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Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study.

ABSTRACT: Background:Undernutrition and HIV/AIDS are highly prevalent in sub-Saharan Africa, Ethiopia inclusive as linked in a vicious cycle. Thus, several studies have documented that undernutrition among HIV/AIDS patients increases the risk of mortality, decrease survival rates, affect the overall clinical outcome and quality of life.Despite this fact, information about the burden of undernutrition and associated factors among adults receiving antiretroviral therapy is lacking in the particular study area. Hence, this study aimed to examine the prevalence of undernutrition and associated factors among adult HIV/AIADS patients receiving antiretroviral therapy patients in Eastern Zone of Tigray, Northern Ethiopia. Methods:A cross-sectional research design was adopted in data collection while systematic sampling technique was employed to sample and select the study subjects. A structured questionnaire was used to collect information from 394 study subjects through face to face method.Also, data on demographics, laboratory and anthropometric variables were collected from each selected patients sampled.The data collected were entered and analyzed using SPSS version 22.. Bivariate and multivariable logistic regression analysis with 95% confidence interval were used to find factors associated with undernutrition. The adjusted odds ratio was calculated to show the strength of the association. Variables with p-value of

SUBMITTER: Gebru TH

PROVIDER: S-EPMC7559062 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study.

Gebru Tsegu Hailu TH Mekonen Haftea Hagos HH Kiros Kbrom Gemechu KG

Archives of public health = Archives belges de sante publique 20201015

<h4>Background</h4>Undernutrition and HIV/AIDS are highly prevalent in sub-Saharan Africa, Ethiopia inclusive as linked in a vicious cycle. Thus, several studies have documented that undernutrition among HIV/AIDS patients increases the risk of mortality, decrease survival rates, affect the overall clinical outcome and quality of life.Despite this fact, information about the burden of undernutrition and associated factors among adults receiving antiretroviral therapy is lacking in the particular ...[more]

PMID: 33072319

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Project description:BackgroundStarting from the ancient time, the people of Ethiopia use medicinal plants as traditional medicine to heal different human and livestock ailments. This ethnobotanical study of medicinal plants was carried out in Ganta Afeshum District, Eastern Zone of Tigray, Northern Ethiopia, to identify medicinal plant species used by the local community to treat various human and livestock ailments.MethodsA total of 78 informants (54 men and 24 women) were selected to collect ethnobotanical information from four study sites. Among the 78 informants, 20 key informants were selected purposefully; the other 58 informants were selected randomly by lottery method. Ethnobotanical data were collected using semi-structured interviews, field observations, guided field walks, and group discussions and were analyzed by preference ranking, paired comparison, direct matrix ranking, informant consensus factor, fidelity level (FL), use-value, independent samples t test, and Pearson correlation coefficients.ResultsA total of 173 medicinal plants were collected and identified that were distributed across 77 families and 156 genera. The family Fabaceae stood first by contributing 17 (9.8%) species followed by Lamiaceae and Solanaceae with 9 (5.2%) species each. Rhamnus prinoides was reported for the treatment of many of the described diseases. One hundred sixteen (67.1%) medicinal plant species were collected from natural vegetation, 34 (19.7) were from home gardens, 13 (7.5%) from farmland, and 10 (5.8%) were from natural vegetation and home gardens. The most widely used life form was herbs (69 species, 39.9%) followed by shrubs (58 species, 33.5%). The most commonly used part of the medicinal plants was the leaves followed by roots. The plants were prepared by grinding, powdering, squeezing, roasting, and burning and were administered through oral, dermal, nasal, anal, ocular, and vaginal, and on the surface of the teeth. The most commonly used applications were by drinking, smearing, eating, fumigation, and chewing. There was no difference between men and women informants, showing that the two sexes had similar knowledge in the use of traditional medicinal plants. Educational level and medicinal plant knowledge of informants were negatively correlated; whereas age and medicinal plant knowledge of informants were positively correlated.ConclusionsGanta Afeshum District is relatively rich in diversity of medicinal plant resources accompanied with a rich indigenous knowledge within the local communities to harvest and effectively use to prevent different human and livestock ailments. However, nowadays, deforestation, agricultural expansion, overgrazing, drought, and overexploitation are threatening these properties. Therefore, people of the study area should apply complementary conservation approaches (in situ and ex situ) for sustainable use of these resources and to prevent species extinction.

Project description:BackgroundMaternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia.MethodsNutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates.ResultsThe overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively.ConclusionsEfforts to ameliorate maternal undernutrition need to consider the influence of the rising epidemiology of adult mortality from chronic diseases. Our data clearly indicate the need for channeling the integrated intervention power of nutrition-sensitive development programs with that of nutrition-specific sectoral services.

