20th International AIDS Conference - Melbourne, Australia

Abstract

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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