Dietary practices, health and nutrition status of HIV/AIDS infected pre-school children in Kibera slum, Nairobi
Chege, Peter Maina
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It is estimated that 38 million persons are living with HIV/AIDS in the world and 29.4 million of them are in Africa. In Kenya, 1.5 million people are infected with HIV/AIDS. It is estimated that 100,000 children below the age of five years are infected with HIV/AIDS. The HIV/AIDS opportunistic infections compounded with appropriate dietary practices and low socio-economic status contributed to the high prevalence of protein energy malnutrition (PEM). This leads to high morbidity and mortality rates. This study determined the dietary practices, morbidity patterns, caregiving practices and the nutrition status of HIV/AIDS infected pre-school children. Descriptive research design was used for the study where a purposively selected sample of 64 HIV/AIDS infected and 64 non-infected pre-school children in Kibera slum was used. Data were collected using a researcher-administered questionnaire and focus group discussion guides. Data were analyzed by use of SPSS. The qualitative data were transcribed coded and categorized to form themes. Results show that, the numbers of meals consumed by the children were inadequate as they took an average of 3.4 meals instead of 5-6 per day. The consumption of kilocalories was inadequate for about 60% of the children. For the majority (over 90%), consumption of protein, vitamin C and iron were adequate while consumption of vitamin B complex, vitamin A, calcium, magnesium, selenium and zinc were inadequate. The consumption of vegetables, fruits, animal products, nuts and tubers were irregular for the majority of the children while only cereals, pulses and fats were consumed regularly. The leafy vegetables were fried in fat for a long time thus destroying volatile nutrients. The main illnesses reported were malaria, cold, cough and pneumonia. The major symptoms of these illnesses were; fever, diarrhoea, vomiting and loss of appetite. The proportion of stunted children was 44% for the HIV/AIDS infected and 22% of the non-infected pre-school children. About 33% of the HIV/AIDS infected and 22% of the non-infected pre-school children were wasted, while 51% of the HIV/AIDS infected and 17% of the non-infected pre-school children were underweight. Only 11% of the caregivers had adequate nutrition knowledge. About 47% of the caregivers were uncomfortable with taking care of the infected children due to lack of finances to cater for the needs of the child. There were positive but weak relationships (r < 0.3), which were significant (p < 0.05) between the nutrition status and the education level of the caregivers, amount of kilocalories taken, number of meals taken per day and nutrition knowledge level of the caregiver. However, there were weak inverse relationships (r < -0.3), that were significant (p < 0.05) between the household size, sick condition and the nutrition status. There was no significant difference between the dietary practices of the HIV/AIDS infected and non-infected children, but there was a significant difference in health and nutrition status. This was attributed to the effect of HIV/AIDS on consumption and utilization of nutrients. Thus, the study found out that the dietary practices were poor, the children were frequently ill and their nutrition status was poor. The study recommends that the government and NGOs to facilitate the households infected and affected by HIV/AIDS towards income generating activities to help them access adequate meals and medication. The caregivers should be trained on health and nutrition care for these children.