Nutritional knowledge, attitude, and practices among HIV-positive individuals in India

Nutritional knowledge and practice among antiretroviral therapy user adults in Bule Hora hospital, southern Oromia, Ethiopia

Introduction

Nutrition is the necessary basis for life, health, and human development over the entire lifespan. Poor nutritional knowledge, poor nutritional practices, and malnutrition among HIV-positive adults can contribute to accelerating the progression of Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and related diseases. Therefore, this study aimed to assess the dietary knowledge, practices and associated factors of HIV-positive adults participating in antiretroviral therapy (ART) at Bule Hora Hospital, West Guji Zone, South Oromia, Ethiopia.

Methods

A cross-sectional institutional study was conducted among 418 HIV-positive adults by systematic sampling technique. Semi-structured questionnaires were used for data collection and analyzed with SPSS version 21.0. Logistic regression analyses were used to identify factors associated with dependent variables using adjusted odds ratio (AOR), with 95% CI (confidence interval) at p < 0.05.

Results

The result of this study showed that the prevalence of poor nutritional knowledge and poor nutritional practices among (HIV) positive adults was 74.9 and 69.1%, respectively. In the multivariate analysis, adult age (AOR = 2.37, 95% CI: 1.30, 4.32), marital status (AOR = 2.46, 95% CI: 1.29, 4, 69), educational level (AOR = 1.83, 95% CI: 1.01, 3.30) and occupational status (AOR = 0.55, 95% CI: 0.25, 0.94) were significantly associated with the nutritional knowledge. Educational level (AOR = 2.58, 95% CI: 1.48, 4.50), monthly income (AOR = 2.80, 95% CI: 1.68, 4.69), and adult occupational status (AOR = 0.48, 95% CI: 0.26, 0.89) were also significantly associated with the level of dietary practice.

Conclusion

It was concluded that the respondents' nutritional knowledge and practices in the city of Bule Hora were poor compared to other national findings. The identified factors related to nutritional knowledge and practices were educational level, monthly income, adult occupation, and marital status of respondents in the study area. Therefore, each concerned agency should address the above gaps in nutritional knowledge and practices of HIV-positive adults in the study area.

Status of food safety knowledge, attitude, and practices of caregivers of children in northern Uganda

The safety of homemade weaning foods in low- and middle-income countries is of great concern as rural households have limited access to standardized commercial weaning foods. In the Acholi subregion of Uganda, complementary foods are locally produced. However, there is limited information on the Food safety knowledge (FSK), food safety attitude (FSA), and food hygiene practices (FHP) of the caregivers. This study examined food safety knowledge, attitude, and practices of the caregivers of children 6-23 months of age in Amuru and Nwoya districts, Northern Uganda, between March 2019 and June 2019. A cross-sectional study was conducted involving 180 caregivers. Data were collected using semi-structured questionnaires and focus group discussions and analyzed using descriptive statistics, multivariate binary logistic regression, and thematic content analysis. Caregivers had sufficient FSK (74.1%) and positive FSA (68.1%). However, only 17.6% of them adhered to FHP. Frequency of food safety training (p = .041) and households with children who suffered from foodborne illness (p = .001) significantly predicted FSK. Conversely, both FSK and FSA were significantly predicted by gender roles in decision-making on household income (p = .006) and households with older children (p = .041). A significant positive correlation was observed between FSK and FSA (r = .406, p = .000). However, major barriers to adherence to FHP were inadequate sanitation facilities and caregiver's workload. The overall nontranslation of sufficient FSK and positive FSA into proper FHP calls for future intervention to harness the sociodemographic factors that influence FSK and FSA and address the barriers to FHP among caregivers.

