Reliability of scored patient generated subjective global assessment for nutritional status among HIV infected adults in TASO, Kampala

A Mokori, MK Kabehenda, C Nabiryo, MG Wamuyu

Abstract

Objective: Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults.

Methods: A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization (TASO), Mulago Centre, Kampala, Uganda. The study group (n=217) consisted of male (n=60) and female (n=157) HIV patients (18-67 years). Purposive sampling was used. Anthropometry (weight, height, BMI), nutritional history (body weight, dietary intake, gastrointestinal symptoms, functional capacity and infections), and clinical status were assessed. Sensitivity and specificity of PG-SGA were determined using Receiver Operating Characteristic (ROC) curve. Data collection was done from April-May 2008.

Results: Only 12% of the subjects were underweight and over half (58.2%) had normal weight. The PG-SGA had low sensitivity (69.2%) and specificity (57.1%) at categorizing the risk for malnutrition indicated by BMI< 18.5.

Conclusion: There was a high prevalence of malnutrition among the study group. Overall, this study indicated the PGSGA could not adequately discriminate between underweight and normal patients. The tool was not reliable enough for determining nutritional status in this population.

Key words: Patient Generated-Subjective Global Assessment; sensitivity; specificity