Date of Award

2021

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr.Fatma Bakshi

Second Supervisor/Advisor

Dr.Muzdalifat Abeid

Department

Internal Medicine (East Africa)

Abstract

BACKGROUND: Human immunodeficiency virus is still a global burden more so in sub-Saharan Africa. Chronic kidney disease and end-stage renal disease are important comorbid conditions that are prevalent in HIV-infected individuals. Patients who are HIV positive and on hemodialysis have triple risk factors for development of malnutrition (i.e. Human immunodeficiency virus, chronic kidney disease, and haemodialysis). Malnutrition greatly impacts these patient’s morbidity and mortality and thus the great need to address this gap which will improve their prognosis.

OBJECTIVE: The objective of the study was to assess the prevalence and severity of malnutrition in people living with HIV on chronic haemodialysis in Dar es Salaam.

METHOD: This was a cross-sectional analytic study done at 5 haemodialysis centers in Dar es Salaam between December 2019 and April 2020. The study included all HIV-positive patients on haemodialysis for three months or more. Detailed history was obtained from the patients and their medical record files using a semi structured questionnaire. A validated nutritional screening tool subjective Global assessment-dialysis malnutrition score was used to assess for malnutrition. Descriptive statistics were analyzed using SPSS.

RESULTS: Total of 56 patients with median age (SD) of 50.0(13.6) years from five haemodialysis centers in Dar es Salaam were enrolled in the study. The years of being HIV positive ranged from 1year to 40 years with a median (SD) of 5(7.4) years. The overall prevalence of malnutrition was 87.5 (49/56), with 85.7 %( 48/5) being mild to moderately malnourished and 1.8 %( 1/56) being severely malnourished.

CONCLUSION: The state of malnutrition in people living with HIV on haemodialysis is high, hence, the study has highlighted the burden. Assessment of nutritional status among these patients is of great importance and emphasis should be placed on regular screening and follow-up by health-care team in haemodialysis centers.

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