Non-attitudinal and non-knowledge based factors constrain households from translating good nutritional knowledge and attitude to achieve the WHO recommended minimum intake level for fruits and vegetables in a developing country setting: evidence from Gulu district, Uganda

BACKGROUND

The high level of incidence of mortality attributed to non-communicable diseases such as cancer, diabetes and hypertension being experienced in developing countries requires concerted effort on investment in strategies that can reduce the risks of development of such diseases. Fruits and vegetables (FV) contain natural bioactive compounds, and if consumed at or above 400 g per day (RDMIL) as recommended by World Health Organization (WHO) is believed to contribute to reduced risk of development of such diseases. The objective of this study was to determine in a developing country set-up, the extent to which rural and urban households conform to RDMIL, the status of nutritional attitude (NA) and knowledge (NK) associated with consumption of FV, and to delineate non-attitudinal and non-knowledge-based factors (NANK) that hinder achievement of RDMIL.

METHOD

A cross-sectional survey of 400 randomly selected households and 16 focus group discussions (FGD) were conducted using Gulu district of Uganda as a microcosm for a developing country setting. Level of consumption of FV was assessed using 24-h dietary recall and compared to RDMIL as a fraction (%). The status of NK and NA were determined using sets of closed-ended questions anchored on a three-point Likert scale. Further quantitative statistical analyses were conducted using t-test, chi-square, Pearson's correlation and multiple linear regression. FGD provided data on NANK factors and were analysed using qualitative content analysis procedure.

RESULTS

Urban and rural inhabitants met up to 72.0 and 62.4% of the RMDIL, respectively, with absolute intake being higher among urban than rural households by 37.54 g. NK and NA were good but the intensity of NK was higher among urban respondents by 11%. RDMIL was positively correlated with NA while socio-demographic predictors of RDMIL varied with household location. FGD revealed that primary agricultural production constraints, market limitations, postharvest management limitations, health concerns, social discomfort and environmental policy restrictions were the major NANK factors that hindered achievement of the RDMIL.

CONCLUSIONS

These results indicate that NANK factors constrain households from translating good NA and NK to achieve the RMDIL.

Factors associated with nutritional status, knowledge and attitudes among tuberculosis patients receiving treatment in Ghana: A cross-sectional study in the Tema Metropolis

Background

Nutritional deficiencies are generally associated with increased risk and severity of tuberculosis. This study investigated the nutritional status, knowledge, and attitudes of tuberculosis (TB) patients receiving treatment in the Tema Metropolis.

Method

A cross-sectional design was used to collect data on the nutritional knowledge, attitude, and status of TB patients. Nutritional status was analysed using World Health Organization’s formula for body mass index. Pearson’s chi-square and logistic regression models were used to assess associations between predictor and outcome variables. All statistical analyses were considered significant at p-values < 0.05.

Result

The prevalence of malnutrition among TB patients was 39.7%, 14.4%, and 4.8% for underweight, overweight, and obesity respectively. There was a high (61.0%) knowledge of nutrition among the patients. Also, 65.8% had good attitude towards nutrition. There were significant associations between normal nutritional status and age of the TB patients (p = 0.041), highest educational level attained (p = 0.036), employment status (p = 0.019), status of alcohol intake (p = 0.031), number of months on TB treatment (p = 0.021), and attitude towards nutrition (p = 0.028).

Conclusion

There was a reasonable nutrition-related knowledge and attitude towards nutrition among the TB patients. However, that did not reflect on their nutritional status. We recommend continuing education on smoking cessation, avoidance of harmful use of alcohol, and the establishment of food aid and other livelihood intervention programs for TB patients.

Nutritional status and associated factors among people living with HIV/AIDS in Ghana: cross-sectional study of highly active antiretroviral therapy clients

Background

Nutrition among people living with HIV/AIDS (PLWHA) is essential in their care and management as it has implication for their immune function. We examined the nutritional status and associated factors among HIV positive clients accessing Highly Active Anti-Retroviral Therapy (HAART) at a public hospital in Ghana.

