TY - JOUR
T1 - Impact of counseling in knowledge, attitude and practice and association of nutritional status with CD4 count and opportunistic infections of HIV patients of Udupi, India
AU - Pokharel, Pratik
AU - Shettigar, Pallavi G.
N1 - Funding Information:
We thank Dr. Kiran Kumar N and District ART Centre, Udupi for providing access to patients and medical record files. Authors also thank Mihika Mavinkurve and Joyson Glen Dsouza for assistance in data collection and my wife Sumira Gautam for her writing assistance and support to carry out the study. Permission was obtained from copyright owner of PG-SGA for data collection and publication of research.
Publisher Copyright:
© 2018 European Society for Clinical Nutrition and Metabolism
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/2
Y1 - 2019/2
N2 - Background and aims: HIV infection and insufficient nutritional intake form a malicious cycle which leads to immunodeficiency and malnutrition. Thus, this research was done to see the effect of nutritional counseling on knowledge, attitude and practice (KAP) of HIV patients of Udupi district. Also, the rational evidence of association of nutritional status with CD4 counts and opportunistic infections combined are limited which led to design of this study. Methods: This interventional study was done in ART Centre, Udupi, India with a sample size of 66 with 33 each in experimental and control group (EG and CG). At first, the biochemical parameters, KAP, 3 day dietary intake and food group intake over Food Frequency Questionnaire (FFQ) were recorded. PG-SGA (Scored Patient-Generated Subjective Global Assessment) scoring was used to categorize patients’ nutritional status. Individual nutritional counseling was provided to EG and change in KAP of EG and CG were recorded after 1 month. Results: Pre-KAP mean of EG was 151.56 which increased to 169.13 after intervention. The mean KAP score of EG was statistically different from CG after counseling, P < 0.001. Of the total, 15 (22.7%) patients were found to be malnourished. The dietary intake of nutrients and food group was significantly lower than RDA. Tukey HSD post hoc analysis showed significant statistical difference for the CD4 count between moderate and severe malnourished category with P = 0.017. Statistically significant nutrient intake differences were also observed between PGSGA groups while odds ratio showed no significant association. Conclusions: Improvement in KAP and poor nutritional status indicates that individual Nutrition and Health Education Counseling be made an integral part in the management of HIV in Udupi. Also, the difference in CD4 count across two PG-SGA stages depicts an association between nutritional status and immune status of HIV patients.
AB - Background and aims: HIV infection and insufficient nutritional intake form a malicious cycle which leads to immunodeficiency and malnutrition. Thus, this research was done to see the effect of nutritional counseling on knowledge, attitude and practice (KAP) of HIV patients of Udupi district. Also, the rational evidence of association of nutritional status with CD4 counts and opportunistic infections combined are limited which led to design of this study. Methods: This interventional study was done in ART Centre, Udupi, India with a sample size of 66 with 33 each in experimental and control group (EG and CG). At first, the biochemical parameters, KAP, 3 day dietary intake and food group intake over Food Frequency Questionnaire (FFQ) were recorded. PG-SGA (Scored Patient-Generated Subjective Global Assessment) scoring was used to categorize patients’ nutritional status. Individual nutritional counseling was provided to EG and change in KAP of EG and CG were recorded after 1 month. Results: Pre-KAP mean of EG was 151.56 which increased to 169.13 after intervention. The mean KAP score of EG was statistically different from CG after counseling, P < 0.001. Of the total, 15 (22.7%) patients were found to be malnourished. The dietary intake of nutrients and food group was significantly lower than RDA. Tukey HSD post hoc analysis showed significant statistical difference for the CD4 count between moderate and severe malnourished category with P = 0.017. Statistically significant nutrient intake differences were also observed between PGSGA groups while odds ratio showed no significant association. Conclusions: Improvement in KAP and poor nutritional status indicates that individual Nutrition and Health Education Counseling be made an integral part in the management of HIV in Udupi. Also, the difference in CD4 count across two PG-SGA stages depicts an association between nutritional status and immune status of HIV patients.
UR - http://www.scopus.com/inward/record.url?scp=85057421033&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057421033&partnerID=8YFLogxK
U2 - 10.1016/j.clnesp.2018.11.001
DO - 10.1016/j.clnesp.2018.11.001
M3 - Article
C2 - 30661681
AN - SCOPUS:85057421033
SN - 2405-4577
VL - 29
SP - 154
EP - 159
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
ER -
