Epidemiological profile of malnutrition status and spatial distribution of children and adolescents living with HIV/AIDS in Tanzania

Author:

Chacha Samuel12ORCID,Hui Jing1,Yuxin Teng1,Wang Ziping1,Ali Saumu1,Mbonile Nicolaus2,Msumari Mary2,Msuya Ndovera3,Malimu Emmanuel45,Revocatus Baraka67,Maokola Werner7,Mtali Godwin8,Simon Victor9,Dang Shaonong1

Affiliation:

1. Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an China

2. Department of Molecular Diagnostics Sumbwanga Regional Referral Hospital Rukwa Tanzania

3. Department of Biochemistry Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

4. Global Fund Ministry of Health Dodoma Tanzania

5. Department of Parasitology Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

6. Department of Data and Statistics Bugando Medical Centre Mwanza Tanzania

7. National AIDS Control Program Ministry of Health Dodoma Tanzania

8. Department of Oncology Bugando Medical Centre Mwanza Tanzania

9. Global Health Program, HJFMRI U.S. Military HIV Research Program Rukwa Tanzania

Abstract

AbstractObjectivesTo determine the prevalence of malnutrition status, analyse the association between malnutrition status and individual‐level factors, and explore the spatial variation among children and adolescents living with HIV/AIDS in Tanzania.MethodsThe study is based on large‐scale baseline routine data from the National AIDS Control Programme on people living with HIV from January 2016 to December 2021 in mainland Tanzania. 70,102 children and adolescents aged 5–19 years receiving active antiretroviral therapy were included in the analysis. Nutritional status of participants was assessed by anthropometric measurement. Pearson's Chi‐square test was used to describe the association between individual‐level factors with all malnutrition outcomes and spatial analysis was used to investigate spatial distribution of malnutrition. The excess risk of malnutrition for each region was calculated while Anselin Local Moran's I and Getis‐Ord statistical tools were used to identify significant hot spots regions of malnutrition.ResultsThe mean age of participants was 11.1 (SD 4.7) years, with 71.7% in the 5–14‐year age group and 58.4% being girls. 39.2% were attending care and treatment clinics services at hospital level with public ownership. 53.4% started using ARV at age 5–14 years and 55.5% had already switched to second‐ or third‐line ARV with 61.1% using ARV for less than 3 years. 51.2% were in WHO HIV clinical stage III or IV. The prevalence of malnutrition was 36.0% for stunting, 28.9% for underweight, 13.0% for wasting, and 48.0% for anthropometric failure. Individual‐level factors which accounted for a higher proportion of malnutrition based on anthropometric failure were male sex (56.3%), age 5–14 years (50.0%), being unmarried (52.9%), being on second‐ or third‐line ARV treatment (51.4%), ART initiation at age 5–14 years (55.7%), ARV for more than 3 years (49.4%), and stage IV of WHO HIV clinical status (57.8%). There were regional hot spots (p < 0.05): the prevalence rate and excess risk of malnutrition for stunting and anthropometric failure were highest in the southern highlands regions, for underweight in the central regions, and for wasting in the northern regions.ConclusionsChildren and adolescents living with HIV/AIDS in Tanzania suffer from poor nutritional status. Malnutrition does not occur arbitrarily, and the regions identified as hot spots should be given priority for nutritional intervention. Effective nutritional interventions for children living with HIV/AIDS should incorporate multiple approaches by considering unique geographical factors.

Publisher

Wiley

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,Parasitology

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