The effect of rehabilitation on nutritional status of alcohol dependent males in Nairobi.

Abstract

Background: Habitual alcohol consumption leads to alcohol dependency which is associated with significant nutritional, medical, economical, and social risks. This has become a major public health issue globally both in developed and developing countries. Rehabilitation of alcohol dependent males requires emphasis not only on medical but also nutritional services which have been observed to increase a rapid and successful recovery process among rehabilitated alcohol dependent males. Adequate supply of nutrients is required to restore the nutritional deficiencies and help repair the damage done and strengthen the body’s defense against diseases. Objective: To determine the effect of rehabilitation on nutritional status of alcohol dependent males in Nairobi Place and Mathari hospital in Nairobi. Study site: Nairobi is located 1°17′S 36°49′E, at 1,795 meters (5,889 ft) above sea level and occupies 696 km 2 (270 sq mi) in the south central of Kenya. Methodology: Experimental (Pre-post) study design was used. A total of 57 rehabilitated alcohol dependent males in two sites viz; Nairobi Place and Mathari Hospital rehabilitation centers in Nairobi were recruited for the study within one week of admission and re-assessed after four weeks. Interviewer administered semi- structured questionnaires were used to collect data on social-demographic characteristics. A food frequency questionnaire was used to collect information on food consumed. A nutrient calculator was used to determine estimated nutrient intake. Anthropometric measurements of height and weight were taken using height board fitted with a tape measure and a digital scale respectively. Under- nutrition was determined based on body mass index (BMI) using a cut of <18.5 based on (weight (kgs)/height 2 (m). Adequacy of nutrient intake was determined based on comparison with estimated average requirements (EAR) for the key selected nutrients. Risk factors independently associated with under-nutrition were compared using Chi- square test of association. T-test was used for continuous variables. Multivariate logistic regression was used to determine factors associated with under-nutrition adjusting for confounders. Data was analyzed using SPSS V.16.0 for windows and results were considered significant at 5% α- level. Results: The proportion of under-nutrition based on BMI before and after rehabilitation of respondents at Nairobi place was 10% and 5% respectively. There was no significant difference (χ 2 =0.604, p=0.865). Mathari had 16.2% and 8.1% underweight before and after rehabilitation respectively, the difference was not statistically significant (χ 2 =1.349, p=0.592). The findings in the first encounter showed that for Nairobi place and Mathari hospital, nutrient inadequacies were high in vitamin C at 80% and 61.9%; zinc at 67.4% and 79.8%; folate at 80% and 49.7% respectively. In the second encounter Nairobi place provided food that had adequate nutrients while Mathari hospital provided food that were inadequate in folate, Vitamin A and Vitamin C at probabilities of 100%, 100%, and 93% respectively. Socio-demographic characteristics and diseases were not significantly associated with under nutrition (p<0.05). Conclusion: The results of this study indicate that alcohol was the cause of under-nutrition in both centers as other factors were not significantly associated with under-nutrition. Rehabilitation play a role in the nutrition status and recovery of alcohol dependent males; it is recommended that the Government and program managers consider and emphasis nutrition in alcohol and drug rehabilitation programs.