrition Assessment, Counselling and Support (NACS): A Users Guide – Module 3: Nutrition, Education and Counselling, Version 2. Washington DC: FHI 360/FANTA.
Global Nutrition Report 2018: Shining a light to spur action on nutrition.
Gluning, I., Kerac, M., Bailey, J., Bander, A and Opondo, C. (2021). The management of Moderate Acute Malnutrition (MAM) in children aged 6-59 months: A systematic review and meta-analysis. The Royal Society of Tropical Medicine and Hygiene doi: 10.1093/trstmh/trab137
Greenblott, Kara, and Nzinga International (2012). The Debilitating Cycle of HIV, Food Insecurity, and Malnutrition: Including a Menu of Common Food Security and Nutrition Interventions for Orphans and Vulnerable Children. Arlington, VA: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAROne, Task Order
Health Institute for Work and Health (2016). “Validity and reliability”: What researchers mean by Quality, Accuracy, Integrity, and Validity; Research Excellence Advancing Employee Health.
Humphrey, W., Richard, M., Marzia, L. (2018). Quality of care for children with acute malnutrition at Health Centre level in Uganda: a cross sectional study in West Nile region during the refugee crisis. BMC Health Services 18, Article number:561
Ickeset, S.B., Baguma, C., Brahe, C.A., Myhre, J.A., Adair L. S., Bentley, M.E., Ammarman, A.S. (2017). Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study. BMC Nutr 3, 32 (https://doi.org/10.1186/s40795-017-0140-8
Inaya Hajj Hussein, Lara Youssef, Andrea Mladenovic, Angelo Leone, Abdo Jurjus, Virginia Uhley (2020). HIV-Infected Children and Nutrition: The Friend and The Foe: DOI: 10.5772/intechopen.85417.
Jessen, J., David, M., Arsen, A., Caroline, T., Greth, S., Sophie, D., Akossiwa, K., Gustave, G. et al. (2015). Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study; doi:10.1186/s12879-015-0952-6.
Jessen, J., David, M., Arsen, A., Caroline, T., Greth, S., Sophie, D., Akossiwa, K., Gustave, G. et al. (2015). Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study; doi:10.1186/s12879-015-0952-6.
Johri, M., Subramanian, SV., Kone, GK et al. (2016). Maternal health literacy is associated with early childhood nutritional status in India. J Nutr; 146:1402-10.
Julie, J., David, M., Arsen, A., Caroline, T., Greth, S., Sophie, D., Akossiwa, K., Gustave, G. et al. (2015). Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study; doi:10.1186/s12879-015-0952-6.
Kissa, BM.K., Roosmarijin, V., Kimberly, P., Peter, SM., Patrick, W. & Carl, L. (2014). Effectiveness of a nutritional education package in improving feeding practices, dietary adequacy and growth of infants and young children in rural Tanzania. BMC Public Health 14, Article number:1077.
Krawinkel, MB. (2012). Interaction of nutrition and infections globally: an overview. Ann. Nutr Metab; 61:39-45
Kudakwashe, C.T., Tsitsi, M.A., Owen, M., (2017). Malnutrition status and associated factors among HIV-positive patients enrolled in ART Clinics in Zimbabwe. BMC Nutrition3, Article number:15
Leigh F. Johnson,et.al (2020) Steep declines in pediatric AIDS mortality in South Africa, despite poor progress towards pediatric diagnosis and treatment targets. PUBMED doi: 10.1097/INF.0000000000002680
Lodha, R., Kabra, SK. (2015). Health and nutritional status of HIV infected children. Indian J Med Res: 141:10-2.)
Mehta, K., Ekstrand, M.L., Heylen, E., Sanjeev, G.N. and Shet, A. (2017). Adherence to antiretroviral therapy among children living with HIV in South India. doi: 10:1007/s10461-015-1207-7).
