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Effectiveness of supplementary feeding for wasted people living with HIV/AIDS on anti-retroviral therapy in Rwanda

Authors
 Dukuzimana, Justine 
College
 Graduate School of Public Health (보건대학원) 
Department
 Global heath security detection program 
Degree
석사
Issue Date
2020
Abstract
Introduction: Underweight is still prevalent in people living with HIV/AIDS (PLWHA) in resource-limited countries like Rwanda. Low body mass index (BMI), mid-upper arm circumference (MUAC) and Z-score below minus three (<-3) are strong risk factors of mortality and morbidity in PLWHA on antiretroviral therapy (ART). In Rwanda, nutrition supplements became a core standard and integrated with HIV care to manage the wasting syndrome seen in PLWHA starting ART. This study aimed to assess the effectiveness of fortified corn-soy blend (CSB+) supplements in improving the nutrition status of PLWHA with wasting syndrome. Methods: The retrospective cohort study was conducted to assess the nutritional status of 149 PLWHA with wasting managed with consecutive ART and nutrition support for a period of six months. The nutritional status of the subjects was determined by BMI and MUAC. BMI below 18.5 kilograms per meter squared (kg/m2) and MUAC below 21cm were defined as underweight according to the World Health Organization (WHO) guidelines. Results: A total of 149 PLWHA were included in the analysis. The mean BMI of 149 PLWHA improved with CSB+ supplementation during the six month study period (17.448±0.546 to 18.631±0.535 kg/m2, P =<0.001). This improvement in BMI was evident in both males (N=53, 17.2±0.53 to 21.9±24.4 kg/m2, P=<0.001) and females (N=72, 17.5±0.53 to 18.6±0.52 kg/m2, P=<0.001). The mean MUAC of 18.47±0.455 cm increased to 20.40±0.532 cm (P <0.001) in the sixth month with CSB+ supplementation. At the end of six months, the overall prevalence of malnutrition decreased (P =0.306) and it was 36.0% and 66.7% as assessed by BMI and MUAC, respectively. The minimum time required to restore healthy BMI (≥18.5 kg/m2) was at least six months. Conclusion: Our study suggests that supplements improve the overall nutrition status of PLWHA with wasting syndrome and at least six months of nutritional supplements are required for BMI recovery. Further studies are needed to assess the level of food security and safety in the households of PLWHA to enable early interventions with supplementary feeding.
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Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Others (기타) > 2. Thesis
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181074
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