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dc.contributor.advisorWalsh, C. M.
dc.contributor.authorHattingh, Zorada
dc.contributor.otherDannhauser, A.
dc.contributor.otherVeldman, F. J.
dc.date.accessioned2015-08-19T14:26:15Z
dc.date.available2015-08-19T14:26:15Z
dc.date.issued2005
dc.identifier.urihttp://hdl.handle.net/11660/978
dc.description.abstractEnglish: Human Immunodeficiency Virus infection causes Acquired Immune Deficiency Syndrome, which has caused millions of deaths, with more expected, particularly in developing countries like South Africa, where poverty is a critical factor. The intake, digestion, absorption and metabolism of food and nutrients emerge as a vicious cycle. The undernourished HIV-infected individual develops micronutrient deficiencies, immunosuppression and oxidative stress, thereby accelerating disease progression. Symptoms include weight loss and wasting, with increased risk of secondary infections. A representative sample of 500 African women (25-34 and 35-44 years) from Mangaung in South Africa’s Free State Province participated in the study. Socio-demographic composition and physical activity levels were determined by questionnaire. Weight, height, circumference (waist and hip) and bioimpedance measurements were used to calculate body mass index and fat distribution and percentage. Dietary intake was determined using a food frequency questionnaire, and nutrient intake was analysed. Biochemical nutritional status was determined through blood samples. Socio-demographic characteristics indicated high unemployment rates. Significantly more HIV positive than HIV negative young women had lived in urban areas for over ten years, and smoked and/or used nasal snuff. Few young women had no education, while more older women had only a primary school or Grade 8-10 education. Significantly more younger and older HIV positive women headed their own households. No significant differences were found in housing conditions, room density and household facilities of younger and older HIV positive and HIV negative women Anthropometric results showed that approximately 50% of all women were overweight/obese. Most women had a gynoid fat distribution and were fat/obese according to fat percentage. However, young HIV positive women had significantly lower body mass index and fat percentage than young HIV negative women. The entire sample had low physical activity levels. Median dietary intakes of energy, macronutrients and cholesterol were high, with young HIV positive women having a significantly higher median energy intake than young HIV negative women. Low median intakes of calcium, total iron, selenium, fat-soluble vitamins, folate and vitamin C, but high median intakes of the B vitamins, were reported overall. Younger women with HIV had significantly higher intakes of calcium, phosphorus, potassium, and vitamins B12, D and E than young HIV negative women. Older HIV positive women had significantly lower intakes of haem iron, nonhaem iron and selenium than older HIV negative women. Although median values for most biochemical parameters were normal, younger HIV positive women had significantly lower median haemoglobin and haematocrit levels, while older HIV positive women had significantly higher serum ferritin and lower transferrin values than their HIV negative counterparts. Significantly more HIV positive younger and older women had low haematocrit values, while significantly more HIV negative older women had low serum iron and high transferrin concentrations. Compared to HIV negative women, younger and older HIV positive women had significantly lower median blood values for total lymphocytes and serum albumin, but significantly higher median blood levels of total serum protein. Plasma fibrinogen and serum insulin concentrations were significantly reduced in young HIV positive women. Older HIV positive women had significantly lower total serum cholesterol values than older HIV negative women. Serum glucose and serum triglycerides did not differ significantly between HIV positive and HIV negative women within both age groups. In younger and older women, increased serum total protein and decreased serum albumin were associated with HIV infection. In younger women, smoking and being unmarried increase the odds of HIV infection, while in older women a higher education level and a decreased non-haem iron intake are associated with HIV infection. An adequate diet, nutritional counselling and active physical activity can improve immune function, quality of life and biochemical nutritional status. Dietary intake alone, however, may be insufficient to correct nutritional deficiencies in this poor community, and the role of food-based approaches and micronutrient supplementation merits further attention. Key words: South Africa; African women; HIV; socio-demographic status; anthropometry; dietary intake; physical activity; iron status; metabolic profileen_ZA
