Food insecurity and ART non adherence, Nampula, Mozambique

Abstract

Introduction: ART scale up in Mozambique was followed by an under evaluated treatment abandon rate, supposedly due to food unmet needs and low access to health centres. This research will evaluate food security contribution to ART abandon in Nampula Province.
Methods: quantitative research, transversal cohort study in 5 health centres of 5 Nampula Province Districts with high HIV incidence and ART abandon rates, using surveys (patients on ART, patients who have abandoned treatment) and statistic documents consultation to evaluate ART non adherence.
Results: we surveyed 208 patients on ART and 86 abandons in Lalaua, Mossuril, Murrupula, Nacaroa and Nampula districts and 58% consider they do not have enough food. ART adherence for patients on treatment over the last 3 months was estimated at 69%. Last 24 hours food intake survey shows that 21% had only one meal, 22% did not eat any vegetables, 24% did not eat any proteins, 56% any fruits. About who is responsible for food supplies, 58% are themselves. About economic income, 63% work in subsistence agriculture, 29% have informal activity and 18% are employed.
Discussion: the ART adherence for the last 3 months at 69% is far under desirable. Our results show that food insecurity affects deeply this population and allow as confirming it as a determinant abandon factor. We may suggest a diet with beans, peanuts, eggs, cabbage and fruits, locally available, as an ART adherence facilitator.
Conclusion: diet seems to have a direct influence over ART abandon rate in Nampula Province and patient nutritional inhabits show high food insecurity. We recommend implementing a nutritional education programme and rural extension intervention with this group, to