The Association between Nutrient Intake, Body Anthropometry and Quality of Life of HIV/AIDS Patients in Ghana

Abstract

HIV/AIDS is a public health problem that is increasingly having its toll on human resources, particularly given the fact that the most vulnerable age group is the youth. Even though tremendous achievements have been chalked through the use of antiretroviral drugs, these drugs are expensive and unaffordable by PLWHA in Ghana. Good nutrition has therefore been deemed as a complement to anti-retroviral drugs for maximum benefit to this group of people. Ironically, most studies into the nutritional aspects of HIV/AIDS have been done in industrialised countries involving subjects with completely different lifestyles, better nutrition and relatively better health care. Extrapolating these findings to the African context could lead to erroneous conclusions. There is, therefore, the need for more research in our part of the world for better policy actions. The objective of this study was to study the association between nutrient intake, body anthropometry and quality of life of HIV/AIDS patients in Ghana. The study involved 281 patients who had been tested and confirmed seropositive for the HIV virus and were attending the Korle Bu and Komfo Anokye Teaching Hospitals. Subjects were grouped into two, based on the stage of their infection; those with HIV but not AIDS as the first group (i.e. non-AIDS group) and those with AIDS as the second group (i.e. AIDS group). Clinical (symptoms), anthropometric (weight and height) and dietary (using 24hr recall method) data were collected simultaneously by the use of semi-structured questionnaires. Quality of life scores were calculated on the basis of the number of clinical symptoms (eleven in all) that a particular subject was free from. On a scale of 0 - 11, the higher the score the better the quality of life. Non-AIDS male subjects had a mean BMI of 23.8 + 3.2 Kg/m2, which was significantly higher (P < 0.0001) than that of the AIDS male subjects, who had 18.3 + 2.3 Kg/m2. Also, non-AIDS female subjects had an average BMI of 23.9 + 3.4 Kg/m2, which was significantly higher (P < 0.0001) than that of the AIDS female subjects, who had 18.0 + 2.3 Kg/m2. There were no significant differences between the BMIs of the two sexes in the same group. The levels of nutrient intakes were better in the non-AIDS subjects than the AIDS subjects. Non-AIDS subjects met the RDA for vitamins A, B)2 (males alone), C; phosphorus, iron, zinc (males alone), protein and dietary fibre; but not vitamins B1, B2 , Niacin, B6, Folate, D and E; minerals Ca, Mg, K, Na, I2 , Se, Cu; as well as energy. AIDS subjects did not meet RDA for any of the nutrients, except the males who met 91.2% of RDA for iron. Energy intake correlated significantly and positively with BMI (r = 0.687, p<0.000l) and weight (r = 0.572, p<0.0001), and negatively with the stage of the infection (r=-0.725, p<0.0001) and avoidance of certain food items (r=-0.411, p<0.000l). Energy intake also correlated significantly and negatively with occurrence of anorexia (r--0.407, p<0.0001), anaemia (r=-0.395, p<0.0001), diarrhoea (r=-0.358, p0.000l), oral lesion (r=-0.336, p<0.0001), sore throat (r=-0.286, p<0.0001), tuberculosis (r=-0.219, p<0.000l), vomiting (r=-0.206, p<0.0001) and skin rashes (r=-0.160, p=0.007). Energy intake did not correlate significantly with the intake of multivitamin and mineral supplements, alcohol consumption or smoking. Quality of life correlated significantly and positively with iron (r=0.547, p<0.000l), protein (r=0.545, p0.000l), energy (r=0.542, p<0.000l), zinc (r=0.526, p<0.000l), Niacin (r=0.510, p<0.000l) and all the other nutrients studied except vitamin A. BMI also correlated significantly and positively with protein (r=0.718, p0.000l), iron (r=0.691, p<0.000l), energy (r=0.687, p0.000l), zinc (r=0.682, p0.000l) and Niacin (r=0.681, P0.000l) and all the other nutrients studied. The quality of life of subjects correlated significantly and positively with their BMI and weight. It is recommended that future studies involving PLWHA should include the use of CD4+ lymphocyte counts in HIV/AIDS disease staging.