Episodes of Undernutrition and its Predictors among Clients on Antiretroviral Treatment in Southwest Ethiopia: A Record Review

Abdu Oumer Abdu,¹ Berhanu Abebaw Mekonnen<sup>2

1</sup>Department of Public Health, College of Heath Sciences and Medicine, Wolkite University, Wolkite, Ethiopia; ²Department of Nutrition and Dietetics, School of Public Heath, Bahir Dar University, Bahir Dar, Ethiopia

Correspondence: Abdu Oumer Abdu Email phnabu@gmail.com

Background: More than a quarter of people living with human immune virus had increased burden of malnutrition leading to poor disease progression and survival. However, evidence on predictors for episodes of malnutrition is limited despite its importance for targeted interventions. This paper assessed the episodes of undernutrition and its predictors among HIV-positive adults on treatment in southwest Ethiopia.
Methods: A facility-based cross-sectional study using secondary data was conducted among 519 randomly selected records of adult clients on antiretroviral treatment. Malnutrition was assessed using the records of weight and height at different points of follow-up (0, 6, 12, 18, and 24 months of ART follow-up). Analysis of variance, covariance, and spaghetti plot were done to compare the mean change in body mass index. To assess predictors of malnutrition episodes, a linear mixed model was used with parameter estimate with 95% confidence interval and P-values were estimated via maximum likelihood method. Akaike’s information criteria was used for model fitness.
Results: A total of 480 records were reviewed with a mean age of 36 years (± 9 years). A total of 354 (73.8%) and 34.6% of clients got dietary counseling and support, respectively. Statistically significant improvement in mean BMI after initiating treatment (P-value=0.0001) was observed. Being male (β=− 0.72; P=0.044), having problems of eating difficulty (β=− 1.61; P=0.0001), anemia (β=− 1.51; P=0.003), shorter follow-up intervals (β=0.04; P=0.129), not getting nutritional counseling (β=0.63; P=0.32), and diarrheal disease (β=− 0.04; P=0.129) were predictors of undernutrition.
Conclusion: Improvement in nutritional status after initiation of ART was seen. The presence of eating disorder, anemia, not getting nutritional counseling, and the short follow-up interval predict undernutrition.

Keywords: episodes of undernutrition, southwest Ethiopia, linear mixed model, antiretroviral treatment