THE PREVALENCE OF PROTEIN ENERGY MALNUTRITION AMONG HIV- INFECTED UNDER FIVE CHILDREN ON HIGHLY ACTIVE ANTI-RETROVIRAL THERAPY (HAART) IN NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, NIGERIA

Abstract

This study was carried out to determine the prevalence and severity of PEM in under-five
children living with HIV and receiving HAART at NAUTH, Nnewi and to determine the
relationship between some predisposing factors of malnutrition and the nutritional status of
these children.
Data on sociodemographic characteristics, family history, nutritional history, and duration on
HAART were collected using interviewer administered questionnaire. Weight and height
were measured and the weight-for-age, weight-for-height and height-for-age calculated. Data
was analysed using SPSS version 21.0.
Three hundred and seventy HIV infected under- five children comprising 208 (56.2%) males
and 162 (43.8%) females were enrolled into the study. The male: female ratio was 1.3 :1. One
hundred and seventy one (46.2%) were above 48 months of age, 165 (44.6%) were between
25-48 months while 43 (9.2%) were 24 months and below. The mean ages of male and
female children were 43.9±13.1 months and 45.2±12.6 months respectively. Most of the
subjects 285 (77%) were of the low socioeconomic class. Six (1.6%) were in stage 1 HIV
disease, 189 (51.1%) of the subjects were in stage 2 HIV disease while 156 (42.2%) and 19
(5.1%) were in stage 3 and 4 HIV disease respectively. Approximately 15% of the children
were orphans.
The prevalence rate of undernutrition was 39.7% while 0.3% of the children had over
nutrition. The prevalence rates of wasting, underweight, stunting and overweight were 13.2%,
15.7%, 27.9% and 0.3% respectively. The prevalence of severe wasting was 3.0%, 17.6%
were severely stunted while 3.0% were severely underweight. Longer duration on HAART
was observed to be positively associated with the nutritional status of these HIV infected
children. Socioeconomic class of these HIV infected children were observed to significantly
affect their nutritional status. Children from low socioeconomic class were more wasted,
stunted and underweight. HIV infected children who were not exclusively breastfed were
more wasted and underweight. Timely introduction of complementary foods was positively
associated with the nutritional status of these children. Children who were fed three times or
less per day were more underweight and stunted. Children whose parents were single or
widowed were more malnourished than those whose parents were married. Those HIV
infected children from families with greater than four children were more wasted and
underweight than those from families with less than four children. However, there was a
negative association between stunting and the number of children in the family. There was no
significant association between the orphan status of these children with their nutritional
status.
In conclusion, prevalence of PEM is still high among HIV infected children even while they
are on HAART. Longer duration on HAART was found to positively affect the nutritional
status of HIV infected children. Low socioeconomic class and poor feeding practices was
found to negatively affect their nutritional status. Therefore, weight and height should be
routinely monitored to detect malnutrition early and institute appropriate management.
Highly Active Antiretroviral therapy should be commenced for all under five HIV infected
children once a diagnosis of HIV is confirmed. Other socioeconomic factors and feeding
problems affecting the nutritional status of these children should be addressed during their
management.

THE PREVALENCE OF PROTEIN ENERGY MALNUTRITION AMONG HIV- INFECTED UNDER FIVE CHILDREN ON HIGHLY ACTIVE ANTI-RETROVIRAL THERAPY (HAART) IN NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, NIGERIA