Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study

Abstract Introduction Despite documentation on injection drug use (IDU) in Kenya, the nutritional status of people who inject drugs (PWIDs) is under-explored. Elsewhere studies report under-nutrition among PWIDs which is attributed to food insecurity; competing priorities between drugs and food supp...

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Main Authors: Valentine Budambula, Moses Ngari, Nancy L.M. Budambula, Aabid A. Ahmed, Tom Were
Format: Article
Language:English
Published: BMC 2024-04-01
Series:BMC Nutrition
Subjects:
Online Access:https://doi.org/10.1186/s40795-024-00851-z
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author Valentine Budambula
Moses Ngari
Nancy L.M. Budambula
Aabid A. Ahmed
Tom Were
author_facet Valentine Budambula
Moses Ngari
Nancy L.M. Budambula
Aabid A. Ahmed
Tom Were
author_sort Valentine Budambula
collection DOAJ
description Abstract Introduction Despite documentation on injection drug use (IDU) in Kenya, the nutritional status of people who inject drugs (PWIDs) is under-explored. Elsewhere studies report under-nutrition among PWIDs which is attributed to food insecurity; competing priorities between drugs and food supply; chaotic lifestyle; reduced food intake; substance use induced malnutrition due to inflammation and comorbidities. Methods This was a cross-sectional study that sought to assess the nutritional status of PWIDs in Coastal Kenya. We recruited 752 participants of whom 371(49%) were on IDUs and 75 non-IDUs and 306 non-drug users using respondent driven sampling, traditional snowball, makeshift outreach and purposive sampling methods. Results More than one half of the participants (56%) had BMI classified as normal while 35% had BMI < 18.5. The proportion with BMI < 18.5 was higher among IDUs (46%) compared to the non-IDUs (33%) and non-drug users (23%) at P < 0.001. Using the mid upper arm circumference (MUAC), 17% were classified as underweight and the proportion was lowest (11%) among non- drugs users compared to 22% among IDUs (P < 0.001). However, the IDUs had lower proportion of overweight (8.1%) compared to 55% among the non- drug users. The proportion with low waist-for-hip ratio was highest among the IDUs (74%) while high waist-for-hip ratio was lowest in the same group of IDUs (11%) at P < 0.001. One half (50%), of the participants had no signs of anaemia, (47%) had mild/moderate anaemia while 21 (2.8%) had severe anaemia. However, IDUs were more likely to be overweight based on waist circumference as a parameter. The IDUs had the highest proportion (54%) of mild to moderate anaemia compared to non-IDUs (37%) and 40% non- drug users (P < 0.001). In the multivariable models, IDUs (aRRR 2.83 (95%CI 1.84‒4.35)) and non-IDUs (aRRR 1.42 (95%CI 1.07‒1.88)) compared to non- drug users were positively associated with BMI < 18.5. Being an IDU was positively associated with mild or moderate anaemia (aRRR 1.65 (95%CI 1.13‒2.41)) while non-IDUs were positively associated with severe anaemia (aRRR 1.69 (95%CI 1.16‒2.48)). Conclusion A significant proportion of the participants were under-nourished with those injecting drugs bearing the heaviest brunt. Being an IDU was positively associated with the low BMI, MUAC, waist for hip ratio and mild or moderate anaemia but high waist circumference. People who inject drugs have high risk for under-nutrition and should be targeted with appropriate interventions.
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spelling doaj.art-f46b388ec32a4a02877d309bea2086862024-04-07T11:11:15ZengBMCBMC Nutrition2055-09282024-04-0110111010.1186/s40795-024-00851-zNutritional status of people who inject drugs in Coastal Kenya: a cross-sectional studyValentine Budambula0Moses Ngari1Nancy L.M. Budambula2Aabid A. Ahmed3Tom Were4Department of Environment and Health Sciences, Technical University of MombasaKEMRI-Wellcome Trust Research ProgrammeDepartment of Biological Sciences, University of EmbuBomu HospitalDepartment of Microbiology and Parasitology, Masinde Muliro University of Science and TechnologyAbstract Introduction Despite documentation on injection drug use (IDU) in Kenya, the nutritional status of people who inject drugs (PWIDs) is under-explored. Elsewhere studies report under-nutrition among PWIDs which is attributed to food insecurity; competing priorities between drugs and food supply; chaotic lifestyle; reduced food intake; substance use induced malnutrition due to inflammation and comorbidities. Methods This was a cross-sectional study that sought to assess the nutritional status of PWIDs in Coastal Kenya. We recruited 752 participants of whom 371(49%) were on IDUs and 75 non-IDUs and 306 non-drug users using respondent driven sampling, traditional snowball, makeshift outreach and purposive sampling methods. Results More than one half of the participants (56%) had BMI classified as normal while 35% had BMI < 18.5. The proportion with BMI < 18.5 was higher among IDUs (46%) compared to the non-IDUs (33%) and non-drug users (23%) at P < 0.001. Using the mid upper arm circumference (MUAC), 17% were classified as underweight and the proportion was lowest (11%) among non- drugs users compared to 22% among IDUs (P < 0.001). However, the IDUs had lower proportion of overweight (8.1%) compared to 55% among the non- drug users. The proportion with low waist-for-hip ratio was highest among the IDUs (74%) while high waist-for-hip ratio was lowest in the same group of IDUs (11%) at P < 0.001. One half (50%), of the participants had no signs of anaemia, (47%) had mild/moderate anaemia while 21 (2.8%) had severe anaemia. However, IDUs were more likely to be overweight based on waist circumference as a parameter. The IDUs had the highest proportion (54%) of mild to moderate anaemia compared to non-IDUs (37%) and 40% non- drug users (P < 0.001). In the multivariable models, IDUs (aRRR 2.83 (95%CI 1.84‒4.35)) and non-IDUs (aRRR 1.42 (95%CI 1.07‒1.88)) compared to non- drug users were positively associated with BMI < 18.5. Being an IDU was positively associated with mild or moderate anaemia (aRRR 1.65 (95%CI 1.13‒2.41)) while non-IDUs were positively associated with severe anaemia (aRRR 1.69 (95%CI 1.16‒2.48)). Conclusion A significant proportion of the participants were under-nourished with those injecting drugs bearing the heaviest brunt. Being an IDU was positively associated with the low BMI, MUAC, waist for hip ratio and mild or moderate anaemia but high waist circumference. People who inject drugs have high risk for under-nutrition and should be targeted with appropriate interventions.https://doi.org/10.1186/s40795-024-00851-zUnder nutritionInjection drug useBMIMUAC and anaemia
spellingShingle Valentine Budambula
Moses Ngari
Nancy L.M. Budambula
Aabid A. Ahmed
Tom Were
Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study
BMC Nutrition
Under nutrition
Injection drug use
BMI
MUAC and anaemia
title Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study
title_full Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study
title_fullStr Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study
title_full_unstemmed Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study
title_short Nutritional status of people who inject drugs in Coastal Kenya: a cross-sectional study
title_sort nutritional status of people who inject drugs in coastal kenya a cross sectional study
topic Under nutrition
Injection drug use
BMI
MUAC and anaemia
url https://doi.org/10.1186/s40795-024-00851-z
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