Nutritional status of HIV seropositive patients in Ashanti Region of Ghana.
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Date
2016-10-05
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Abstract
The relationship between HIV/AIDS and nutritional status has been a
distinguishing characteristic of the disease course since the earliest days of the
epidemic. Since the introduction of Highly active antiretroviral therapy (HAART),
there has been divergent views concerning the nutritional status of HIV patients.
Therefore to contribute to the sparse information on the nutritional status among
HIV infected patients, a comparative cross sectional study was conducted to
compare and investigate the nutritional status of participants on HAART and
participants who are HAART naïve. In all two hundred and eighty seven (287)
confirmed People Living with HIV/AIDS (PLWHAs) consisting of 179 participants
on highly active antiretroviral therapy (HAART) and 108 HAART naïve
participants were included in the study. The participants were recruited from the
antiretroviral (ART) clinics at ST. Michael’s Hospital, Pramso and Bomso specialist
clinic, Bomso all in Ashanti region of Ghana. Anthropometry(BMI, MUAC,
WHR,TSF, BSF), Complete haemogram, immunological (CD4) and biochemical
(albumin, total protein, zinc, transferrin, ferritin, urea, ALP, ALT, AST) analysis
were conducted for all the participants. Socio demographic features were
collected using an interviewer administered questionnaire. Ethical clearance was
obtained from Committee on Human Research, Publications and Ethics (CHRPE),
School of Medical Sciences, Kwame Nkrumah University of Science & Technology
(KNUST), Kumasi. All participants gave informed consent to take part in the
study after verbal and written explanation of the methods and risks involved had
been given. Out of the 287 HIV/AIDS Participants categorized into HAART naïve
and on HAART participants, 108 were highly active antiretroviral therapy
(HAART) naïve participants of which 41were males and 67 were females and 179
participants on HAART of which 48 were males and 131 were females. The ages of
participants ranged from 18 to 60. No significant difference was observed in the
BMI and MUAC between participants on HAART and participants who are
HAART naïve though the mean values of these measurements indicated overweight
and obesity. HAART naïve participants had a significantly higher WHR (p=0.016)
as a measure of central adiposity as compared to participants on HAART. All
anemia incidence among participants on HAART were in the Grade 1 anaemia
toxicity grade (54.7%; 98/179) whereas in the HAART naïve participants, there
were incidence of Grade 2 (13.9%; 15/108) and Grade 3 anemia (16.7%; 18/108).
Microcytic hypochromic anaemia was significantly higher in HAART naïve
participants (29.2%) as compared to participants on HAART where no case was
recorded. Hypozincaemia, hypoalbuminaemia and low transferrin levels were
significantly higher among HAART naïve participants as compared to participants
who are on HAART therefore putting HAART naïve participants at greater risk of
developing nutritional deficiencies. This study is therefore beneficial in the advocacy
for complete assessment of nutritional status in HIV partients before and after the
initiation of antiretroviral therapy in Ghana.
Description
A thesis submitted in
fulfillment of the
requirements for the degree of
Master of Philosophy
in the
Department of Molecular Medicine,
School of Medical Sciences
by
Isaiah Kofi Arhin
Kwame Nkrumah University of Science and Technology,
Kumasi
August, 2015