Nutritional Advice El Mondo
Objectives:
Undernutrition is one of the most common problems among people living with Human Immunodeficiency Virus (HIV), contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Therefore, this review article has been conducted.
Does undernutrition increase the risk of mortality and morbidity among adults living with HIV in Sub-Saharan Africa (SSA)?
Study design:
This review article included 53 studies (cohort and cross-sectional studies) with a total of 367,680 adults living with HIV (76.2% females).
Publication year of the included studies ranged from 2006 to 2019.
The sample size of the included studies ranged from 71 in Kenya to 68,378 in Tanzania. Most were cohort studies (n = 47, 88.7%). About 63.8% of the included cohort studies had a follow-up period of less than 5 years for mortality and/or less than 2 years for morbidities.
NOS quality scores ranged from 5 to 9 for cohort studies and 8 to 10 for cross-sectional studies.
The mean quality score of the included studies was 7.34 [SD = 0.14].
There was no publication bias.
Results and conclusions:
The investigators found a meta-analysis of 23 cohort studies (involving 125,790 individuals) indicated that undernutrition significantly [AHR = 2.1, 95% CI = 1.8 to 2.4, I2 = 66.4%, p 0.001] increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death [AHR = 2.3, 95% CI = 1.9 to 2.8) as compared to mildly undernourished adults living with HIV.
The investigators found, furthermore, the pooled estimates of 10 cohort studies (involving 104,387 adults living with HIV) revealed that undernutrition significantly increased the risk of developing tuberculosis [AHR = 2.1, 95% CI = 1.6 to 2.7, I2 = 75.2%, p 0.001] among adults living with HIV.
The investigators concluded that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, these findings may be used to update the nutritional guidelines used for the management of people living with HIV (PLHIV), by different stakeholders, especially in limited-resource settings.
Original title:
Effects of undernutrition on mortality and morbidity among adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis by Alebel A, Demant D, […], Sibbritt D.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780691/
Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition right here.