Methods

This was a descriptive cross-sectional study of 152 clients. Anthropometric measurements for weight and height were carried out in 2019. Data were analysed using SPSS 22.0. Descriptive and analytical statistics comprising frequency, percentage, and binary logistic regression were adopted in presenting the results.

Results

Seventy-nine percent and 74% of the clients had good nutrition knowledge and attitude, respectively. Also, 42% were malnourished (underweight = 13.8%, and overweight = 28.3%). Clients with primary (AOR = 0.36, 95% CI = 0.07–1.84), JSS/JHS (AOR = 0.26, 95% CI = 0.08–0.84), SSS/SHS (AOR = 0.22, 95% CI = 0.05–1.02) and tertiary (AOR = 0.26, 95% CI = 0.08–0.88) were less likely to be malnourished compared with those with no formal education. Those with good nutrition-related knowledge were 56% (AOR = 0.44, 95% CI = 0.18–1.09) less likely to be malnourished than those with poor knowledge; this was however, not statistically significant.

Conclusion

We found a high prevalence of malnutrition among the clients which militates against progress towards achieving the Sustainable Development Goal targets 3.3 and 3.4 of stopping AIDS epidemic and preventing premature deaths from malnutrition. Our findings justify the need for the implementation of innovative interventions by stakeholders in Ghana’s health industry to improve the nutritional status of people living with the disease.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-021-00418-2.

An evidence-based nutrition education programme for orphans and vulnerable children: protocol on the development of nutrition education intervention for orphans in Soweto, South Africa using mixed methods research

BACKGROUND

Focus on interventions for orphans and vulnerable children (OVC) in South Africa on education, quality of life (QoL) and nutrition-related matters have been reported diminutive. The risk of dropping out of school for an OVC with poor QoL and without varied food intake is very high. The problem with poor; QoL, nutritional care and academic performance (AP) of the OVC is that it sets the foundation for their adults' life. The purpose of this longitudinal study is to develop, implement and to test the efficacy of an evidence-based nutrition education programme (NEP) for OVC that will integrate their families/caregivers, schools and communities.

METHODS

A longitudinal study, and a mixed-methods approach steered by action research will be used. This study will be in three phases. Phase 1 will be the needs assessment; Phase 2 will be the development of nutritional education materials, and Phase 3 is the intervention. QoL, dietary intakes, body composition, and anthropometric status, physical activities, and AP of 520 OVC in Soweto will be assessed using standard techniques. Nutrition knowledge, attitude and practices (KAP) of the caregivers will be assessed using previously validated questionnaires. Focus group discussion (FGD) will be conducted to gain an in-depth understanding of what OVC eat and factors affecting their food intakes. Data will be collected at baseline, week 12 and week 24. Generalised Least Squares (GLS) regression model will be used to test the study hypotheses. Atlas-ti and Thematic Framework Analysis (TFA) will be used for qualitative data analysis.

DISCUSSION

This study will provide detailed information on the QoL, food intakes concerning academic performance and general well-being of OVC in an Africa setting. The participatory mixed methods nature of the study will provide valuable insights into the drivers and challenges to QoL, AP, and nutritional status of this group. This approach will assist the policymakers' and other stakeholders in decision making regarding the general well-being of the OVC.

TRIAL REGISTRATION

ISRCTN12835783 . Date registered 14.01.2019.

Development, Implementation, and Process Evaluation of a Theory-Based Nutrition Education Programme for Adults Living With HIV in Abeokuta, Nigeria