Project description:BackgroundTreatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia.MethodsRetrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure.ResultThe incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73)].Similarly, lower CD4 count (<100 m3/dl) at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84).Bedridden [AHR = 5.02; 95% CI: (1.98-12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing treatment failure [AHR = 7.0, 95% CI: (3.19-15.37)]. Similarly having fair [AHR = 4.99 95% CI: (1.90-13.13)] and poor drug adherence [AHR = 2.56; 95% CI: (1.12-5.86)]were significantly associated with higher odds of treatment failure as compared to clients with good adherence.ConclusionThe rate of treatment failure in Bale zone hospitals needs attention. Prevention and control of TB and other opportunistic infections, promotion of ART initiation at higher CD4 level, and better functional status, improving drug adherence are important interventions to reduce treatment failure among ART clients in Southeastern Ethiopia.

Project description:BackgroundMedicinal plants have been used for ages in Ethiopia. Some 887 plant species have been documented to heal human and livestock health problems. Documenting the traditional use of medicinal plants is a vital step in obtaining information on bioactive chemicals, preserving indigenous knowledge and ultimately interesting, medicinal plant species. We conducted this study with the aim of documenting the ethnobotanical knowledge associated with medicinal plant use in Adwa District, Northern Ethiopia.MethodsThe study was conducted from September 2018 to December 2019. A total of 393 informants (242 males and 151 females) were selected. Data were collected using semi-structured interviews, guided walks and group discussions. We calculated informant consensus factors (ICF) and fidelity level (FL) and performed ranking and paired comparisons. Data were analysed using descriptive statistics, including independent sample t test and ANOVA.ResultsOverall, we documented 127 medicinal plants belonging to 105 genera, under 54 families to be used by local people to address 43 human and 15 livestock ailments. Families Fabaceae and Solanaceae were the most important ones with 11 (8.66%) species each. Herbs were the dominant growth form (55 species), followed by shrubs (39). The most frequently used plant parts were leaves (24.27%) followed by roots (14%). The most important preparation method was crushing and pounding (42.7%) followed by fumigation (smoke and vapour) (23, 11.1%). The common route of administration was via skin application (67 or 32%) followed by oral (63, 27%). ICF showed that tonsillitis had the higher value (0.95). Cucumis ficifolius A. Rich. was the most preferred medicinal plant (36) treating abdominal pain, followed by Kalanchoe quartiniana A. Rich. for blackleg (34).ConclusionsAdwa District is relatively rich in medicinal plant diversity and traditional knowledge on use, preparation and application of the medicinal flora. However, agricultural expansion (51%), overgrazing (43%) and drought (37%) were mentioned most when informants were asked about the threats to medicinal plants in Adwa District. Hence, on-site and off-site medicinal plant conservation would help protect medicinal plants in the district.

Project description:BackgroundIn Ethiopia, undernutrition among women on antiretroviral therapy has been a major challenge to achieve the full impact of intervention. Twenty seven percent and 17% of reproductive age Ethiopian women are chronically malnourished and anemic, respectively. Most studies to examine risk factors have been limited to the general population and ART-naive HIV-positive women, making it difficult to generalize findings to ART-treated HIV-positive women. The objectives of this study were thus to assess nutritional status and associated factors among adult women (? 20 years) on antiretroviral therapy.MethodsFrom August to September we conducted an Institution based cross-sectional survey among 276 women on antiretroviral therapy in Humera Hospital, Tigray, Ethiopia. Data was collected using structured and standard face to face interview, anthropometric measurements, BD FACS (CD4 count machine) and Sysmex-21 (hemoglobin analyzer). Logistic regression was done using SPSS version 16 to identify factors that are associated with nutritional status.ResultsThe prevalence of under nutrition (Body mass index < 18.5 kg/m(2)) Was 42.3% (95% CI: 37.4% - 47.3%). Severe, moderate and mild under nutrition was detected on 12%, 10% and 20.3% respondents, respectively. The prevalence of wasting (percentage body weight loss >5%) was 75% (95% CI: 70.4% - 79.2%). Severe wasting was accounted for 26.9% of respondents.In the multivariate analysis, Household food insecurity [AOR = 1.85; 95%CI 1.16, 2.86], inadequate dietary diversity [AOR = 1.19; 95%CI 1.08, 1.75], anemia [AOR = 1.67; 95%CI 1.05, 2.65] and absence of nutritional support [AOR = 0.34 95%CI 0.22, 0.54) were found to be independent predictors of under-nutrition.ConclusionHIV/AIDS is associated with an increased burden of undernutrition even among ART treated women in Humera Hospital, Tigray, Ethiopia. In addition to ART among HIV positive women interventions to ameliorate poor nutritional status may be necessary in this and similar settings. Such interventions aimed at improving household food security, dietary diversity, micronutrient supplementation, proper use of therapeutic food, as well as treating oral candidiasis.

