Adequacy of Nutrient Intake, Morbidity and Nutritional status of HIV and AIDS Infected Children at Pre and Post Amaranth Grain Supplementation

Abstract

Introduction: Morbidity and mortality related to human immunodeficiency virus (HIV) infection in the developing world remain unacceptably high, despite major advances in HIV therapy and increased funding internationally for care. The HIV epidemic largely overlaps with populations’ already experiencing malnutrition [1]. Combating under nutrition and HIV and AIDS are two of the eight United Nations Millennium Development Goals to be achieved by 2015 [2,3]. Food and nutrition interventions are critical components of comprehensive responses to the HIV pandemic [4-6]. Provision of high quality and adequate food is a significant challenge to the caregivers due to financial constraints, inability to access adequate amounts of food and low diversibility of the diets [4]. A diverse and adequate diet is fundamental for better health for people living with HIV and AIDS [7]. Although the nutrition quality of amaranth grain in other countries has been established, amaranth grain is an underutilized crop in Kenya and yet it has the potential to broaden the food base, enhance diet diversification and reduce the levels of malnutrition among vulnerable groups such as HIV and AIDS infected children.Objective: To determine the impact of amaranth grain supplementation on the adequacy of nutrient intake and nutrition status of HIV and AIDS infected children attending the comprehensive care clinic at Thika District Hospital, Kenya. Methodology: The study was a longitudinal (6 months) experimental pre and post single group design, with a comprehensive sample of 52 children. The study included baseline assessment and an intervention phase. The intervention included monthly provision of adequate amaranth flour to be consumed by the children on a daily basis, nutrition education and counseling. The data collected comprised demography, dietary intake, anthropometric, morbidity, and CD4 counts.Results: Baseline findings indicated inadequate mean intake of total kilocalories (1281.10±379.69), vitamin A (268.35±216.65), calcium (412.41±253.79) and selenium (26±12.93). There was significant difference (P < 0.001) between mean intake of all nutrients at baseline and after intervention at 95% confidence level. Pre-intervention stunting was 36.5%, wasting 34% and underweight 30.8%. Wasting and underweight reduced significantly (P= 0.001) after intervention but not so for stunting (P= 0.083). Conclusion: The findings indicated that dietary intake and morbidity are significant predicators of nutritional status of HIV infected children. It is recommended that public awareness and education on the nutritive value and nutritional benefits of amaranth grain be promoted by nutritionists. Sensitization of the consumption of amaranth grain need to be upscaled by nutritionists and other care providers of persons infected with HIV and AIDS.