Introduction: Healthy diets play a role in the management and care for adults living with HIV/AIDS (ALH). Appropriate nutrition education (NE) is necessary to equip ALH with relevant knowledge and skills for healthy eating. A needs assessment identified the need for a nutrition education programme (NEP) as part of the nutrition service for ALH in Abeokuta, Nigeria. The aim of this study was to design a theory-based NEP and to evaluate the implementation process among ALH attending selected federal and state hospitals in Abeokuta as out-patients. Materials and Methods: An exploratory descriptive needs assessment in the qualitative and quantitative domains was conducted among a convenient sample of ALH (N = 243) at the selected hospitals. The quantitative needs assessment identified needs for improvement in the primary outcome [quality of life (QoL)] and the secondary outcomes [quality of dietary intake, nutrition knowledge, attitudes, and practice (KAP), and anthropometric status]. Participants' perceptions of the NEP were obtained using an interviewer administered questionnaire among 70 ALH who attended the implementation of the NEP and process evaluation thereof at the intervention hospital. Results: The qualitative results identified a lack of knowledge on planning varied meals with limited resources. The identified needs, existing guidelines and literature were integrated with appropriate constructs of the Social Cognitive Theory (SCT) and the Health Belief Model (HBM) into the NEP. The NE manual, participant's work book, flipcharts, and the brochure were tailored to address the identified challenges. Discussion: The process evaluation showed that the NEP was implemented as planned and that the participants' perceptions were positive. The use of the NE manual, participant's work book, flipcharts, and brochure demonstrated the practicality of incorporating behavioral theories in NE for ALH.

Nutritional knowledge, dietary practice and associated factors among adults on antiretroviral therapy in Felege Hiwot referral hospital, Northwest Ethiopia

Background

Nutritional support is identified as one of the most critical and immediate needs for people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Adequate nutrition is vital to optimize response to medical treatment, manage opportunistic infections, maintain the immune system, and support optimal quality of life for people living with HIV/AIDS (PLWHA). Evidence has shown that the progression of the disease could be slowed with good nutrition. Nutrition interventions increase compliance with treatment regimens and optimize the benefits of antiretroviral drugs. The nutritional knowledge, dietary practice and associated factors among adults on antiretroviral therapy are not well understood generally in Ethiopia and particularly in Bahir Dar City. Therefore, the aim of this study was to assess the nutritional knowledge, dietary practice and associated factors among adult PLWHA on anti-retroviral therapy (ART) in Felege Hiwot Referral Hospital.

Methods

Institution based cross-sectional study was conducted from April 13 to May 18, 2017 in Felege Hiwot Referral Hospital. Systematic random sampling technique was used to select 539 adults on highly active antiretroviral treatment (HAART). Data were collected using a semi-structured and pretested questionnaire. Bivariate and multivariate logistic regression analyses were carried out to identify factors associated with nutritional knowledge and dietary practice.

Results

This study shows that 25.8, 52.5 and 21.7% of respondents had poor, average and good nutritional knowledge scores respectively. Ever heard about good nutrition and received dietary counselling were significant factors for nutritional knowledge. This study also reveals that 3.2, 66.4 and 30.4% of respondents had poor, average and good dietary practice scores respectively. Presence of gastrointestinal symptom, ever heard about good nutrition and good nutritional knowledge were significant factors for dietary practice.

Conclusions

This study found that the magnitude of good nutritional knowledge and good dietary practice were 21.7 and 30.4%. Nutrition education and counseling should be given by health care workers for patients on ART to improve their nutritional knowledge. The media should also strengthen its role in disseminating nutrition information. The health professionals should routinely diagnose and treat gastrointestinal symptoms to maintain patients' appetite for food their by increasing dietary intake.

The mix of good nutritional attitude and poor nutritional knowledge is associated with adequate intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of Northern Uganda

Nutritional knowledge and attitude of a population greatly affect intake of essential micronutrients. Much of the understanding on the impact of nutritional knowledge and attitude on nutrient intake has been derived from studies conducted among affluent societies using commercial food products. However, information on the link between status of nutritional knowledge and attitude on intake of essential nutrients from wild fruits and vegetables among rural communities is largely lacking. This study examined the status of nutritional knowledge and attitude associated with intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of northern Uganda. A cross-sectional study design making use of individual household questionnaire and proximate dietary recall of a calendar year consumption period involving 248 randomly selected rural households was applied. Results showed that households had good nutritional attitude but poor nutritional knowledge. Status of knowledge was dependent on nutrition training (p = 0.028; coefficient, β = 0.710) and age of the respondent (p = 0.044; β = -0.023), whereas status of attitude was predicted by age of the respondent (p = 0.014; β = 0.048). Consumption of wild fruits and vegetables contributed adequately to the dietary vitamin A and iron requirements of the households. The results have demonstrated that intake of vitamin A and iron from wild fruits and vegetables among rural households is associated with good nutritional attitude but poor nutritional knowledge. A concerted effort is necessary to improve household nutritional knowledge for better utilization of wild fruits and vegetables.

