Effectiveness and challenges of Insta prescribed porridge on nutritional status of under 5 malnourished HIV/AIDS children at Lea Toto, Kangemi, Nairobi, Kenya
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Date
2014-03-12
Authors
Masinde, Lily Jane Ateko
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Abstract
A lot is published on the role of good nutrition in mitigating the effects of HIV/AIDS,
but little is known about the effectiveness of prescribed diets (Food by Prescription
(FBP)) in malnourished HIV infected children. The aim of the study was to determine
the effectiveness of a prescribed porridge blend, branded 'Insta First Food (FF)', in
improving the nutritional status of malnourished HIV infected children below 5 years
attending Lea Toto comprehensive care centre, Kangemi slum, Nairobi. FF is a
combination of whole maize (Zea mays L.), millet (Eleusine coracana (L.) Gaertn.),
sorghum (Sorghum bocolor (L.) Moench), soya (Glycine max (L.) Merr.), sugar
(Saccharum officinarum L.), oil, with added vitamins and minerals.
The study was a quasi experimental design that compared nutritional status at baseline
(entry) and final (exit). 234 HIV infected children aged 6-59 months with a Z score <
-2 were eligible. The children completed the study when they attained a Z score> -1,
relapsed, died or failed to achieve a Z score > -1 after 3 months. (July - October
2008). A questionnaire on socio-dernographic/economic factors was administered to
the caregivers and supplementary data such as infections suffered from were derived
from medical records at the study centre. Chi-square was used to test associations
between dependent variables (Z scores), and independent variables. A paired T-test
was performed to test for mean difference between baseline and after intervention.
Frequency distribution on individual variables was undertaken and cross tabulations
between all categorical variables and Z-scores performed to uncover the distribution
patterns. Pearson chi-square test was performed to test for association between Zscores
and individual categorical variables.
81.2% attained a Z score of> -2 in 2 or 3 indicators (WAZ, HAZ and WHZ) whereas
only 18.8% had 0 or 1 indicator showing> -2 after 3 months period. Weight gain was
significant (p<0.05). Inconsistency in improvement of Z scores was significantly
linked to socio-demographic/economic factors especially age of child (P=0.002),
relationship of caregiver to child (P=0.072), correct porridge preparation (P=0.020)
and age of care giver (P=0.071). There was significant association between training
and correct porridge preparation (p<O.OOl). Children aged 0.5 - < 2 years were 3.3
times more likely to improve their nutrition status as compared to those above 2 years;
correct food preparation placed a child at 2.6 fold better than wrong preparation;
children with caregivers aged ~30 years were 1.9 times more likely to improve.
Addressing malnutrition in HIV infected children should entail an integrated
programme that addresses nutrition and socio demographic/economic factors such as
age of child and caregiver, training on food intervention, family planning, medical
and child care.
Description
Department of Community Health, 68p. The RC 607 .A26M8 2009
Keywords
HIV infections --Nutritional aspects, HIV-positive persons --Nutrition | AIDS (Disease) --Diet therapy, HIV infections --Diet therapy