PREDICTORS OF RECOVERY RATE AMONG UNDERNOURISHED ADULT PEOPLE ON ANTIRETROVIRAL THERAPY TREATED WITH READY-TO-USE THERAPEUTIC FOOD AT PUBLIC HEALTH FACILITIES OF BORENA ZONE, SOUTH EAST ETHIOPIA; A MULTICENTER RETROSPECTIVE COHORT STUDY.

Abstract

Undernutrition among people living with human immunodeficiency virus (PLHIV) is a significant public health concern. Ethiopia has tried to improve the nutritional status of these people by providing ready-to-use therapeutic (RUTF) foods. However, data are scarce on the recovery rate and its predictors among undernourished people receiving antiretroviral therapy (ART) in the study area. Objective: To assess recovery rate and its predictors among undernourished adult people on antiretroviral therapy treated with ready-to-use therapeutic food at public health facilities Borena Zone, 2023. Methods: A multicenter retrospective cohort study was conducted among all 483 undernourished adults treated with RUTF at health facilities of Borena Zone from January 2017 to December 2022. Data were collected from medical records started from November 01-30/2023. Open Data Kit version 1.25.2 and Stata 16 software were employed for data extraction and analysis, respectively and the Cox regression model was used to identify predictors of recovery rate at a 5% significance level. The Cox-proportional hazard regression model assumption was checked by using the Schoenfeld residual test. Results: In this study, 55.5% (95% CI: 51–60%) of people recovered, with an overall recovery rate of 14.2 per 100 person-month observations. Attending formal education (AHR: 1.51 [95%CI: 1.13,2.00]), presence of opportunistic infections (AHR: 0.58 [95%CI: 0.43,0.77]), WHO clinical stage I or II (AHR: 1.76 [95%CI: 1.28, 2.41]), moderate acute malnutrition (AHR: 3.63 [95% CI: 2.54, 5.20]) and newly enrolled to ART (AHR:0.59 [95%CI: 0.39, 0.89]) were independent predictors of nutritional recovery. Conclusion: The study revealed that the nutritional recovery rate was below the minimum requirement of 75% recovery. Attending formal education, WHO clinical stages I and II, presence of opportunistic infections, newly enrolled to ART, and moderate acute malnutrition at enrollment were predictors of nutritional recovery. Caregivers should prioritize people with severe malnutrition and high immune-compromised status, recommend screening, and promptly treat opportunistic infections to improve recovery among these vulnerable groups.