Mengistu.K., Alemu. K., Destaw. B. (2014). Prevalence of Malnutrition and Associated factors among Children Aged 6-59months at Hidabu Abote District, North Shewa, Oromia Regional State. J Nutr Disorders Ther T1:001. Doi:10.4172/2161-0509.T1-001
Menon, P., Cyriac, S., Coastes, SJ., & Aguavo, VM. (2013). “Diet Quality, Water and Toilets: What Roles for Child Undernutrition in India?” In Annals of Nutrition and Metabolism, edited by Gil, A. Martinez, Granada JA, Editors…. Spain: 20th International Congress of Nutrition.
Ministry of Health (2011). Uganda Nutrition Action Plan 2011-2016: Scaling Up Multi-Sectoral Efforts to Establish a Strong Nutrition Foundation for Uganda’s Development. Comprehensive national nutrition policy.
Moramrco, S., Amerio, G., Chaful, M.L., Bonvecchio, D., Abrmo, E. and Buonomo, E. (2017). Nutritional counselling improves dietary diversity and feeding habits of Zambian malnourished children admitted in Rainbow nutritional programs. Biomedicine and Prevention issues; Volume 1– (93)- doi:1019252/00000005D
Mukona, D. Matara, F., & Mathilda, Z. (2015). Factors contributing to malnutrition among HIV positive children aged between 6 and 60 months. IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 4, Issue 1 Ver. II (Jan.-Feb. 2015), PP 62-71 www.iosrjournals.
Mwiru, RS., Spiegelman, D., Duggan, C., et al. (2015). Nutritional status and other baseline predictors of mortality among HIV -infected children initiating therapy in Tanzania. J Int Assoc Phys AIDS Care. 14(2):172-179.
Nalwoga, A., Dermot, M., Jim, T. & Kabarinde, A. (2010). Nutritional status of children living in a community with high HIV prevalence in rural Uganda: a cross sectional population based- survey. https://doi.org/10.1111/j.1365-3156.2010.02476.x
Nancy Nevin-Folino et al., (2015) Academy of Nutrition and Dietetics: Revised 2015 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Pediatric Nutrition. DOI: https://doi.org/10.1016/j.jand.2014.12.005
Nicolas, P.N., Calitxe, I.P., Carol E., Nadia, O., Abomo, E. & Paul, N. (2018). Malnutrition among the HIV-infected children under 5years of age at the Laquintinie hospital Douala, Cameroon. The Pan African Medical Journal; 30:91
Nyeko,R et al., (2016) Treatment outcome among children under-five years hospitalised with severe acute malnutrition in St. Mary’s hospital Lacor, Northern Uganda. Treatment outcome among children under-five years hospitalised with severe acute malnutrition in St. Mary’s hospital Lacor, Northern Uganda. https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-016-0058-6
Oumer, A., Kubsa, M.E. & Mekonnen, B.A (2019). Malnutrition as predictor of survival from antiretroviral treatment among children living with HIV/AIDS in Southwest Ethiopia: survival analysis. BMC Pediatr 19, 474. https://doi.org/10.1186/s12887-019-1823-x
Pedraza, DF., & Gama, JS., (2015). Food and nutrition security in families with children under 5 years old in the city of Campina Grande, Rev Bras Epidemiol; 18:906-17
Pragati, C., Mukta, A. & Rameshwar L.S. (2018). Management of moderate acute malnutrition: Comparison of different approaches. Asian Journal of Clinical Nutrition; volume 10/Issue:1/Page NO:47-57. DOI:10.3923/ajcn.2018.47-57.)
Pridmore, P. & Carr-Hill, R. (2010). Tackling the drivers of child undernutrition in developing countries: what works and how should interventions be designed? Public Health Nutrition, Available on CJO; doi: 10.1017/S1368980010001795.
Sajama, N., Padam, S. & Ian, D. (2019). Trends and inequalities in stunting in Nepal: a secondary data analysis of the Nepal demographic health surveys from 2001 to 2016. BMC Nutrition 5, Article number: 19 https://doi.org/10.1186/s40795-019-0283-x.
