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Die bladsy is laas op 15 Januarie 2019 om 11:10 bygewerk. Nutritional status of HIV-infected adults in Maseru, Lesotho
Moeketsi, Neheng Relebetse
English: The main aim of this study was to determine the nutritional status and lifestyle behaviors of HIV infected adults in Maseru Lesotho. Dietary intake, lifestyle (smoking and alcohol consumption), anthropometry, physical examination and associations between these variables were determined. To determine the dietary intake, 24- hour recalls of usual food intake and food frequency In general dietary intake was below the recommendations. Over 90% of patients ate less than the recommended two servings of milk and milk products, 82.5% consumed less than the recommended two servings of meat and meat alternatives and more than 80% ate less than the recommended three servings of fruits and vegetables. Most patients ate the daily recommended fat intake and consumed the recommended number of bread and cereal exchanges. Median energy and macronutrient intakes were low (energy questionnaires were used. To determine the adequacy of the diet, patient's intake was compared with the recommendations from the Food Guide Pyramid. For the anthropometric assessment weight and height was used to calculate BMI. Waist and hip circumferences were determined for waist circumference and waist-to-hip ratio (fat distribution) and skin fold measurements to determine percentage fat. All anthropometric variables were measured using standardised techniques. Lifestyle factors (including smoking and alcohol consumption), and socio-demographic factors were obtained using questionnaires completed in a personal interview with each patient. A nutrition related physical examination to determine signs of malnutrition was performed on each participant by the researcher. The sample included 160 HIV -infected patients attending four different clinics in the Maseru district (Bophelong, Sen katana, Mabote and Ratjomose). Of these patients, 27.5% were males and 72.5% were females. The median age of the patients was 36 years. Fifty percent of patients were married and 55% were unemployed. Majority (82%) of patients had only primary education as their highest educational qualification. In general dietary intake was below the recommendations. Over 90% of patients ate less than the recommended two servings of milk and milk products, 82.5% consumed less than the recommended two servings of meat and meat alternatives and more than 80% ate less than the recommended three servings of fruits and vegetables. Most patients ate the daily recommended fat intake and consumed the recommended number of bread and cereal exchanges. Median energy and macronutrient intakes were low (energy 3462.5kJ/day, carbohydrates 43g, proteins 35g and fats 13g). Only ten percent of patients were underweight (BMI <18.5kg/m2), while 17% were overweight and 8.8% were obese (BMI ≥: 30kg/m2). Most patients (more than 60%) had a normal weight (BMI 18.5kg/m2 - 24.5kg/m2). Almost fifty percent of women had a high risk waist-to-hip ratio (≥ 0.08). Only 9% of male patients had a waist circumference above 102cm. The majority of patients did not smoke (82%). About 40% consumed alcohol and of those 78% consumed alcohol monthly with beer as the most consumed type of alcohol. The median number of drinks consumed was three drinks/day with eight drinks/day as the maximum. Patients with a dangerous to harmful consumption of alcohol had a significantly higher median energy intake than patients with a low to moderate alcohol consumption. The median BMI of low to moderate alcohol consumers and of the dangerous to harmful alcohol consumers differed significantly, with patients that used the most alcohol having a higher median BMI. There was a tendency for subjects with lower room density to have higher energy intake. BMI was strongly associated with fat percentage, with patients that had the lowest BMI, also having the lowest percentage fat. Female patients had a significantly higher fat percentage than male patients. More than 60% of patients had clinical signs of malnutrition, including symptoms related to the mouth (angular stomatitis, smooth and sore tongue and bleeding gums). Sixty percent of patients reported night blindness. Nutrition interventions should be included in programmes aiming at improving the nutritional status of HIV-infected persons. Nutrition education programmes should be implemented at community level and should concentrate on improving knowledge related to nutrition, preserving locally available and affordable foods and encouraging production of different types of crops that can improve access to food in Lesotho.
