Household food insecurity access scale and dietary diversity score as a proxy indicator of nutritional status among people living with HIV/AIDS, Bahir Dar, Ethiopia, 2017.

Aragaw Yimer Ahmed,Oumer Sada Muhammed,Foziya Mohammed Hussein,David A. Lightfoot

doi:10.1371/journal.pone.0199511

Aragaw Yimer Ahmed, Oumer Sada Muhammed

Open Access

https://doi.org/10.1371/journal.pone.0199511

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Journal: PloS one	Publication Date: Jun 28, 2018
Citations: 34	License type: CC BY 4.0

Affiliation: Wollo University, Addis Ababa University

Abstract

BackgroundBoth household food insecurity and household dietary diversity have been found reliable in describing the dietary intake of a population. However, it had not been proven as reliable instrument for assessing nutritional status of individuals in a clinical context. There has been a need for evidence on the validity of using proxy and easy dietary indicators for nutritional status.MethodA facility based cross sectional study design was employed on 423 people with HIV infection visiting all ART clinics in Bahir Dar, North Ethiopia. Nutritional status was determined by computing BMI. Food insecurity was assessed using household food insecurity access scale. Dietary diversity was measured using a tool adopted from Food and Nutrition Technical Assistance Project. Data were entered to Epidata version 3.1and analyzed by SPSS version 20. Reliability analysis, sensitivity and specificity analysis were determined.ResultThe sensitivity of the household food insecurity access scale and dietary diversity score was 87.9% and 79.8%, respectively, while their specificity was 56.2% and 70.2%. The AUC at 95% CI for the household food insecurity access scale and household dietary diversity score were 73.4 (68.4–78.4) and 73.1 (68.1–78.2) while their cut of point that maximized their sensitivity and specificity was 1 and 6 respectively. Household food insecurity access scale and household dietary diversity score were found to be reliable tools with a Cronbach’s Alpha of 0.926 and 0.799, respectively.ConclusionIn assessing under nutrition among PLHIV especially in limited resource settings, both the household food insecurity access scale and household dietary diversity score were found valid and reliable proxy indicators for measuring nutritional status.

Highlights

MethodsStudy setting and samplingA facility-based, cross-sectional study design was employed in February, 2017 in Bahrdar city administration, a capital of Amhara regional state, North- western Ethiopia
The dietary diversity scores consist of a simple count of food groups that a household or an individual has consumed over the past 24 hours[2]
Reliable assessment of nutritional status is essential for identifying nutritional issues and at-risk groups in a given population for the development of dietary intervention programs and for monitoring the efficiency of such interventions[5]

Summary

Methods

Study setting and samplingA facility-based, cross-sectional study design was employed in February, 2017 in Bahrdar city administration, a capital of Amhara regional state, North- western Ethiopia. Household food insecurity access scale and dietary diversity score included all of the available ten ART clinics, of which seven were governmental and three private. The sample size (423 PLHIV)for the study was determined assuming a 50% of proportion, a 95% confidence level, a 5% margin of error and an expectation of 10% non-response rate.Using proportional to population size the required sample size was allocated for all clinics. Household food insecurity access was measured using items from the Household Food Insecurity Access Scale (HFIAS) of FAO-FANTA. For the purpose of this paper, we were used the total score (9-items based on the frequency score). A total score of 27 represents the most food-insecure household whereas a lower score represents a more food-secure household [8]

Results

Discussion

Conclusion