Public health-nutrition intervention programme in Nigeria, Abraham Amlogu, Kate Godden, Ihab Tewfik, Sundus Tewfik and Charles Wambebe
Purpose: This presented pilot intervention provides evidence that suggests the use of local resources as therapeutic nutrition. The latter can act as a fundamental part of the comprehensive package of care at the country level.
Background: HIV/AIDS is a pandemic disease and its scourge has had a devastating impact on health, nutrition, food security and overall socioeconomic development in affected countries. Since 2007, sub-Saharan Africa (SSA) has remained the region most heavily affected by HIV/AIDS across the world, accounting for 67% of all people living with HIV and for 75% of AIDS deaths. HIV infection increases energy requirements through increases in resting energy expenditure (12% higher), while reduced food intake, nutrient mal-absorption, negative nitrogen balance and metabolic alterations exacerbate weight loss and wasting, perpetuating the cycle. Moreover, intervention programmes, which simply employ antiretroviral drugs, have been found to lack effectiveness, particularly when the patient is undernourished.
Design/methodology/approach: Local ingredients, which were known for their availability, accessibility and micro- and macronutrient strengths were selected and optimised into a nutritional functional meal (Amtewa). Daily consumption was ascertained to assess its effects on nutritional intake and biomedical indices of the study participants (N=100) who were/were not taking anti-retroviral drug therapy (ART).
Findings: Mean CD4 count for ART-Test group at baseline and sixth months increased by 40.8cells/mm3 while the ART-Control group decreased by 18.12cells/mm3. These positive outcomes would qualify the Amtewa meal for the next phase of intervention (400 participants) to ascertain its effectiveness on the health status of HIV infected subjects and appraise its position within the National Health Services framework as an innovative approach to attenuate the progression of HIV to AIDS in Nigeria.
Originality/value: The Amtewa-based approach in HIV management is innovative, culturally relevant, reliable and requires low technology in order to assure compliance, sustainability and cost effectiveness.
Keywords: HIV, AIDS, Public Health Nutrition Intervention, CD4, Micro/macronutrients, ART, Nutritional Functional Meal