Afrikaans: Die hoofdoel van hierdie studie was om die voedingstatus en leefstyl van HIV geïnfekteerde volwassenes in Maseru, Lesotho te bepaal. Dieetinname, leefstyl (rook en alkoholinname), antropometrie, fisiese tekens van wanvoeding en verbande tussen hierdie veranderlikes is bepaal. Om dieetinname te bepaal, is 'n 24-uur herroep van gewoontelike inname en 'n kort voedselfrekwensievraelys voltooi. Om toereikendheid van die dieet te bepaal, is die pasiënt se inname vergelyk met die aanbevelings van die voedselgidspiramiede. Vir die antropometriese evaluering is massa en lengte gemeet om liggaamsmassaindeks (LMI) te bereken. Middelen heupomtrekke is bepaal om middelomtrek en middel-heupverhouding (vetverspreiding) te bereken en velvoumetings is gedoen om vetpersentasie te bereken. Alle antropometriese veranderlikes is volgens gestandardiseerde tegnieke gemeet. Leefstylfaktore (wat rook en alkoholinname ingesluit het), en sosio-demografiese inligting is dmv vraelyste, is deur die navorser in 'n gestruktureerde onderhoud met elke deelnemer ingesamel. 'n Fisies ondersoek, om kliniese tekens van wanvoeding te bepaal, is deur die navorser op elke deelnemer gedoen. Die steekproef het 160 MIV -geïnfekteerde pasiënte, vanaf vier verskillende klinieke in die Maseru area (Bophelong, Senkatana, Mabote en Ratjomose), ingesluit. Van hierdie pasiënte was 27.5% manlik en 72.5% vroulik. Die median ouderdom van pasiënte was 36 jaar. Vyftig persent van pasiënte was getroud en 55% was werkloos. Die meerderheid (82%) het slegs primêre skoolopleiding gehad. In die algemeen was dieetinname ontoereikend. Meer as 90% van pasiënte het minder as twee porsies uit die melk en melkproduktegroep geëet, 82.5% het minder as die aanbevole twee porsies uit die vleis en vleiservangersgroep geëet, en meer as 80% het minder as drie porsies vrugte en groente geëet. Meeste het voldoende hoeveelhede vet, brood en graanporsies ingeneem. Mediaan energie en makrovoedingstofinname was laag (energie 3462.5kJ/dag, koolhidrate 43g, proteïene 35g en vet 13g). Slegs tien persent van pasiënte was ondergewig (LMI <18.5kg/m2), terwyl 17% oorgewig was en 8.8% vetsugtig (LMI ≥ 30kg/m2). Die meeste pasiënte (meer as 60%) het 'n normale LMI gehad (BMI 18.5kg/m2 - 24.5kg/m2). Bykans vyftig persent van vroue het 'n hoë risiko middel-heup-verhouding gehad (≥ 0.8). Slegs 9% van die manlike deelnemers het 'n middelomtrek bo 102cm gehad. Die meerderheid pasiënte het nie gerook nie (82%). Ongeveer 40% het wel alkohol gebruik en van die wat dit wel gebruik het, het 78% dit maandeliks gebruik. Bier was die tipe alkoholiese drankie wat mees algemeen ingeneem is. Die median hoeveelheid drankies wat gebruik is was drie drankies per dag. Pasiënte met 'n gevaarlik hoe" alkoholinname het 'n betekenisvolle hoër mediaan energieinname gehad as pasiënte wat alkohol min of matig gebruik het. Die mediaan LMI van min tot matige alkohol verbruikers was ook betekenisvol hoe" as die van pasiënte met 'n gevaarlike alkoholinname. Daar was 'n neiging vir persone wat in 'n huis met min verterkke gebly het om 'n hoer" energiei-nname te hê. LMI is sterk geassosieer met vetpersentasie en persone met die laagste LMI het ook die laagste persentasie vet gehad. Vroulike pasiënte het betekenisvol hoer" persentasies vet as mans gehad. Meer as 60% van die pasiënte het kliniese tekens van wanvoeding getoon, wat hoofsaaklik simptome van die mond ingesluit het (angulêre stomatitis, gladde en seer tong en tandvleis wat bloei). Sestig persent het nagblindheid geraporteer. Toepaslike voedingintervensies om die voedingstatus van HIV geinfekteerde persone te verbeter is dringend nodig. Voedingvoorligtingsprogramme behoort op gemeenskapsvlak geïmplimenteer te word en moet klem lê op die verbetering van kennis wat verband hou met voeding, die behoud van plaaslik beskikbare voedsel, en die bevordering van voedselproduksie wat toegang tot voedsel in Lesotho kan verbeter.