Association of Supplemental Nutrition Assistance Program (SNAP) with Food Security and Nutrition Status among Persons Living with HIV.

Aims: Nutritional status can be compromised by food insecurity which is common among HIV infected persons. Providing food assistance is expected to improve food insecurity and nutritional status among persons infected with HIV. This study aimed at examining the relationship of participating in the Supplemental Nutrition Assistance Program (SNAP), the largest food assistance program in the United States, with food security and nutritional status among HIV infected adults. Study Design: A cross-sectional study design was used in this study. Place and Duration of Study: This study was conducted in Miami, FL, USA, between April 2011 and August 2012. Methodology: We included 159 HIV infected individuals in this study, 113 participants were SNAP recipients while 46 were not. All study participants were, however, eligible to participate in SNAP. Each participant completed demographic and food security surveys as well as dietary and nutrition status assessment. Statistical analyses were conducted using univariate and multivariate analyses. Results: More than half (56%) of the sample experienced food insecurity and had inadequate intakes of several nutrients. There were no significant differences in food security level and nutritional status between SNAP participants and eligible non-participants, even after controlling for demographic and health characteristics. Individuals with very low food security had 4.7 times increased odds (95% CI: 1.29-17.38) of illicit drugs use, which was prevalent (38%) among HIV+ SNAP participants in Miami. Drug users were more than twice likely to have inadequate intakes of vitamins B1, B2, B6, and zinc, compared to non-drug users.  Conclusion: Our results do not support an association between SNAP participation and food security or nutritional status in this cohort of HIV infected individuals with prevalent substance abuse. However, it demonstrates that food insecurity and inadequate nutrient intake continues to be prevalent among HIV infected adults and it is related to drug abuse. Resources need to be identified and targeted at addressing both food insecurity and poor nutritional outcomes among populations of HIV infected adults.

Intestinal parasitic infections and eosinophilia in an human immunedeficiency virus positive population in Honduras

The occurrence of intestinal parasites, their regional distribution and their relations to eosinophilia were studied in 133 human immunodeficiency virus (HIV) positive individuals from Honduras. After signing an informed consent, participants answered a socio-demographic and risk factor questionnaire, a complete physical examination, medical history, and a series of laboratory tests. All participants were HIV positive but not acquired immunodeficiency syndrome positive. Of them, 67 percent were co-infected with pathogen and non pathogen parasites. Overall occurrence of nematodes was: 44.3 percent for Trichuris trichiura, 24 percent for Ascaris lumbricoides, 12 percent for Hookworm and 7.5 percent for Strongyloides stercoralis. No cases of Giardia lamblia, acute amebiasis or cryptosporidiasis were diagnosed. Mean eosinophil percents for participants were consistently and significantly higher in infected than in non infected individuals: 22 percent for Hookworm vs 7.2 percent (p < 0.001), 11 percent for Trichuris compared to 5.2 percent (p < 0.001), 13.2 percent compared to 7.5 percent for S. stercoralis (p < 0.05), and 12 percent compared to 6 percent for Ascaris cases (p < 0.05). Helminths and non pathogenic protozoa, as single or mixed infections, occurred among the participants. There was a strong correlation between eosinophilia and helminthiasis infections; however, none was identified between CD4 levels and eosinophilia. Because parasitic infections aggravate malnutrition and promote a disbalanced Th2 response in a potentially immuno-compromised host, their effect on HIV disease progression needs further study, mainly in countries were HIV and parasitic infections are highly prevalent.

Occurrence of Cryptosporidium oocysts and Giardia cysts in water supplies of San Pedro Sula, Honduras

During June 1996, water supplies of the city of San Pedro Sula, Honduras, were sampled to obtain an assessment of Cryptosporidium oocyst and Giardia cyst concentrations. Each sample was concentrated and stained with an indirect immunofluorescent antibody, and parasites were counted through microscopic analysis. In three surface water supplies, Cryptosporidium oocyst concentrations ranged from 58 to 260 oocysts per 100 L, and Giardia cysts were present in concentrations ranging from 380 to 2 100 cysts per 100 L. Unlike the surface water samples, groundwater had a higher concentration of Cryptosporidium oocysts (26/100 L) than Giardia cysts (6/100 L), suggesting that the groundwater aquifer protects the water supply more effectively from larger Giardia cysts. Cryptosporidium oocyst concentrations are within the typical range for surface water supplies in North America whereas Giardia cyst concentrations are elevated. Efforts should be made to protect raw water from sources of contamination

