Undernutrition and associated factors among adults HIV positive on antiretroviral therapy (ART) in hospitals of East Hararge Zone, Oromia, Ethiopia

Abstract

Background: Undernutrition and HIV are major public health problems which contribute to high morbidity and mortality particularly in sub-Saharan Africa and they linked in vicious cycle. Opportunistic infections like diarrhea worsen the effect of undernutrition in HIV positive adults. The magnitude of udernutrition and its associated factors didn’t understand well in Eastern part of Ethiopia. Objective: The objective of this study was to assess the magnitude of undernutrition among HIV positive adults on Anti-Retrviral Therapy (ART) and associated factors in hospitals of East Hararge zone, Oromia region, Ethiopia from April to July 2016. Methods: Health facility based cross-sectional study design was used. Data were collected using pretested structured questionnaire among randomly selected 459 HIV positive adults on ART services. Basic descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were used to assess the association between outcome variable and explanatory variables. Odds ratio along with 95% CI was estimated to measure the strength of association. Level of statistical significance was declared at p value less than 0.05. Result: The prevalence of undernutrition (BMI≤18.5kg/m2 ) was 30%. The mean BMI was 20.3 SD ± 2.9kg/m2. In the multivariate logistic regression analysis undernutrition was significantly associated with CD4 (200-500) [AOR=0.576 95% CI (0.338, 0.979)] and CD4 greater than 500 [AOR=0.431 95%CI, 0.239-0.778)], duration on ART greater than 12 months [AOR=0.466 95%CI (0.224,0.966)], unable to get nutritional care and support [AOR=2.188 95%CI (1.349,3.549)], diarrhea [AOR=1.641 95%CI (1.036, 2.6)], khat chewing [AOR=0.589 95%CI (0.377, 0.92)], and severe food insecure[AOR= 1.594 95%CI(1.008, 2.521)]. Conclusion and recommendation: the prevalence of undernutrition was found to be high as in East Hararge zone hospitals. Diarrhea, Severe food insecurity, nutritional care and support, khat chewing, CD4 greater than 200/µl, and duration on ART greater than 12 months were independently significant factors affecting undernutrition. Comprehensive nutritional assessment, engaging to IGAs and Early management of OI were recommended.