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<p>Undernutrition remains a persistent challenge for children receiving antiretroviral therapy (ART) in low- and middle-income countries. This study determined the prevalence and determinants of severe undernutrition among HIV-positive children under five receiving ART in Ilala District, Tanzania. Clinical and demographic data were analyzed for 334 children enrolled at Care and Treatment Clinics (2020–2024). Nutritional status was evaluated according to WHO growth standards, and Generalized Additive Models explored non-linear associations between immunological and virological markers and nutritional indices. The prevalence of severe undernutrition was 8.1% for underweight, 17.7% for stunting, and 3.0% for wasting. Key determinants included ART adherence, CD4 count, age, household food insecurity, meal frequency and guardian occupation. Optimal ART adherence was associated with higher height-for-age (β = 1.22) but lower weight-for-age (β = −0.54) and lower weight-for-height (β = −1.81). Consumption of three daily meals was associated with higher weight-for-age (β = 0.26) and higher weight-for-height (β = 0.40). Non-linear immunological and virological thresholds accounted for up to 30.5% of deviance in wasting, offering actionable clinical targets for nutritional interventions. These findings provide novel insights for risk-stratification, indicating that nutritional interventions should be intensified when children’s immune markers fall below identified thresholds to improve clinical and nutritional outcomes.</p>

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Prevalence and factors contributing to severe undernutrition in children on antiretroviral therapy (ART) drugs in Ilala District, Tanzania

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Ashura Kassim Kiliza,
  • Xiao Liang,
  • Kassim Rashid Kiliza,
  • Hui Lu

摘要

Undernutrition remains a persistent challenge for children receiving antiretroviral therapy (ART) in low- and middle-income countries. This study determined the prevalence and determinants of severe undernutrition among HIV-positive children under five receiving ART in Ilala District, Tanzania. Clinical and demographic data were analyzed for 334 children enrolled at Care and Treatment Clinics (2020–2024). Nutritional status was evaluated according to WHO growth standards, and Generalized Additive Models explored non-linear associations between immunological and virological markers and nutritional indices. The prevalence of severe undernutrition was 8.1% for underweight, 17.7% for stunting, and 3.0% for wasting. Key determinants included ART adherence, CD4 count, age, household food insecurity, meal frequency and guardian occupation. Optimal ART adherence was associated with higher height-for-age (β = 1.22) but lower weight-for-age (β = −0.54) and lower weight-for-height (β = −1.81). Consumption of three daily meals was associated with higher weight-for-age (β = 0.26) and higher weight-for-height (β = 0.40). Non-linear immunological and virological thresholds accounted for up to 30.5% of deviance in wasting, offering actionable clinical targets for nutritional interventions. These findings provide novel insights for risk-stratification, indicating that nutritional interventions should be intensified when children’s immune markers fall below identified thresholds to improve clinical and nutritional outcomes.