Dietary Intake, Nutrition Status, Morbidity and Factors Affecting Food Service of Male Prisoners Living with uman Immunodeficiency Virus at Selected Prisons Kenya
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Date
2018-01
Authors
Kavithe, Rachel Kavisa
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Dietary intake and consequent nutrition status impacts on HIV either negatively or
positively. Within prison settings, barriers exist that limit ability of prisoners to
improve and maintain their health. Prisoners are a population recognized as
vulnerable and socially excluded and poor nutrition status has been a hindrance to
providing adequate treatment to those among them living with HIV. Generally, men's
prison population is higher, have more muscle mass and perform hard chores hence
making their nutritional requirements greater. The prisons were chosen because they
had high HIV rates at 8.2% compared to the general population's 5.9%, The purpose
of this cross sectional analytical study (n=113) was to assess factors affecting food
service, dietary intake, nutrition and morbidity status of male prisoners living with
HIV at selected prisons in Kenya. Purposive sampling procedure was used to select
the prisons and study population. Simple random sampling was used to select the
subjects for the study whereas proportionate sampling was used to get specific
numbers per prison due to variance of number of prisoners living with HIV in the
selected prisons. A structured questionnaire was used to collect demographic, 24 hour
recall, food frequency and anthropometric data. An observation checklist and Focused
Group Discussions was used to collect qualitative data. Anthropometric data were
analyzed using World Health Organization classification while 24 hour recall was
analyzed for mean nutrient consumption for key nutrients by use of Nutri-survey
software. The 7 day recall was analyzed for food frequency. These data were further
analyzed using SPSS software. Association between morbidity and nutrition status
was analyzed using regression analysis. Pearson Chi-square was used to compare
percentages between prisons. Pearson's Product Moment correlation (r) was used to
analyze continuous data where P -value <0.05 was considered significant. Descriptive
statistics were used to describe and summarize data on respondents', demographic
characteristics and morbidity status. Results revealed that 50.4% of the prisoners were
between ages 36-53 years. Primary education was attained by 60.2% and Secondary
21.2%. Mean dietary intake for macronutrients was Energy (815±218Kcal.), Protein
(56±12g), fat (32±6g), Carbohydrates (322±45g), Fiber (41±23g) and PUFA (8±1g).
None of the prisoners attained Recommended Daily Allowances (RDA) for energy,
fat and PUFAs. Mean key micronutrient intake was Vitamin A (1195.1±812.7J.1g),
,. Vitamin B6 (1.9±0.9mg), Vitamin C (55.7±18.4mg), Iron (l0.2±2.7mg), Magnesium
(488.l±152.3mg) and Zinc (13.9±6.7mg). However, none met the RDA for Sodium,
Calcium and Iron. Normal nutrition status per Body Mass Index was 66.4% based on
World Health Organization classification. A total of 14.2% of respondents were
underweight, 15.9%overweight and 3.5% obese. The most prevalent illnesses were
Anemia (20.9%) and Malaria (16.9%). A number of respondents also reported
diarrhea (14.1%) and oral thrush (6.8%) which could have had a negative relationship
with nutrition status. There was no significant relationship (P<0.05) between the study
variables. Consumption of a nutritionally balanced diet in prisons can only be
achieved by variety of foods that contain necessary nutrients. Support for therapeutic
foods should be at source whenever needed and nutrition officers should be employed
to support Nutrition Assessment Counselling and Support at prisons. Prison staff and
prisoners should be given nutrition education as an integral part of health promotion
and disease prevention. Prisoners' health is important and therefore management
should be as stipulated in guidelines without discrimination. The nutrition guidelines
for HIV should apply equally to both prisoners and non-imprisoned People Living
with HIV.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirement for the Award of the Degree of Master of Science (Food, Nutrition and Dietetics) in the School of Applied Human Sciences of Kenyatta University, January, 2018
Keywords
Male Prisoners, Immunodeficiency Virus, Kenya