Nutritional status and HIV in rural South African children

Abstract

BackgroundAchieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability of governments/policymakers to address nutritional status of children in general and those infected or affected by HIV/AIDS in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of nutritional status.MethodsThe study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Linear and logistic regression analyses were conducted to establish the determinants of child nutritonal status.ResultsPrevalence of malnutrition, particularly stunting (18%), was high in the overall sample of children. HIV prevalence in this age group was 4.4% (95% CI: 2.79 to 5.97). HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence.ConclusionsThis study documents poor nutritional status among children aged 12-59 months in rural South Africa. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival.

Evaluation of the Nutritional State of Children and Teenagers Infected by HIV Treated in a University Hospital in Abidjan (Côte d’Ivoire)

“…Malnutrition is frequent in children affected by HIV, despite antiretroviral treatment [12,13,14]. At the time of our study, the majority of children did no longer present with immune-deficiency (71.2 %).…”

“…Stunting was the most frequently met clinical form of malnutrition in both groups (20% and 19.7%); these rates are similar to those found by Kimani-Murage in South Africa (18%). [14] In children aged more than 5 years, nineteen (10.7%) children were wasted. Higher prevalence of chronic malnutrition were reported by Chouldhary (42% for children ≤ 5 years of age and 40% for children>5 years of age) [9].…”

HIV Morbidity and Mortality in the Pediatric Population of Côte d’Ivoire

“…Severe Acute Malnutrition was the leading cause of hospitalization in both groups (29.03% and 40%). The work of Kimani Murage in South Africa [16] and Choudhary in India, on the nutritional assessment of a HIV-infected children population revealed prevalences of 18% of severe acute malnutrition, 12.9% among children under 5 years and 39.4% in those over 5 years [17]. The early HIV/AIDS testing and malnutrition treatment improves the quality of life of children living with HIV.…”

Anthropometry and body composition of vertically HIV-infected children and adolescents under therapy with and without protease inhibitors

“…Stunting has been observed in HIV-infected children (5,(25)(26)(27)(28) and HAART is normally thought to improve growth (27) . However, HAART seems less effective in those under 1 year of age because of their poor clinical condition as they fulfilled the inclusion criteria for this therapy at a very young age, which suggests a more advanced disease (6) .…”