Project description:BackgroundPeople living with human immunodeficiency virus (HIV) with immuno-virological discordant responses are at an increased risk to develop acquired immunodeficiency syndrome (AIDS) and severe non AIDS events which are risk factors for death. This study was aimed to assess prevalence of immuno- virological discordant responses and associated risk factors among highly active antiretroviral therapy (HAART) users in Tigray, Northern Ethiopia.MethodsA cross sectional study was conducted from September to December 30, 2016 on 260 people living with HIV who started first line HAART from January 2008 to March 2016 at Mekelle hospital and Ayder comprehensive specialized hospital. Baseline and follow-up clinical data and CD4+ result were collected from patient charts. Besides, socio-demographic data and blood samples for CD4 + count and viral load measurement were collected during data collection period. Fisher's exact test, bivariate and multivariate logistic regressions were used for data analysis. P-value < 0.05 with 95% CI was considered as statistically significant.ResultAmong the 260 study participants, 8.80% (95% Confidence Interval (CI) =8.77-8.84%) and 2.70% (95% CI = 2.68-2.72%) had virological and immunological discordant responses, respectively with an overall immuno-virological discordance response of 11.50% (95% CI = 11.46-11.54%). The median age of the study participants at HAART initiation was 35 (IQR: 28-44 years). More than half (58.1%) of the study participants were females. Age at or below 35 years old at HAART initiation (AOR ((95% CI) = 4.25(1.48-12.23), p = 0.007)), male gender ((Adjusted Odds Ratio (AOR) (95% CI) =1.71(1.13-1.10), p = 0.029)), type of regimen given ((AOR(95% CI) = 0.30 (0.10-0.88), p = 0.028)) and good treatment adherence ((AOR (95% CI) = 0.12 (0.030-0.0.48), p = 0.003)) were associated risk factors for virological discordant response. Likewise, immunological discordant response was associated with tuberculosis co-infections (p = 0.016), hepatitis B virus co-infections (p = 0.05) and low CD4+ count (≤100 cells/μl) at baseline (p = 0.026).ConclusionsOver all, immuno-virological discordance response was 11.5% in the study area. Males, low baseline CD4+ count, poor/fair treatment adherence, and TB and HBV co-infections were significantly associated with higher immuno-virological discordance. We recommend that decision of patient treatment outcome, regimen change and patient management response should be done using trends of both viral load and CD4+ count concurrently.

Project description:BackgroundDelayed treatment initiation of Tuberculosis patients results in increased infectivity, poor treatment outcome, and increased mortality. However, there is a paucity of evidence on the delay in new adult pulmonary Tuberculosis patients to initiate treatment in Tigray, Northern Ethiopia.ObjectiveTo assess the factors associated with treatment initiation delay among new adult pulmonary tuberculosis patients in Tigray, Northern Ethiopia.MethodsThe study design was cross-sectional. A total of 875 new adult pulmonary tuberculosis patients were recruited from 21 health facilities from October 2018 to October 2019. Health facilities were selected by simple random sampling technique and tuberculosis cases from the health facilities were consecutively enrolled. Data were collected using structured questionnaire within the first 2 weeks of treatment initiation. Delay was categorized as patient, health system and total delays. Data were analyzed using SPSS version 21 and logistic regression was used to identify factors associated with the odds of delays to initiate treatment. A p-value of less than 0.05 was reported as statistically significant.ResultsThe median patient, health system and total delays were 30, 18 and 62 days, respectively. Rural residence, being poor, visiting non-formal medication sources, being primary health care and the private clinic had higher odds of patient delay whereas being HIV positive had lower odds of patient delay. Illiteracy, first visit to primary health care and private clinic had higher odds of health system delay whereas a visit to health facility one time and have no patient delay had lower odds of health system delay.ConclusionThe median patient delay was higher than the median health system delay before initiating treatment. Hence, improved awareness of the community and involving the informal medication sources in the tuberculosis pathways would reduce patient delay. Similarly, improved cough screening and diagnostic efficiency of the lower health facilities would shorten health system delay.

Dataset Information

Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study.

Publications

Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study.

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