Time to Nutritional Recovery and Its Predictors Among Undernourished Adult Patients Living with Human Immune Deficiency Virus Attending Anti-Retroviral Therapy at Public Health Facilities in Southwest Ethiopia. A Multicenter Study.

IF 1.5 Q4 INFECTIOUS DISEASES

HIV AIDS-Research and Palliative Care Pub Date : 2022-06-14 eCollection Date: 2022-01-01 DOI:10.2147/HIV.S366655

Soresa Alemu, Sabit Zenu, Dereje Tsegaye

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Abstract

Background: Infection with the human immunodeficiency virus is one of the factors that contribute to malnutrition. Several initiatives have been launched in Ethiopia to improve HIV patients' nutritional status and achieve early recovery when malnourished patients are found. Despite these efforts, adult HIV patients' malnutrition recovery remains poor.

Objective: The objective of this study was to assess the time to recovery from undernutrition and associated factors among adult HIV patients on ART at public health facilities in Ilu Aba Bor zone, Southwest Ethiopia, 2021.

Methods: An institution-based retrospective cohort study of 374 adult HIV patients with undernutrition receiving ART at public health institutions in Southwest Ethiopia was conducted. Data were extracted from the patient's record and entered into Epi-Data version 3.1 before being exported to STATA version 14. The Kaplan-Meier method was used to estimate the time to recovery, and the difference in survival time between predictor variables was tested using the Log rank test. Weibull regression models, both bivariable and multivariable, were fitted. A p-value of 0.05 was declared statistically significant.

Results: The recovery rate was 67.7% and the median recovery time was 65 days (95% CI = 61.6-68.4) and 145 days (95% CI = 130.7-159) for MAM and SAM, respectively. Marital status (Married) (AHR = 0.61; CI = (0.43,0.86)), ART status (pre ART) AHR = 0.492; CI = (0.305,0.793), CD4 (200-350c/m3, AHR = 2.116;CI = (1.447,3.21), type of malnutrition (AHR = 0.22; CI= (0.156,0.307)), ART adherence level (AHR = 3.33, CI = (1.997,5.56)) WHO clinical staging (AHR = 0.685, CI = (0.485,0.948)), sex (male), (AHR = 0.678; CI = (0.509,0.901)) and age (35-54), (AHR = 1.86; CI = (1.408,2.47)) were predictors of recovery time.

Conclusion: Compared to previous studies, the recovery rate was high. SAM, advanced clinical stage, sex, and marital status were all negatively associated with nutritional recovery time, whereas ART adherence, CD4 count, and age were predictors. As a result, a therapeutic feeding program should focus on factors that slow recovery time.

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在埃塞俄比亚西南部公共卫生机构接受抗逆转录病毒治疗的患有人类免疫缺陷病毒的营养不良成年患者的营养恢复时间及其预测因素一项多中心研究。

背景:感染人类免疫缺陷病毒是导致营养不良的因素之一。埃塞俄比亚发起了几项倡议，以改善艾滋病毒患者的营养状况，并在发现营养不良患者时实现早期康复。尽管做出了这些努力，成年艾滋病毒患者的营养不良恢复情况仍然很差。目的:本研究的目的是评估2021年在埃塞俄比亚西南部Ilu Aba Bor地区公共卫生机构接受抗逆转录病毒治疗的成年艾滋病毒患者从营养不良中恢复的时间及其相关因素。方法:对埃塞俄比亚西南部公共卫生机构接受抗逆转录病毒治疗的374名成年营养不良艾滋病患者进行了一项基于机构的回顾性队列研究。从患者记录中提取数据，输入Epi-Data版本3.1，然后导出到STATA版本14。使用Kaplan-Meier法估计恢复时间，使用Log秩检验检验预测变量之间的生存时间差异。拟合了双变量和多变量威布尔回归模型。p值为0.05为有统计学意义。结果:MAM和SAM的回收率为67.7%，中位恢复时间分别为65天(95% CI = 61.6 ~ 68.4)和145天(95% CI = 130.7 ~ 159)。婚姻状况(已婚)(AHR = 0.61;CI = (0.43,0.86))， ART状态(ART前)AHR = 0.492;CI = (0.305,0.793)， CD4 (200-350c/m3, AHR = 2.116;CI =(1.447,3.21)，营养不良类型(AHR = 0.22;CI=(0.156,0.307))、抗逆转录病毒治疗依从性水平(AHR = 3.33, CI=(1.997,5.56))、WHO临床分期(AHR = 0.685, CI=(0.485,0.948))、性别(男性)(AHR = 0.678;CI =(0.509, 0.901))和年龄(35至54岁)要高许多,(AHR = 1.86;CI =(1.408,2.47))为恢复时间的预测因子。结论:与以往研究相比，该方法回收率高。SAM、晚期临床阶段、性别和婚姻状况均与营养恢复时间负相关，而抗逆转录病毒治疗依从性、CD4计数和年龄是预测因子。因此，治疗性喂养计划应侧重于减缓恢复时间的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV AIDS-Research and Palliative Care INFECTIOUS DISEASES-

CiteScore

3.00

自引率

6.70%

发文量

审稿时长

16 weeks

期刊介绍： About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.

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