埃塞俄比亚南部锡达马州哈瓦萨市哈瓦萨大学综合专科医院HIV患者治疗性喂养计划的营养治疗结果及其预测因素：一项回顾性队列研究

Nutritional Treatment Outcomes of Therapeutic Feeding Program and Its Predictors Among HIV Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa City, Sidama, Southern Ethiopia: A Retrospective Cohort Study.

作者信息

Tadesse Helen, Toma Alemayehu

机构信息

Department of Human Nutrition, College of Agriculture, Hawassa University, Hawassa, Sidama, Ethiopia.

School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, Hawassa, Sidama, Ethiopia.

出版信息

HIV AIDS (Auckl). 2023 Mar 8;15:83-93. doi: 10.2147/HIV.S395936. eCollection 2023.

DOI:10.2147/HIV.S395936

PMID:36919023

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10008424/

Abstract

BACKGROUND

HIV-induced malnutrition is highly prevalent in different parts of the world particularly in sub-Saharan Africa. The food intervention package is one of the strategies that targets malnutrition among HIV-infected people through nutritional evaluation, counseling and care. However, little is known concerning the outcomes of intervention in such patients in treatment program. Therefore, this study aimed to assess nutritional treatment outcomes and its predictors among adult HIV-positive undernourished individuals in Ethiopia.

METHODS

Facility based retrospective cohort study was deployed in Adult Antiretroviral therapy clinic of Hawassa University Comprehensive Specialized Hospital. Data of 419 patients were extracted from the food by prescription registration book and patient cards using structured questionnaires. Statistical significance was assessed using Cox-proportional Hazard model by determining hazard ratios and 95% confidence interval.

RESULTS

The proportion of adult HIV patients who recovered from malnutrition after they were enrolled in the food by prescription therapy was 53.0%. The variables found to have an association with good nutritional treatment outcomes of food by prescription in the final model are being female (Adjusted Hazard Ratio (AHR) = 3.38, 95% CI: 2.15, 5.32), secondary education (AHR = 2.16, 95% CI: 1.11, 4.18), tertiary education (AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20; 95% CI: 0.12, 0.35), and HAART (AHR = 2.70, 95% CI: 1.50, 4.86). Having Severe Acute Malnutrition (SAM) at baseline nutritional assessment (AHR = 3.42, 95% CI; 2.81, 5.15), taking ART for more than 12 months (AHR = 0.26, 95% CI: 0.13, 0.84) and starting HAART immediately after testing positive (AHR = 0.26, 95% CI: 0.13, 0.84) are significantly associated with nutritional treatment failure.

CONCLUSION

Fifty-three percent of HIV patients recovered from malnutrition after they were enrolled in the food by prescription therapy.

摘要

背景

由人类免疫缺陷病毒（HIV）导致的营养不良在世界不同地区，尤其是撒哈拉以南非洲地区极为普遍。食物干预方案是通过营养评估、咨询和护理来解决HIV感染者营养不良问题的策略之一。然而，对于此类患者在治疗方案中的干预效果却知之甚少。因此，本研究旨在评估埃塞俄比亚成年HIV阳性营养不良个体的营养治疗效果及其预测因素。

方法

在哈瓦萨大学综合专科医院的成人抗逆转录病毒治疗诊所开展基于机构的回顾性队列研究。使用结构化问卷从食物处方登记册和患者卡片中提取419例患者的数据。通过确定风险比和95%置信区间，采用Cox比例风险模型评估统计学显著性。

结果

在接受食物处方治疗后从营养不良中康复的成年HIV患者比例为53.0%。在最终模型中发现与食物处方的良好营养治疗效果相关的变量包括女性（调整后风险比[AHR]=3.38，95%置信区间：2.15，5.32）、中等教育程度（AHR=2.16，95%置信区间：1.11，4.18）、高等教育程度（AHR=3.75，95%置信区间：1.66，8.48）、重度急性营养不良（SAM）（AHR=0.20；95%置信区间：0.12，0.35）以及高效抗逆转录病毒治疗（HAART）（AHR=2.70，95%置信区间：1.50，4.86）。在基线营养评估时患有重度急性营养不良（SAM）（AHR=3.42，95%置信区间；2.81，5.15）、接受抗逆转录病毒治疗超过12个月（AHR=0.26，95%置信区间：0.13，0.84）以及在检测呈阳性后立即开始HAART（AHR=0.26，95%置信区间：0.13，0.84）与营养治疗失败显著相关。