Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia
Severe acute malnutrition (SAM) affects up to 50 % of children with HIV, especially those who reside in resource-constrained healthcare setting like Ethiopia. During subsequent follow-up of children factors related to incidence of SAM after antiretroviral therapy (ART) is set on, however, there is n...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | Journal of Nutritional Science |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2048679023000423/type/journal_article |
| _version_ | 1797822500765171712 |
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| author | Dejen Tsegaye Tsehay Kebede Fassikaw Kebede |
| author_facet | Dejen Tsegaye Tsehay Kebede Fassikaw Kebede |
| author_sort | Dejen Tsegaye |
| collection | DOAJ |
| description | Severe acute malnutrition (SAM) affects up to 50 % of children with HIV, especially those who reside in resource-constrained healthcare setting like Ethiopia. During subsequent follow-up of children factors related to incidence of SAM after antiretroviral therapy (ART) is set on, however, there is no prior evidence. An institution-based retrospective cohort study was employed among 721 HIV-positive children from 1 January to 30 December 2021. Data were entered using Epi-Data version 3.1 and exported to STATA version 14 for analysis. Bi-variable and multivariable Cox-proportional hazard models were employed at 95 % confidence intervals to identify significant predictors for SAM. According to this result, the overall mean (±sd) age of the participants was found to be 9⋅83 (±3⋅3) years. At the end of the follow-up period, 103 (14⋅29 %) children developed SAM with a median time of 30⋅3 (13⋅4) months after ART initiation. The overall incidence density of SAM was found to be 5⋅64 per 100 child (95 % CI 4⋅68, 6⋅94). Children with CD4 counts below the threshold [AHR 2⋅6 (95 % CI 1⋅2, 2⋅9, P = 0⋅01)], disclosed HIV status [AHR 1⋅9 (95 % CI 1⋅4, 3⋅39, P = 0⋅03)] and Hgb level ≤10 mg/dl [AHR 1⋅8 (95 % CI 1⋅2, 2⋅9, P = 0⋅03)] were significant predictors for SAM. Significant predictors of acute malnutrition were having a CD4 count below the threshold, children who had previously reported their HIV status, and having haemoglobin <10 mg/dl. To ensure better health outcomes, healthcare practitioners should improve earlier nutritional screening and consistent counselling at each session of care. |
| first_indexed | 2024-03-13T10:09:58Z |
| format | Article |
| id | doaj.art-dc164a23b46044588eb9984681801d09 |
| institution | Directory Open Access Journal |
| issn | 2048-6790 |
| language | English |
| last_indexed | 2024-03-13T10:09:58Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Nutritional Science |
| spelling | doaj.art-dc164a23b46044588eb9984681801d092023-05-22T06:03:26ZengCambridge University PressJournal of Nutritional Science2048-67902023-01-011210.1017/jns.2023.42Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest EthiopiaDejen Tsegaye0https://orcid.org/0000-0002-3285-3855Tsehay Kebede1Fassikaw Kebede2https://orcid.org/0000-0002-6117-5272Department of Nursing, College of Health Sciences, Debre Markos University, Debre MarkosDepartment of Geography, College of Social Science, Bahir Dar University, Bahir DarDepartment of Epidemiology, College of Health Sciences, Woldia University, WoldiaSevere acute malnutrition (SAM) affects up to 50 % of children with HIV, especially those who reside in resource-constrained healthcare setting like Ethiopia. During subsequent follow-up of children factors related to incidence of SAM after antiretroviral therapy (ART) is set on, however, there is no prior evidence. An institution-based retrospective cohort study was employed among 721 HIV-positive children from 1 January to 30 December 2021. Data were entered using Epi-Data version 3.1 and exported to STATA version 14 for analysis. Bi-variable and multivariable Cox-proportional hazard models were employed at 95 % confidence intervals to identify significant predictors for SAM. According to this result, the overall mean (±sd) age of the participants was found to be 9⋅83 (±3⋅3) years. At the end of the follow-up period, 103 (14⋅29 %) children developed SAM with a median time of 30⋅3 (13⋅4) months after ART initiation. The overall incidence density of SAM was found to be 5⋅64 per 100 child (95 % CI 4⋅68, 6⋅94). Children with CD4 counts below the threshold [AHR 2⋅6 (95 % CI 1⋅2, 2⋅9, P = 0⋅01)], disclosed HIV status [AHR 1⋅9 (95 % CI 1⋅4, 3⋅39, P = 0⋅03)] and Hgb level ≤10 mg/dl [AHR 1⋅8 (95 % CI 1⋅2, 2⋅9, P = 0⋅03)] were significant predictors for SAM. Significant predictors of acute malnutrition were having a CD4 count below the threshold, children who had previously reported their HIV status, and having haemoglobin <10 mg/dl. To ensure better health outcomes, healthcare practitioners should improve earlier nutritional screening and consistent counselling at each session of care.https://www.cambridge.org/core/product/identifier/S2048679023000423/type/journal_articleAcute malnutritionAIDSChildrenEthiopiaHIVSAM |
| spellingShingle | Dejen Tsegaye Tsehay Kebede Fassikaw Kebede Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia Journal of Nutritional Science Acute malnutrition AIDS Children Ethiopia HIV SAM |
| title | Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia |
| title_full | Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia |
| title_fullStr | Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia |
| title_full_unstemmed | Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia |
| title_short | Rate, risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest Ethiopia |
| title_sort | rate risk factors and estimations of time to develop severe acute malnutrition after children receiving antiretroviral therapy at selected health facilities in northwest ethiopia |
| topic | Acute malnutrition AIDS Children Ethiopia HIV SAM |
| url | https://www.cambridge.org/core/product/identifier/S2048679023000423/type/journal_article |
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