dc.description.abstractAfrikaans: Verworwe Immuniteitsgebreksindroom is die eindresultaat van infeksie met die Menslike Immuniteitsgebrekvirus. Miljoene mense het reeds vanweë die siekte gesterf, en die ergste word nog verwag. Alhoewel veelvuldige faktore tot infektering met die virus bydra, is armoede ‘n kritieke faktor. ‘n Vernietigende kringloop wat die inname, vertering, absorpsie en metabolisme van voedsel en voedingstowwe beïnvloed, ontstaan. Die ondervoede MIV-geïnfekteerde individu ontwikkel mikrovoedingstoftekorte, immuniteitsonderdrukking en oksidatiewe stres, wat die siekte aanwakker. Simptome soos gewigsverlies, met ‘n verhoogde risiko vir sekondêre infeksies, kom algemeen voor. ‘n Verteenwoordigende steekproef van 500 swart vroue (ouderdomsgroepe 25 tot 34 en 35 tot 44 jaar) van Mangaung, Bloemfontein is vir die studie gekies. Sosio-demografiese samestelling en fisiese aktiwiteitsvlakke is deur middel van ‘n vraelys bepaal. Gewig, lengte, middel- en heupomtrek en bio-impedansmates is gebruik om liggaamsmassaindeks, vetpersentasie en vetverspreiding te bepaal. Dieetinname is deur middel van ‘n voedselfrekwensie vraelys bepaal en ontleed om voedingstofinname te bepaal. Bloedmonsters is versamel om biochemiese voedingstatus te bepaal. Sosio-demografiese eienskappe het hoë werkloosheidsvlakke onder alle respondente getoon. Betekenisvol meer van die MIV-positiewe as MIV-negatiewe jong vroue was vir langer as tien jaar in ‘n stedelike gebied woonagtig, en het gerook en/of gesnuif. Min jong vroue het geen skoolopleiding gehad nie, terwyl ouer vroue meestal slegs primêre skoolopleiding of Graad 8-10 gehad het. Betekenisvol meer van die MIV-positiewe vroue van albei ouderdomsgroepe was self hoof van die huishouding. Geen betekenisvolle verskille in behuisingstoestande, vertrekdigtheid en huishoudelike fasiliteite is tussen jonger en ouer MIV-positiewe en MIV-negatiewe vroue gevind nie. Volgens antropometriese resultate en vetpersentasie-meting was ongeveer 50% van die respondente oorgewig of vetsugtig. Vetverspreiding was hoofsaaklik ginoïd. Ten spyte hiervan was die liggaamsmassa-indeks en vetpersentasie van jong MIV-positiewe vroue betekenisvol laer as dié van MIV-negatiewe jong vroue. Fisiese aktiwiteitsvlakke van alle respondente was laag. Mediaan dieetinnames vir energie, makrovoedingstowwe en cholesterol was hoog. Mediaan energie-inname van jong MIV-positiewe vroue was onverwags betekenisvol hoër as dié van MIV negatiewe jong vroue. Lae mediaaninnames van kalsium, totale yster, selenium, vetoplosbare vitamiene, folaat en vitamien C, gepaardgaande met hoë mediaaninnames van B-vitamiene, is deur die totale steekproef gerapporteer. Jong MIV-positiewe vroue het betekenisvol meer kalsium, fosfor, kalium, vitamien B12, D en E ingeneem. Ouer MIV-positiewe vroue het betekenisvol laer innames van heemyster, nie-heemyster en selenium as ouer MIV-negatiewe vroue getoon. Alhoewel mediaanwaardes van die meeste biochemiese parameters normaal was, was mediaan hemoglobien- en hematokritvlakke van HIV-positiewe jong en ouer vroue betekenisvol laer, terwyl ouer MIV-positiewe vroue betekenisvol hoër serum ferritien- en betekenisvol laer transferrienwaardes as MIV-negatiewe ouer vroue getoon het. Betekenisvol meer MIV-positiewe jong en ouer vroue het lae hematokritwaardes getoon, terwyl betekenisvol meer MIV-negatiewe ouer vroue lae serum yster- en hoë transferrienvlakke getoon het. Mediaan bloedwaardes van totale limfosiete en serum albumien van jong en ouer MIV-positiewe vroue was betekenisvol laer, maar betekenisvol hoër vir totale serum proteïen in vergelyking met waardes van MIV-negatiewe jong en ouer vroue. Plasma fibrinogeen- en serum insulienkonsentrasies was betekenisvol verlaag in MIV-positiewe jong vroue. Totale serum cholesterolwaardes van ouer MIV-positiewe vroue was betekenisvol laer as dié van MIV-negatiewe ouer vroue. Geen betekenisvolle verskille is vir serum glukose en serum trigliseriede tussen MIV-positiewe en MIV-negatiewe vroue gevind nie. Verhoogde serumproteïen- en verlaagde serumalbumienvlakke is in beide ouderdomsgroepe met MIV-infeksie geassosieer. Rook en ‘n ongetroude status in jong vroue, en ‘n hoër vlak van opleiding en verlaagde nie-heemyster inname in ouer vroue is met MIV-infeksie geassosieer. ‘n Voldoende dieet, voedingsberading en aktiewe fisiese aktiwiteit is regverdigbaar ter verbetering van immuunfunksie, lewenskwaliteit en biochemiese voedingstatus. Dieetinname alleen mag egter onvoldoende wees om voedingstoftekorte in hierdie arm gemeenskap reg te stel. Die rol van voedselgebaseerde benaderings en mikrovoedingstofsupplementasie benodig verdere aandag.
dc.description.sponsorshipNational Research Foundation (NRF)en_ZA
dc.language.isoenen_ZA
dc.publisherUniversity of the Free Stateen_ZA
dc.subjectThesis (Ph.D. (Human Nutrition))--University of the Free State, 2005en_ZA
dc.subjectHIV-postive womenen_ZA
dc.subjectSouth Africaen_ZA
dc.subjectBloemfonteinen_ZA
dc.titleThe health and nutritional status of HIV positive women (25-44 years) in Mangaungen_ZA
dc.typeThesisen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA


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