Nutritional status and associated factors among adolescents living with HIV in Shinyanga municipal council, Shinyanga

Abstract

Background Nutrition is recognized as a prime indicator of the health of individuals. Adolescence is a period between 10 and 19 years of age. It is a critical part of development in the life cycle, and period of physical and emotional change as the body matures. Adolescent’s nutritional status directly impact the adolescent’s growth and health status. Nutrition status among HIV infected adolescents is the most crucial factor in ensuring ART success. Without good nutrition, ART adherence is unlikely, leading to avoidable HIV-related morbidity and mortality. Shinyanga is the second region in Tanzania with the highest HIV prevalence (6.2%) among young people aged 15 to 24 years as compared to a national average (3.7%). It is reported that, delay in growth and physical development among HIV infected adolescent has an intrinsic to infection i.e., these delays may be influenced by changes in nutrient absorption. This means that, HIV compromises the nutrition of adolescents and increases vulnerability to infection. Shinyanga has a history of being one of the regions in Tanzania with food shortages. The assessment of nutritional status among HIV infected adolescents in Shinyanga has not been comprehensively studied, despite of this region being the second region with the highest HIV prevalence among adolescents. This study aimed at assessing the nutrition status and associated factors with among adolescents living with HIV in Shinyanga municipal. Objective To determine the nutritional status and associated factors among adolescents living with HIV in Shinyanga Municipal Council. Methods An analytical cross-sectional study design was undertaken between the month of June and July 2020 in Shinyanga municipal council. A simple random sampling technique was used. Adolescents aged between 10 and 19 years old who were residents of Shinyanga municipal council and HIV infected attending Care and Treatment Centres from selected health centers were studied. Data collection tool was adopted from Nutrition and Consumer Protection Division questionnaire for Individual Dietary Diversity Score (IDDS). Data cleaning and analysis were conducted using Statistical Package for Social Sciences (SPSS) version 23 software. BMI was categorized by using WHO categorization of BMI for children and adolescents between 5- and 19-years z-scores. Nutritional status for adolescent was calculated using BMI for age and classified into four groups: thin, normal, overweight and obese. Descriptive statistics were summarized using frequencies and proportions for categorical variables while mean or median with standard deviation or inter-quartile range were used to summarize continuous variables. Multinomial logistic regression analysis was used to determine factors associated with nutritional status among HIV-infected adolescents. Relative Risk Ratio (RRR) and 95% CI were used to determine strength and direction of the association. The results were considered statistically significant at p-value < 0.05. Results A total of 158 adolescents living with HIV were studied. Majority of the adolescents (58.2%) were females, mean age of (16.5±1.4) years, living with parents (73.4%) with mean height and weight of (134.8±15.6) cm and (41.1±10.7) kg, respectively. Prevalence of thinness and overweight were more pronounced among males’ adolescents compared to their females’ counterparts (10.8% vs 5.5%) and (20.0% vs 13.3%); P=0.328, respectively. Adolescents who were not consuming specialized food products or micronutrients had higher prevalence of thinness (14.3%) as compared to those consuming these products. Adolescent whose mothers were self-employed and unemployed had lower risk of being thin [RRR=0.09, 95% CI 0.01, 0.63; P=0.02)] and [RRR=0.10, 95% CI 0.02, 0.63; P=0.01)], respectively as compared with adolescent whose mothers had formal employment. Adolescent who did not feel that they had lost weight in the past month had 3.31 times higher risk of being thin as compared to adolescents who felt they had lost weight in the past month [RRR=3.31, 95%CI 1.91, 11.8; P=0.08]. Conclusion Stunting, overweight and obesity were prevalent in this population and differed across sex, parental occupation and nutritional factors. In addition, the level of thinness in this study was high indicating the need for early interventions among HIV infected adolescents in Shinyanga Municipal. Recommendations Further larger study is needed to confirm these results and explore factors associated with thinness among adolescent HIV-infected population in the Shinyanga region.