Nutritional status of adult inpatients in Bujumbura, Burundi (impact of HIV infection)

Abstract

Objective: To determine the prevalence and analyse the characteristics and causes of malnutrition among inpatients in an HIV highly endemic area. Design: Prospective cross-sectional study. Setting: Department of Internal Medicine, University Hospital, Bujumbura, Burundi. Subjects: 226 adult inpatients. Main outcomes measures: Evaluation of nutritional status using anthropometry. Degree of malnutrition de®ned by the percentage of body weight loss (BWL), calculated by reference to the usual body weight. Results: Among the 226 patients recruited (mean age: 34.4 AE 11.9 y, M:F sex ratio: 1.72), 102 (45.1%) were HIV seropositive. 62 (60.8%) of these HIV seropositive were AIDS cases. The AIDS de®ning criterion was wasting syndrome' for 25 (40.3%) and opportunistic infection (OI) for 37 (59.7%) including 34 cases of tuberculosis (TB). The nutritional status of 119a226 patients (52.7%) was normal (BWL 10%). Moderate malnutrition (10% BWL 20%) was observed in 47 (20.8%) and severe malnutrition (BWL b 20%) was observed in 60 (26.5%). HIV seroprevalence and, among HIV seropositive subjects, the percentage of AIDS cases increased according to decreasing level of nutrition (Chi2 for trends: P`0.001 in both instances). The fat free mass mass of malnourished subjects was lower and the fat body mass was higher among HIV seropositive subjects than HIV seronegative subjects. Among HIV seropositive subjects, malnutrition was associated with TB (P`0.001) and dysphagia (P`0.05). Among HIV seronegative subjects, malnutrition was associated with decreased food availability (P`0.003) and TB (P`0.05). One week after admission, the mortality rate was higher among HIV seropositive subjects (10.8%) than seronegative subjects (2.4%, P 0.009). Other factors associated with death were decreased fat free mass (P`0.01) and tricipital skinfold thickness (P`0.04). Conclusions: The prevalence of malnutrition is high among the inpatients investigated. Main factors are HIV infection and TB. Strategies adapted to the African context should be developed to prevent, detect and treat malnutrition and associated factors, particularly among HIV seropositive subjects.

Alterations in serum levels of trace elements in tuberculosis and HIV infections

“…In Uganda, mean haemoglobin concentrations were lower among HIV-infected adults with TB than in HIV-infected adults without TB (Shah et al, 2001). Low plasma transferrin concentrations have been described among HIV-infected adults with TB (Niyongabo et al, 1999b). There are two explanations for the association of low iron status with infection.…”

Women's input into household decisions and their nutritional status in three resource-constrained settings

“…Households have lost breadwinners and caregivers, leaving them even poorer and more vulnerable to starvation, and therefore more vulnerable to HIV/AIDS. In Africa, HIV/ AIDS is associated with malnutrition-related mortality 10 and reduced food availability 11 . Women have been particularly at risk since they are the primary food providers 12 and may have to resort to trading sex for food or money, increasing their vulnerability to HIV/ AIDS 2 .…”

Quantification of lean tissue losses during cancer and HIV infection/AIDS

“…Prevalence of undernutrition and fat-free mass loss in cancer and HIV-infected/AIDS patients FFM loss together with a decrease in body cell mass are the features of adult and children patients with cancer [9 ,10] and HIV infection/AIDS, complicated or not with tuberculosis, in comparison with patients without HIV infection [11][12][13][14]. The mechanisms of FFM loss in patients with cancer and HIV infection/AIDS are shown in Fig.…”