Malnutrition and its Associated Factors among Adults Attending Anti-Retroviral Therapy at Three Selected Hospitals in Bushenyj District, Uganda

ABSTRACT 

Background: Malnutrition is a life-threatening condition among HIV positive adults and little is known about its patterns and associated factors in Southwestern Uganda. The aim of the study was to assess malnutrition and associated factors among HIV-positive adults in Bushenyi district, Uganda Materials and Methods: This was a cross sectional study conducted at three selected hospitals handling HIV patients in Bushenyi district. A total of 253 participants were enrolled in the study and a semi-structured questionnaire was used to collect data while a review of patient records was conducted on CD4 count. Malnutrition was diagnosed by using the body mass index (BMI) and multiple logistic regression was conducted using SPSS Version 20 and significance was reported at 95% confidence interval in the presence of under and over nutrition to identify risk ~actors. Results and Discussion: The mean age of the study participants was 33.4 years (range: 23.6- 57.6 years: median: 30 years), 48.6% of the participants had their age in the range of 18 — 54 yrs. [he study established an overall malnutrition prevalence of 34.8%, and this mainly due to over lutrition. Socio-economic factors associated with under nutrition were being illiterate, alcoholic nd unemployed while over nutrition was associated with the educated, employed in females. In Lddition, under nutrition was associated with having opportunistic infections, due to ones riability to pay for medications, low adherence to HAART and in stage 1 of HIV/AIDS while ~ver nutrition was associated with employed patients, and those who would afford to pay for the riedications. Nutritional factors associated with under nutrition were eating fewer meals and arbohydrates while over nutrition were associated with eating three meals a day and mainly rotein. ~onclusions Malnutrition is a threat in adult HIV patients in rural communities of Uganda. Jnder nutrition was associated with low socio-economic status which leads to poor nutritional nd health options, while over nutrition was associated with a higher socio-economic status lowing a need to improve on HIV community extension activities to improve on patient utcomes in this community

Table of Contents

Acknowledgements

Dedication

Declaration .

Table of Contents

List of Tables

List of Figures ix

Operational Definitions

List of Abbreviations and Acronyms xi

List Appendices

Abstract

CHAPTER ONE 1

1.0 Introduction 1

1.1 Background

1.1.1. Historical Perspective 1

1.1.2 Theoretical perspective 3

1.1.3 Conceptual perspective 4

1.1.4 Contextual Perspective 6

1.2 Problem Statement 7

1.3 Study Objectives 8

1.4 Research Questions 8

1.5 Significance of the Study 8

1.6 Conceptual Framework 10

1.6.1 Drawing showing the Interaction of Variables 10

1.6.2 Description of Conceptual Framework 11

CHAPTER TWO: LITERATURE REVIEW 12

2.1 Introduction .12

2.2 Risk factors associated with malnutrition among HIV-positive Adults 13

2.3 Types of malnutrition prevalent among HIV-positive Adults on ART 16

2.4 General Integration of Literature Review 17

CHAPTER THREE: METHODS 18

3.1 Study design 18

3.2 Study area 18

3.3 Study population 19

3.4 Selection Criteria 19

3.5 Sample Size Determination 19

3.6 Sampling Technique 20

3.7 Data collection 20

3.8 Data Analysis 21

3.9 Quality control 21

3.10 Ethical considerations 21

CHAPTER FOURS 24

4.0 RESULTS 24

4.1 Study Participants and Study Area 24

4.2 Prevalence of under and over nutrition among study participants 24

4.3 Major social risk factors associated with malnutrition in the study population 28

4.4 Major economic risk factors associated with malnutrition in the study population 30

4.5 Major health risk factors associated with malnutrition in the study population 34

4:6 Major nutritional risk factors associated with malnutrition in the study population 39

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION 42

5.1 Discussion 42

5.1.1 Study participants 42

5.1.2 Prevalence of under nutrition and over nutrition among study participants 42

5.1.3 socio-economic factors associated with malnutrition among the participants 43

5.1.4 Health and nutritional factors associated with malnutrition among the study participants 44

5.2 Conclusions 45

5.3 Limitations of the study 46

5.4 Recommendations 46

REFERENCES LIST 47