Undernutrition among Ethiopian adults living with HIV: a meta-analysis

Animut Alebel; Getiye Dejenu Kibret; Pammla Petrucka; Cheru Tesema; Nurilign Abebe Moges; Fasil Wagnew; Getnet Asmare; Gemechu Kumera; Zebenay Workneh Bitew; Daniel Bekele Ketema; Tesfahun Tiruneh; Mamaru Wubale Melkamu; Yitbarek Tenaw Hibstie; Belisty Temesgen; Setegn Eshetie

doi:10.1186/s40795-020-00334-x

Undernutrition among Ethiopian adults living with HIV: a meta-analysis

BMC Nutr. 2020 Apr 16:6:10. doi: 10.1186/s40795-020-00334-x. eCollection 2020.

Authors

Animut Alebel^{1

2}, Getiye Dejenu Kibret¹, Pammla Petrucka^{3

4}, Cheru Tesema¹, Nurilign Abebe Moges¹, Fasil Wagnew¹, Getnet Asmare⁵, Gemechu Kumera¹, Zebenay Workneh Bitew⁶, Daniel Bekele Ketema¹, Tesfahun Tiruneh⁷, Mamaru Wubale Melkamu⁷, Yitbarek Tenaw Hibstie⁷, Belisty Temesgen⁷, Setegn Eshetie⁸

Affiliations

¹ 1College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
² 2Faculty of Health, University of Technology Sydney, Sydney, Australia.
³ 3College of Nursing, University of Saskatchewan, Saskatoon, Canada.
⁴ 4School of Life Sciences and Bioengineering, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania.
⁵ Department of Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
⁶ 6Department of Nursing, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
⁷ Debre Markos Referral Hospital, Debre Markos, Ethiopia.
⁸ 8College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract

Background: Malnutrition and human immunodeficiency virus (HIV) are interlaced in a vicious cycle and worsened in low and middle-income countries. In Ethiopia, even though individuals are dually affected by both malnutrition and HIV, there is no a nationwide study showing the proportion of malnutrition among HIV-positive adults. Consequently, this review addressed the pooled burden of undernutrition among HIV-positive adults in Ethiopia.

Methods: We searched for potentially relevant studies through manual and electronic searches. An electronic search was carried out using the database of PubMed, Google Scholar, and Google for gray literature and reference lists of previous studies. A standardized data extraction checklist was used to extract the data from each original study. STATA Version 13 statistical software was used for our analysis. Descriptive summaries were presented in tables, and the quantitative result was presented in a forest plot. Heterogeneity within the included studies was examined using the Cochrane Q test statistics and I ² test. Finally, a random-effects meta-analysis model was computed to estimate the pooled proportion of undernutrition among HIV-positive adults.

Results: After reviewing 418 studies, 15 studies met the inclusion criteria and were included in the meta-analysis. Findings from 15 studies revealed that the pooled percentage of undernutrition among HIV-positive adults in Ethiopia was 26% (95% CI: 22, 30%). The highest percentage of undernutrition (46.8%) was reported from Jimma University specialized hospital, whereas the lowest proportion of undernutrition (12.3%) was reported from Dilla Hospital. The subgroup analyses of this study also indicated that the percentage of undernourishment among HIV-positive adults is slightly higher in the Northern and Central parts of Ethiopia (27.5%) as compared to the Southern parts of Ethiopia (25%).

Conclusion: This study noted that undernutrition among HIV-positive adults in Ethiopia was quite common. This study also revealed that undernutrition is more common among HIV-positive adults with advanced disease stage, anemia, diarrhea, CD4 count less than 200 cells/mm³, and living in rural areas. Based on our findings, we suggested that all HIV-positive adults should be assessed for nutritional status at the time of ART commencement.

Keywords: Adults; Ethiopia; HIV; Undernutrition.