Pierre Zalagile Akilimali1*, Patou Masika Musumari2, Esperance Kashala-Abotnes3, Pierrot LundimuTugirimana4, Paulin Beya Mutombo1, Frederick J Veldman6, Patrick Kalambayi Kayembe6, Thorkild Tylleskar3, Mapatano Mala Ali1

1University of Kinshasa, School of Public Health, Department of Nutrition Democratic Republic of Congo
2Kyoto University School of Public Health, Department of Global Health and Socio-Epidemiology, Kyoto, Japan
3University of Bergen, Department of Global Health and Primary Care, Centre for International Health, Norway
4Faculty of Medicine, University of Goma, Goma, Democratic Republic of the Congo
5University of Kinshasa, School of Public Health, Department of Epidemiology and Biostatistics, Democratic Republic of Congo
6KwaZulu-Natal University, Dietetic and Human Nutrition, Pietermaritzburg, South Africa

Objective: To assess the prevalence of food insecurity and its impact on nutritional status among HIV infected patients on antiretroviral therapy in a conflict and post conflict setting.

Design: Cross-sectional study.

Setting: This Goma multicenter cross-sectional study was carried out from February 1st to March 3rd, 2016.

Subjects: Data on nutritional status among 583 HIV-infected patients on ART were measured using Body Mass Index as a proxy. Food insecurity was the primary independent variable and was measured using the Household Food Insecurity Access Scale. The prevalence of under nutrition and food insecurity was also estimated. A logistic regression model was used to identify the relationship between under nutrition and food insecurity, adjusted for other covariates.

Results: The prevalence of food insecurity in the study group was 91.3% (95% CI: 89.0 – 93.6%). The prevalence of undernutrition was 24.1% (95% CI: 20.6-27.6%).Nineteen percent of respondents were non- adherent (95% CI: 15.9% – 22.3%). Only two percent have received a nutritional support during the previous month. Being household food insecure (AOR = 4.47, 95% CI: 1.35 – 14.78) and living in a household with low socio-economic status (AOR = 2.02, 95% CI: 1.10 – 3.69) were significantly associated with under nutrition.

Conclusion: This study measured a high prevalence of food insecurity in Goma. The study highlight the negative impact of food insecurity on undernutrition and how the situation is exacerbated by the presence of HIV.Further studies are suggested to assess nutritional status with a high validity (sensitivity & specificity) way in HIV-infected patient on ART in this setting.

Keywords: Armed conflict; Food insecurity; Undernutrition; Non-adherence; Antiretroviral