Mwakasungura Felistar, Mkumbwa Rebecca, Sunguya Bruno
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLOS Glob Public Health. 2025 Feb 25;5(2):e0003664. doi: 10.1371/journal.pgph.0003664. eCollection 2025.
The dual burden of HIV and malnutrition is a significant public health challenge in high burden Sub-Saharan African countries. Tanzania is no exception. Care and treatment of HIV has been strengthened in these countries, however integration with nutrition care and support remains poor. This study evaluated adherence to nutritional guidelines for people living with HIV (PLHIV) in Dar es Salaam Tanzania and identified its influencing factors. A mixed method study was conducted among PLHIV, health facility administrators, and healthcare providers from April 29 to May 27, 2024. Data were collected through observation checklists, structured questionnaires, and in-depth interviews. Statistical and qualitative analyses were performed to assess adherence and determinants. Among 478 participants who received care, only 19.5% were managed while adhering to the national nutritional guidelines. Universally, anthropometric assessments were taken, however, only 1% received micronutrient supplements. Higher education (AOR = 5.08, p = 0.019) and attendance at referral hospitals (AOR = 8.23, p = 0.032) positively influenced adherence. Conversely, nurse attendance (AOR = 0.34, p = 0.038), adequate staffing (AOR = 0.31, p = 0.010), and urban residence (AOR = 0.47, p = 0.009) negatively influenced adherence. Key facilitators included consistent training and supportive leadership while financial constraints and high staff turnover remained important barriers. There is a significant gap in adherence to nutritional guidelines among PLHIV in Dar es Salaam, Tanzania. This highlights the need for improved resource distribution, staff training, and clients education in Tanzania and countries with similar contexts.
在撒哈拉以南非洲高负担国家，艾滋病毒与营养不良的双重负担是一项重大的公共卫生挑战。坦桑尼亚也不例外。这些国家加强了对艾滋病毒的护理和治疗，然而，与营养护理和支持的整合仍然很差。本研究评估了坦桑尼亚达累斯萨拉姆艾滋病毒感染者（PLHIV）对营养指南的依从性，并确定了其影响因素。2024年4月29日至5月27日，对PLHIV、医疗机构管理人员和医疗服务提供者进行了一项混合方法研究。通过观察清单、结构化问卷和深入访谈收集数据。进行了统计和定性分析，以评估依从性和决定因素。在478名接受护理的参与者中，只有19.5%的人在遵守国家营养指南的情况下得到管理。普遍进行了人体测量评估，然而，只有1%的人接受了微量营养素补充剂。高等教育（调整后比值比[AOR]=5.08，p=0.019）和在转诊医院就诊（AOR=8.23，p=0.032）对依从性有积极影响。相反，护士出诊（AOR=0.34，p=0.038）、人员配备充足（AOR=0.31，p=0.010）和城市居住（AOR=0.47，p=0.009）对依从性有负面影响。关键促进因素包括持续培训和支持性领导，而资金限制和高员工流动率仍然是重要障碍。坦桑尼亚达累斯萨拉姆的PLHIV在遵守营养指南方面存在显著差距。这凸显了坦桑尼亚及类似情况国家需要改善资源分配、员工培训和客户教育。