Sasi,J et.al (2020) Survival and HIV-Free Survival Among Children Aged ≤3 Years — Eight Sub-Saharan African Countries, 2015–2017. PMCID doi: 10.15585/mmwr.mm6919a3
Sera, Y., Amanda, W., Sandi, Mc., Sheri, D.W (2014). A review of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS. AIDS Behav. Oct;18(05): 505-515
Smith Scott (2013). “Determining the sample size, how to ensure you get the correct sample size”. Qualtrics
Sunguya BF., Poundel, KC., Mlunde, LB., Shakya, P., Urassa, DP. Et al. (2013). Effectiveness of nutrition training of health workers towards improving caregivers feeding practices for children aged 6months-2years: a systematic review. Nutr J 12:66.
Sunguya, B.F., Poudel, K.C., Otsuka, K. et al. (2011). Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough. BMC Public Health 11, 869 https://doi.org/10.1186/1471-2458-11-869
Sunguya, B.F., Poudel, K.C., Otsuka, K. et al. (2011). Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough. BMC Public Health 11, 869 https://doi.org/10.1186/1471-2458-11-869
Swetha, GK., Hemalatha, R., Prasad, UV. et al. (2015). Health and nutritional status of HIV-infected children in Hyderbad, India. Indian Med Res: 141:46-54.)
The Ethiopia Demographic and Health Survey (2011). https://dhsprogram.com/pubs/pdf/fr255/fr255.pdf
The Uganda Bureau of Statistics and ICF (2018). Uganda Demographic Health Survey 2016. Kampala, Uganda: UBOS and Rockville, Maryland, USA: UBOS and ICF.
UNAIDS (2017). “Ending AIDS: Progress towards the 90-90-90- targets”
UNICEF (2019). UNICEF/WHO/WORLD BANK: Joint Child Malnutrition Estimates (country level) data.unicef.org/topic/nutrition/malnutrition/
United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019: Highlights. ST/ESA/SER. A/423.
USAID (2014). Food Security and HIV Nutrition. Multi-sectoral Nutritional Strategy 2014-2015; Technical Guidance Brief.
WHO (2012). Ministry of Agriculture, Animal Industry, and Fisheries and Ministry of Health. Comprehensive national nutrition policy, strategy or plan
WHO (2016). Nutrition: Double burden of malnutrition.
WHO (2018) https://www.afro.who.int/health-topics/hivaids
WHO (2018). HIV diagnosis and ARV use in HIV-exposed infants: a programmatic update July 2018.
World Food Program (2016). World Food Program in State of Nepal: Restoring Food and Nutrition Security and Building Resilient Livelihoods in Earthquake affected Areas. Standard Project Report.
Yasuoka, J., Okawa,S., Sovannary, T., Makoto, M., Pheak, C., Sokunthea, Y., Kazuki, Y. (2020). Nutritional status and dietary diversity of school age children living with HIV: a cross sectional study in Phnom Penh, Cambodia. BMC Health ,1181
Yikii, F., Turyahabwe, N. & Bashaasha, B. Prevalence of household food insecurity in wetland adjacent areas of Uganda. Agric & Food Secur 6, 63 (2017). https://doi.org/10.1186/s40066-017-0147-z
Yoshida, S., Matsushima, M., Wakabayishi, H., Mutai, R., Murayama, S., Hayashi, T., Ichikawa, H., Nakano., Y., Wanatabe, T., & Fujinuma, Y. (2016). Validity and Reliability of the Patient Centered Assessment Method for Patient Complexity and Relationship with Hospital Length of Stay: a prospective Cohort Study. BMJ Open, 7(e016175)
Zhang, Y., Huang, X., Yang, Y., Liu, X., Yang C. and Wang, A. (2018). Double burden of malnutrition among children in under 5 in poor areas of China. PLoS ONE 13(9): e0204142.
Copyright (c) 2023 Emily Abigaba, Irene Aheisibwe, PhD
This work is licensed under a Creative Commons Attribution 4.0 International License.
