title: Undernutrition and associated factors among adults living with Human Immune Deficiency Virus in Dembia District, northwest Ethiopia: an institution based cross-sectional study.
abstract: BACKGROUND
  Appropriate dietary intake determines the disease progression and success of Anti-Retroviral Therapy (ART). Undernutrition unacceptably increases the risk of mortality among adults living with Human Immune Deficiency Virus (HIV). However in resource limited settings including Ethiopia, many of HIV positive clients lack access to sufficient quantities of nutritious food. There is limited evidences showing the magnitude of undernutrition in this segment of the community, particularly in the rural residents. Therefore, this study aimed to assess undernutrition and associated factors among HIV positive adults attending ART clinic in Dembia District.
  
  
  METHODS
  An institution based cross-sectional study was conducted in Dembia District from October 1 to 30, 2015. Systematic random sampling technique was used to recruit the study subjects. The anthropometric measurement, Body Mass Index, was computed to determine the nutritional status of the study participants. In order to identify factors associated with undernutrition a multivariable logistic regression analysis was employed. The Adjusted Odds Ratio (AOR) with 95 % Confidence Interval (CI) was calculated to show the strength of association. In multivariable analysis, variables with a P-value of <0.05 were considered as statistically significant.
  
  
  RESULTS
  Of the study participants, about 23.2 % [95 % CI: 19.2, 27.2 %] were undernourished in Dembia District. The result of adjusted analysis revealed that, the odds of undernutrition was higher among adults whose age ranged between 18-29 years [AOR = 2.50, 95 % CI: 1.10, 5.69], who had a Cluster of Differentiation (CD)4 count less than 200 cells/mm(3) [AOR = 6.21, 95 % CI: 2.97, 12.98), were widowed [AOR = 2.18, 95 % CI: 1.08,4.40), and anemic [AOR = 3.17, 95 % CI: 1.70, 5.92].
  
  
  CONCLUSIONS
  The prevalence of undernutrition among HIV positive adults was higher in the study area. Furthermore, being in the age range of 18-29 years, widowed, anemic, and having a CD4 count of less than 200 cells/mm(3) were positively associated with undernutrition. Therefore, efforts should be strengthened to mitigate the higher burden of undernutrition by considering the identified determinants.
authors.affiliation: Othoniel Health Science College, Gondar, Ethiopia.
authors.forename: Anbesaw
authors.initials: A
authors.lastname: Mitiku
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Tadesse Awoke
authors.initials: TA
authors.lastname: Ayele
authors.affiliation: Department of Public Health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia.
authors.forename: Mekonen
authors.initials: M
authors.lastname: Assefa
authors.affiliation: Department of Human Nutrition, Institute of Public Health, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Amare
authors.initials: A
authors.lastname: Tariku
keywords: HIV positive adults; Northwest Ethiopia; Undernutrition