Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries

Details

• Alternative Title:
  Public Health Nutr
• Personal Author:
  Anema, Aranka ; Zhang, Wendy ; Wu, Yingfeng ; Elul, Batya ; Weiser, Sheri D ; Hogg, Robert S ; Montaner, Julio SG ; El Sadr, Wafaa ; Nash, Denis
• Description:
  Objective
  
  To examine the availability of nutritional support services in HIV care and treatment sites across sub-Saharan Africa.
  
  Design
  
  In 2008, we conducted a cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods.
  
  Setting
  
  President’s Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries.
  
  Subjects
  
  A total of 336 HIV care and treatment sites, serving 467 175 enrolled patients.
  
  Results
  
  Of the sites under study, 303 (90%) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98%, 64%, 36% and 31% of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2·2, 95% CI 1·1, 4·5). Rural sites (AOR: 2·3, 95% CI 1·4, 3·8) had increased odds of micronutrient supplementation availability. Sites providing ART for >2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2·4, 95% CI 1·4, 4·1). Sites providing ART for >2 years (AOR: 1·6, 95% CI 1·3, 1·9) and rural sites (AOR: 2·4, 95% CI 1·4, 4·4) had greater odds of food ration availability.
  
  Conclusions
  
  Availability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact on patient and programme outcomes.
  
  
• Subjects:
  Adolescent Adult Africa South Of The Sahara Anti-Retroviral Agents Child Child, Preschool Counseling Cross-Sectional Studies Dietary Supplements Female HIV Infections Humans Male Malnutrition Nutritional Support Patient Compliance Treatment Outcome Young Adult

  More +
• Keywords:
  Africa Antiretroviral Therapy HIV Nutrition
• Source:
  Public Health Nutr. 15(5):938-947
• Pubmed ID:
  21806867
• Pubmed Central ID:
  PMC5341131
• Document Type:
  Journal Article
• Funding:
  U62 PS223540/PS/NCHHSTP CDC HHSUnited States/ ; CAPMC/ CIHRCanada/
• Volume:
  15
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:36f1eeb108d7e43a0af71ef0449ae62c13848cbed391bee43a86d80c8d891c48
• Download URL:
  https://stacks.cdc.gov/view/cdc/44571/cdc_44571_DS1.pdf
• File Type:
  [PDF - 432.04 KB ]