WEPE246 - Poster Exhibition
Poor feeding practices among HIV-positive children living in food rich region - a call for tailored feeding counseling
B. Sunguya1, K. Poudel2, L. Mlunde1, D. Urassa3, J. Yasuoka1, M. Jimba1
1University of Tokyo, Community and Global Health, Tokyo, Japan, 2University of Massachusetts, Amherst, Department of Public Health, School of Public Health and Health Sciences, Massachussetts, United States, 3Muhimbili University of Health and Allied Health, School of Public Health and Social Sciences, Dar es Salaam, Tanzania, United Republic of
Background: Undernutrition among
HIV-positive children can be ameliorated if they are given adequate foods in
the right frequency and diversity. Food insecurity is known to
undermine such efforts, but even in food rich areas, children suffer from
undernutrition. As yet no study has examined feeding practices and their
associations with nutrition status among vulnerable populations such as HIV-positive children. We therefore
examined the magnitude of
undernutrition and its association with feeding practices among HIV-positive
children in a region where food production is high in Tanzania.
Methods: We conducted this mixed-method study among 748
children aged 6 months-14 years attending 9 of a total of 32 care and treatment
centers in Tanga region, Tanzania. We collected quantitative data using a
standard questionnaire and qualitative data through seven focus group
discussions (FGDs). For quantitative data, we conducted multivariate regression
analyses to examine the association between feeding practices and nutrition
statuses. For qualitative data, we conducted thematic analyses based on the
common themes that emerged.
Results: HIV-positive children had high magnitudes of
undernutrition. Stunting, underweight, wasting, and thinness were prevalent
among 61.9%, 38.7%, 26.0%, and 21.1% of HIV-positive children, respectively.
They also had poor feeding practices. Of all children, 88.1% were fed at a frequency below the recommended
level for HIV-positive children. Moreover, 62.3% of all children had consumed three or less food varieties, a low level of
dietary diversity. Lower feeding frequency was associated with stunting
(β=0.11, p=0.016); underweight (β=0.12, p=0.029); and thinness (β=0.11,
p=0.026). Lower feeding frequency was associated with low wealth index
(β=0.06, p< 0.001), food insecurity (β=-0.05, p< 0.001), and caregiver''s education. In the
FGDs, participants discussed the causal relationships among the key associations; undernutrition was mainly due to
low feeding frequency and dietary diversity. Such poor feeding practices resulted from poor nutrition knowledge, food insecurity, low
income, and poverty.
Conclusions: Feeding practices and nutrition status were poor
among HIV-positive children even in food rich areas. Improving feeding
frequency may help to ameliorate undernutrition. To improve it, tailored interventions should target children of poor households, the food insecure, and caregivers who have
received only a low level of education.
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