The status of nutritional knowledge, attitude and practices associated with complementary feeding in a post-conflict development phase setting: The case of Acholi sub-region of Uganda

Inappropriate complementary feeding is an important challenge to proper child nutrition in post-conflict rural areas in many sub-Saharan African countries. While in protected areas during conflict situation and soon after during recovery, communities normally receive nutrition education as part of capacity building to improve knowledge, attitude, and practices to enable them manage maternal and child nutrition issues during the post-conflict development phase. It is largely unknown whether capacity in nutrition provided is maintained and adequately applied in the post-conflict development situation. Using Acholi sub-region of Uganda, an area that experienced violent armed conflict for 20 years (mid-80s-early 2000), as a case study, we examined the status of nutritional knowledge, attitude, and practices associated with complementary feeding among caregivers of 6- to 23-month-old children in a post-conflict development phase following return to normalcy nearly 10 years post-conflict emergency situation. The results showed that a high proportion of caregivers had good knowledge (88%) and attitude (90.1%) toward complementary feeding. However, only a half (50%) of them practiced correct nutrition behavior. Education status of the household head and sex of the child significantly predicted caregiver knowledge on complementary feeding (p ≤ 0.05). Education status of the household head also predicted caregiver attitude toward complementary feeding (p ≤ 0.05). Poverty, food insecurity, and maternal ill health were the major factors that hindered caregivers from practicing good complementary feeding behavior. These results demonstrate that nutrition education on complementary feeding provided to the community during conflict emergency and recovery situation is largely retained in terms of knowledge and attitude but poorly translated into good child feeding practices due to poverty, food insecurity, and maternal ill health. Maternal health, food security, and poverty reduction should be prioritized if adequate complementary feeding is to be achieved among conflict-affected communities in the post-conflict development phase.

ASHA-Life Intervention Perspectives Voiced by Rural Indian Women Living With AIDS

In this focus group study, we explored the experiences of 16 rural women living with AIDS (WLA) who participated in the Asha-Life (AL) intervention to gain an understanding of the environmental, psychosocial, and cultural impact of the AL on their lives. Four themes emerged among AL participants: (a) the importance of tangible support, (b) need for social support, (c) ongoing challenges to accessing antiretroviral therapy (ART), and (d) perspectives on future programs. Our research findings support the development of future programs targeting mother-child dyads which emphasize nutritional knowledge, while reducing barriers to receiving ART, and physical, emotional, and financial support.

Factors predicting nutrition and physical activity behaviors due to cardiovascular disease in tehran university students: application of health belief model

Background:

Disease preventing methods focus mostly on lifestyle factors such as physical activity, healthy diet and not smoking. Previous studies verified using theory and models to change unhealthy behaviors, so that health belief model (HBM) is a useful framework for describing the healthy nutrition behavior.

Objectives:

This study aimed to predict factors related to unhealthy nutrition and inactive life in students of Tehran University, Tehran, Iran based on the Health Belief Model (HBM).

Patients and Methods:

In this cross sectional study, proportional quota sampling from three different educational levels was conducted from October to December 2012. A self-administered validated instrument based on the Health Belief Model (HBM) with 69 items and four sections was used to collect data. In this study through using linear and logistic regression, the effect of body mass index, age, gender, marriage, self-efficacy, cues to action, knowledge, perceived severity, susceptibility, benefits and barriers on nutrition and physical activity behavior were assessed. SPSS version 18 was used to analyze data.

