Nutrition and health education combined with consumption of self produced vegetables in the management of HIV/AIDS
Ngugi, Louise Wanjiku
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Sub-Sahara Africa continues to host over 75% of PLWHA. Interventions, even those involving supplementary feeding have not been adequately evaluated. Most of these interventions are donor dependent and therefore not sustainable, considering the economic status of most victims, in the situation that donor funding is withdrawn. This study was designed to assess the effect of nutrition and health education combined with consumption of self-grown vegetable. The study was a combined cross-sectional and longitudinal design in two sites in Kenya, Nakuru and Thika Counties. Cross sectional design was used to determine the current status of the PLWHA and the health care providers with regard to nutritional and HIV knowledge, and the socio-demographic, socio-economic status of the study groups. The longitudinal component involved nutrition and health education alone in Nakuru, which served as the control and education combined with vegetable production and consumption in Thika as the study group. A total sample of 133 was used with 72 in Nakuru and 61 in Thika. The nutritional, health and knowledge status were assessed initially and then after 6 months, during which the PLWHA were trained, grew and consumed the vegetables. Results showed that up to 78% had the highest level of education as upper primary. The mean age of PLWHA was about 46 and 42 years in the Nakuru and Thika respectively and was significantly different in the two counties. Nutrition and HIV/AIDS knowledge was low among both the PLWHA and health care providers. Majority of PLWHA indicated having been trained mainly on behavioral changes. After the intervention, the mean knowledge score in nutrition and HIV significantly increased from 15.9 and 17.8 to 21.0 and 17.3 (p<0.05) scores in Nakuru and Thika respectively. Knowledge of diarrhoea as a direct consequence of poor nutrition in HIVIAIDS was by 27.8% and that of correct weight for height by 54.1 % of PLWHA. These proportions were not significantly different between the two counties. The prevalence of under-nutrition increased in Nakuru (l 0.7 to 12.9 %) and in Thika (20.3 to 27.6 %) significantly whereas over nutrition increased in Nakuru (11.6 to 20 %) and decreased in Thika (27.1 to 19 %). Caloric intake significantly increased from 1607Kcal and 1439 Kcal to 1976 Kcal and 1817 Kcal in Nakuru and Thika respectively. The intakes however remained below the RDA for PLWHA in both counties. Intakes of selenium and zinc were above their RDI in the two counties but below the upper tolerable limits, with 108J.!gin Nakuru and 76.8Jlg in Thika. Zinc intake was 14.8mg and 10.2mg in Nakuru and Thika Counties respectively. The mean individual dietary diversity score (IDDS) were low but increased significantly in Nakuru and Thika from 3.7 and 3.8 to 4.8 and 5.0 (p<0.05) in that order. Over 75% of the PLWHAs were consuming more of refined foods and exotic vegetables. The commonly consumed foods were maize and wheat products, rice, sweet potatoes, Irish potatoes and green bananas. In management of co-morbidities in HIV/AIDS, less than 20% of PLWHA sort treatment in hospitals. About 30% bought off-the-counter drugs, while 70% did nothing. Very few adjusted their diets at baseline and after the intervention. Those with knowledge of oral rehydration salts for management of diarrhea increased to 57% from 20%. Proportion with knowledge of appropriate hand washing techniques was low at less than 20 %. The study concludes that malnutrition, morbidity and hygiene practices of people living with HIV/AIDS can be improved through nutrition and health education, when combined with consumption of self-produced vegetables.