Estado del metabolismo de los lípidos en la infección por VIH-1 y SIDA / Metabolic state of the lipids in the VIH-1 and AIDS infection

Los niveles plasmáticos anormales de lípidos y lipoproteínas han sido reportados en estudios realizados en individuos sintomáticos y asintomáticos infectados con el VIH-1. La hipocolesterolemia e hipertrigliceridemia son los disturbios más frecuentemente observados en las diferentes fases de la progresión de la enfermedad. Estos cambios en el perfil lípidico se encuentran asociados a la activación viral y la consecuente respuesta immune, en especial, la producción de citoquinas. El estado del metabolismo de los lípidos puede ser aún más influenciado por enfermedades oportunistas y la anorexia. En consecuencia, la alteración del metabolismo lipídico podría contribuir a la progresión de la enfermedad, el síndrome de consumo y la elevada mortalidad frecuentemente observada en la infección por VIH-1.

Increased prevalence of Plasmodium falciparum malaria in Honduras, Central America

We report on our investigation of a malaria outbreak in Honduras, Central America, in January 1997. We tested 202 patients with fever and chills using thin and thick blood film microscopy. Sixteen patients lived in the city and the rest lived in rural areas. A total of 95 samples (47%) were positive for malaria parasites. Seventy-nine percent (63/80) of the rural patients were infected with Plasmodium vivax and 21% (17/80) were infected with P. falciparum. In the urban area, all 15 infected patients had P. vivax malaria and none showed evidence of P. falciparum. Since previous reports indicate that falciparum malaria accounts for only 2% of the overall malaria infections in Honduras, the results reported here suggest that there is a dramatic increase in falciparum malaria in the area of Honduras investigated in this study.

Notificamos los resultados de un estudio de un brote de malaria que se produjo en Honduras, Centroamérica, en enero de 1997. Sometimos a examen microscópico frotis delgados y frotis gruesos de la sangre de 202 pacientes con fiebre y escalofríos. Dieciséis pacientes eran habitantes de la zona urbana y el resto de la zona rural. Un total de 95 especímenes (47%) fueron positivos a parásitos de la malaria. Setenta y ocho por ciento (62/80) de los pacientes del área rural estaban infestados con Plasmodium vivax y 22% (17/80) con P. falciparum. En la zona urbana, todos los 15 pacientes que estaban infestados tenían P. vivax y en ninguno se detectó P. falciparum. Ya que según informes previos la malaria de tipo falciparum representa solamente 2% de todos los casos de malaria en Honduras, nuestros resultados sugieren que hay un gran incremento del número de casos de malaria falciparum en la zona de Honduras en que se llevó a cabo esta investigación.

Nutritional status of institutionalized elderly in south Florida

To assess the nutritional status of an elderly nursing home population of South Florida, forty-seven persons with ages ranging from 65 to 96 years were studied. Complete clinical examination and anthropometric measures were performed, along with blood cell count, biochemical blood parameters and assessment of water-soluble vitamins levels. The most common clinical finding were edentulous (67%), general pallor (44%), hyperpigmentation (33%), dry skin (26%) and arcus corneitis (26%). Thirty-five percent of the studied population had cholesterol levels greater than 220 mg/dl. Triglyceride levels were also significantly elevated in a considerable subset of our subjects, with 30% having levels above threshold value of 150 mg/dl. Small proportions of subjects showed low levels of albumin (6%), total protein (28%), ascorbic acid (2%), and thiamin (9%). Forty-five percent of males were pyridoxine deficient, while 63% of the females presented such deficiency. This study underscores the need to define, with greater precision, the nutritional status of aged populations as well as improve our inadequate standards associated with the normal aging process. Nutritional intervention--only possible when appropriate standards are defined--can potentially serve not only to prevent the occurrence of significant morbidity and mortality, but can also be employed to enhance quality of life in the elderly individuals