Prevalence and determinants of undernutrition among adults living with HIV in Ethiopia: A systematic review and meta-analysis

Abstract Background Undernutrition among HIV-positive adults in Ethiopia highlights the cycle of cause- and-effect relationships between undernutrition and HIV infection. Aim The study aimed to assess the prevalence of undernutrition and its determinants among HIV-positive adults in Ethiopia. Methods Intensive searches were carried out utilizing PubMed, EMBASE (Elsevier), Cochrane, and and other electronic databases such as Science Direct, African Journal Online (AJOL), Google Scholar, and gray literature. Data synthesis/findings A total sample size of 5,648 and a total number of undernourished individuals of 1,474 from 11 articles met the inclusion criteria. The study found that the pooled prevalence of 26.70% (95% CI: 21.31%, 32.10%) of HIV-positive patients in Ethiopia are undernourished. Factors determining undernutrition include having opportunistic infections (OR: 3.496, 95% CI 1.776-5.217), being at an advanced WHO clinical stage II or above (OR: 2.916, 95% CI 1.088-4.744), having a cluster differentiation (CD4) count below 200 cells (OR: 3.099, 95% CI 1.418-4.779), and food insecurity (OR: 3.352, 95% CI 1.418-5.287). Conclusion The systematic review and meta-analysis found that Ethiopia’s HIV-positive population faces high undernutrition rates in comparison to studies done in sub-Saharan Africa. Opportunistic infections, advanced WHO clinical disease stage, CD4 counts below 200 cells/mm³, and food insecurity were identified as statistically significant factors determining the high prevalence of undernutrition. This suggests a cyclic link between undernutrition and health outcomes. The meta-analysis identifies factors influencing undernutrition in Ethiopia’s HIV-positive population, but more research is needed to determine the efficacy of interventions and address root causes.