@article{fdi:010078116,
  title = {{A}dherence to ready-to-use food and acceptability of outpatient nutritional therapy in {HIV}-infected undernourished {S}enegalese adolescents : research-based recommendations for routine care},
  author = {{N}iasse, {F}. and {V}arloteaux, {M}arie and {D}iop, {K}. and {N}diaye, {S}. {M}. and {D}iouf, {F}. {N}. and {M}bodj, {P}. {B}. and {N}iang, {B}. and {D}iack, {A}. and {C}ames, {C}{\'e}cile},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground{R}eady-to-use food ({RUF}) is increasingly used for nutritional therapy in {HIV}-infected individuals. {H}owever, practical guidance advising nutrition care to {HIV}-infected adolescents is lacking, so that little is known about the acceptability of such therapy in this vulnerable population. {T}his study assesses the overall acceptability and perception of a {RUF}-based therapy and risk factors associated with sub-optimal {RUF} intake in {HIV}-infected undernourished adolescents in {S}enegal.{M}ethods{P}articipants 5 to 18years of age with acute malnutrition were enrolled in 12 {HIV} clinics in {S}enegal. {P}articipants were provided with imported {RUF}, according to {WHO} prescription weight- and age-bands (2009), until recovery or for a maximum of 9-12months. {M}alnutrition and recovery were defined according to {WHO} growth standards. {A}dherence was assessed fortnightly by self-reported {RUF} intake over the period. {S}ub-optimal {RUF} intake was defined as when consumption of the {RUF} provision was <50%. {RUF} therapy acceptability and perceptions were assessed using a structured questionnaire at week 2 and focus group discussions ({FGD}s) at the end of the study. {F}actors associated with sub-optimal {RUF} intake at week 2 were identified using a stepwise logistic regression model.{R}esults{W}e enrolled 173 participants, with a median age of 12.5years ({I}nterquartile range: 9.5-14.9), of whom 61% recovered from malnutrition within the study period. {M}edian follow-up duration was 66days (21-224). {RUF} consumption was stable, varying between 64 and 57% of the {RUF} provided, throughout the follow-up. {A}t week 2, sub-optimal {RUF} intake was observed in 31% of participants. {D}islike of the taste of {RUF} (a{OR}=5.0, 95% {CI}: 2.0-12.3), {HIV} non-disclosure (5.1, 1.9-13.9) and food insecurity (2.8, 1.1-7.2) were the major risk factors associated with sub-optimal {RUF} intake at week 2. {FGD}s showed that the need to hide from others to avoid sharing and undesirable effects were other constraints on {RUF} feeding.{C}onclusions{T}his study revealed several factors reducing the acceptability and adherence to {RUF} therapy based on {WHO} guidelines in {HIV}-infected adolescents. {T}ailoring prescription guidance and empowering young patients in their care are crucial levers for improving the acceptability of {RUF}-based therapy in routine care.{T}rial registration{C}linical{T}rials.gov identifier: {NCT}03101852, 04/04/2017.},
  keywords = {{A}cute malnutrition ; {A}cceptability ; {A}dherence ; {HIV} ; {R}eady-to-use food ; {C}hildren ; {A}dolescents ; {A}frica ; {SENEGAL}},
  booktitle = {},
  journal = {{BMC} {P}ublic {H}ealth},
  volume = {20},
  numero = {1},
  pages = {art. 695 [12 ]},
  year = {2020},
  DOI = {10.1186/s12889-020-08798-z},
  URL = {https://www.documentation.ird.fr/hor/fdi:010078116},
}