Results:

Totally, 368 students including 318 female students (86.4%) and 50 male students (13.6%) with a mean age of 24.9 years (SD = 4.55) took part in the study. Among all independent variables, gender (P < 0.001), knowledge (P = 0.023) and perceived barriers (P = 0.004) predicted nutrition behavior. In case of physical activity, knowledge (P = 0.011), perceived severity (P = 0.009), perceived barriers (P = 0.019) and self-efficacy (P = 0.033) had significance association with physical activity behavior.

Conclusions:

This study indicated that health belief model contrasts could predict the risky behavior of university students due to heart disease. However, more researches are needed to verify the predictors of high risky behaviors in students.

Community knowledge and experience of mosquitoes and personal prevention and control practices in Lhasa, Tibet

Since 2009, great public attention has been paid in Lhasa City (Tibet, China) to mosquito bites and accompanying inflammatory complications. However, the potential contribution of knowledge levels, experiences, disease control and preventive practices (KEP) towards mosquitoes has not received much attention. To investigate community KEP concerning mosquitoes in Lhasa, a cross-sectional survey was undertaken in four sub-districts of urban Lhasa in 2012. Questionnaires were designed to collect information regarding socio-demographics and KEP concerning the harmful effects of mosquitoes on participants. The scoring for KEP was developed after consultation of literature. A total of 591 eligible questionnaires were examined. The majority of respondents were female (61.8%) with a mean age of 46 years. Nearly all of the respondents were of Tibetan nationality (97.4%) and living in registered native households (92.7%), who have less than primary school education. The averages of overall score, knowledge score, experience score, and practice score were 9.23, 4.53, 1.80, 2.90, respectively. The registered household with the highest overall score, knowledge score and practice score was non-native. Female subjects with monthly incomes between 1000 and 3000 RMB had higher experience scores. The correlation analysis revealed that significant positive linear correlations existed between knowledge and experience, knowledge and practices, and experience and practices towards mosquitoes. Past experiences with mosquitoes can result in a better knowledge of effective mosquito control practices in the present and the future. Though the average of overall scores related to mosquitoes is high among the participants in Lhasa, however, the knowledge about the ecological habits of mosquitoes should be strengthened. The findings in this study may help to develop strategies and measures of mosquito and mosquito-borne diseases in the future, not only in Lhasa, but also in similar altitude, latitude and longitude regions worldwide.

Nutritional knowledge, attitude, and practices among pregnant and lactating women living with HIV in the Manzini region of Swaziland

The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland. Interviews were conducted using a structured questionnaire to collect data from 324 subjects seeking healthcare from selected regional hospitals, health centres, and clinics in Manzini region. The results showed mean percentage scores of nutritional knowledge (67%), attitude (67%), and practices (51%) whereby educational level (p = 0.002), employment status (p = 0.009), income (p = 0.008), religion (p = 0.007), type of accommodation (p = 0.006), type of transport used when going for shopping (p = 0.001), and BMI (p = 0.015) were significantly associated with nutritional practices. Significant positive correlations between nutritional KAP were observed: nutritional K and A (r = 0.155, p = 0.005), nutritional K and P (r = 0.456, p = 0.001), and nutritional A and P (r = 0.230, p = 0.001). Multiple linear regression analysis indicated that type of transport used when going for shopping (p = 0.002), educational level (p = 0.001), income (p = 0.001), employment (p = 0.038), knowledge of food proportion in a plate (p = 0.000), a positive attitude towards high-fibre diet (p = 0.004), and eating a variety of foods (p = 0.006) were predictors of nutritional practices. Educational level was identified as a common predictor of nutritional knowledge, attitude, and practices, suggesting that both formal and informal education systems are potential factors influencing dietary practices among pregnant and lactating women living with HIV in Swaziland.