{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:19:21Z","timestamp":1787015961234,"version":"build-2736575974"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the prevalence of malnutrition status, analyse the association between malnutrition status and individual\u2010level factors, and explore the spatial variation among children and adolescents living with HIV\/AIDS in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study is based on large\u2010scale baseline routine data from the National AIDS Control Programme on people living with HIV from January 2016 to December 2021 in mainland Tanzania. 70,102 children and adolescents aged 5\u201319\u2009years receiving active antiretroviral therapy were included in the analysis. Nutritional status of participants was assessed by anthropometric measurement. Pearson's Chi\u2010square test was used to describe the association between individual\u2010level factors with all malnutrition outcomes and spatial analysis was used to investigate spatial distribution of malnutrition. The excess risk of malnutrition for each region was calculated while Anselin Local Moran's I and Getis\u2010Ord statistical tools were used to identify significant hot spots regions of malnutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of participants was 11.1 (\n                      <jats:italic>SD<\/jats:italic>\n                      4.7) years, with 71.7% in the 5\u201314\u2010year age group and 58.4% being girls. 39.2% were attending care and treatment clinics services at hospital level with public ownership. 53.4% started using ARV at age 5\u201314\u2009years and 55.5% had already switched to second\u2010 or third\u2010line ARV with 61.1% using ARV for less than 3\u2009years. 51.2% were in WHO HIV clinical stage III or IV. The prevalence of malnutrition was 36.0% for stunting, 28.9% for underweight, 13.0% for wasting, and 48.0% for anthropometric failure. Individual\u2010level factors which accounted for a higher proportion of malnutrition based on anthropometric failure were male sex (56.3%), age 5\u201314\u2009years (50.0%), being unmarried (52.9%), being on second\u2010 or third\u2010line ARV treatment (51.4%), ART initiation at age 5\u201314\u2009years (55.7%), ARV for more than 3\u2009years (49.4%), and stage IV of WHO HIV clinical status (57.8%). There were regional hot spots (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.05): the prevalence rate and excess risk of malnutrition for stunting and anthropometric failure were highest in the southern highlands regions, for underweight in the central regions, and for wasting in the northern regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children and adolescents living with HIV\/AIDS in Tanzania suffer from poor nutritional status. Malnutrition does not occur arbitrarily, and the regions identified as hot spots should be given priority for nutritional intervention. Effective nutritional interventions for children living with HIV\/AIDS should incorporate multiple approaches by considering unique geographical factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.13852","type":"journal-article","created":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T23:38:35Z","timestamp":1673221115000},"page":"203-214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiological profile of malnutrition status and spatial distribution of children and adolescents living with\n                    <scp>HIV<\/scp>\n                    \/\n                    <scp>AIDS<\/scp>\n                    in Tanzania"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5274-9564","authenticated-orcid":false,"given":"Samuel","family":"Chacha","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"},{"name":"Department of Molecular Diagnostics Sumbwanga Regional Referral Hospital  Rukwa Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teng","family":"Yuxin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saumu","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaus","family":"Mbonile","sequence":"additional","affiliation":[{"name":"Department of Molecular Diagnostics Sumbwanga Regional Referral Hospital  Rukwa Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Msumari","sequence":"additional","affiliation":[{"name":"Department of Molecular Diagnostics Sumbwanga Regional Referral Hospital  Rukwa Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ndovera","family":"Msuya","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Malimu","sequence":"additional","affiliation":[{"name":"Global Fund Ministry of Health  Dodoma Tanzania"},{"name":"Department of Parasitology Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baraka","family":"Revocatus","sequence":"additional","affiliation":[{"name":"Department of Data and Statistics Bugando Medical Centre  Mwanza Tanzania"},{"name":"National AIDS Control Program Ministry of Health  Dodoma Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Maokola","sequence":"additional","affiliation":[{"name":"National AIDS Control Program Ministry of Health  Dodoma Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godwin","family":"Mtali","sequence":"additional","affiliation":[{"name":"Department of Oncology Bugando Medical Centre  Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Simon","sequence":"additional","affiliation":[{"name":"Global Health Program, HJFMRI U.S. Military HIV Research Program  Rukwa Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaonong","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13336"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1596\/978-1-4648-0423-6_ch3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00648-6"},{"key":"e_1_2_7_5_1","unstructured":"Government of the United Republic of Tanzania University of Dodoma Development Partners and UNICEF.Tanzania National Nutrition Survey;2018. 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