Nutritional Status of HIV-Infected Adults on Antiretroviral Therapy and the Impact of Nutritional Supplementation in the Northern Cape Province; South Africa

Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy.Design: A descriptive; prospective trial was performed. Setting: The investigation was conducted at ARV roll-out centres in Kimberley; Upington; Kuruman; Prieska and Springbok in the Northern Cape Province of South Africa. Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study.Outcome measures: Each participants's body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant; enriched maize product. Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention; the median BMI was 20 kg/m2 (range 12.6-29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns; with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week; 49.4experienced weight gain and 40.2lost weight. Eighteen (20.7) patients gained more than 5of their baseline weight; which was significant. Only eight (9.2) patients lost more than 5of their baseline weight. Twenty-two patients who presented with a BMI 18.5 kg/m2 at baseline had a median weight gain of 1.13 kg during the intervention period; while the group with a BMI 18.5 kg/m2 presented with no change in median weight. Conclusions: Nutritional supplementation; provided according to provincial policy and combined with ARVs; nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape

Nutritional Status of HIV-Infected Adults on Antiretroviral Therapy and the Impact of Nutritional Supplementation in the Northern Cape Province; South Africa

Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy.Design: A descriptive; prospective trial was performed. Setting: The investigation was conducted at ARV roll-out centres in Kimberley; Upington; Kuruman; Prieska and Springbok in the Northern Cape Province of South Africa. Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study.Outcome measures: Each participants's body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant; enriched maize product. Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention; the median BMI was 20 kg/m2 (range 12.6-29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns; with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week; 49.4experienced weight gain and 40.2lost weight. Eighteen (20.7) patients gained more than 5of their baseline weight; which was significant. Only eight (9.2) patients lost more than 5of their baseline weight. Twenty-two patients who presented with a BMI 18.5 kg/m2 at baseline had a median weight gain of 1.13 kg during the intervention period; while the group with a BMI 18.5 kg/m2 presented with no change in median weight. Conclusions: Nutritional supplementation; provided according to provincial policy and combined with ARVs; nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape

Molecular epidemiology of Escherichia coli isolated from young South African children with diarrhoeal diseases.

Molecular techniques were used for studying the epidemiology of diarrhoeal infections due to Escherichia coli in the Gauteng region in South Africa. In total, 151 E. coli strains isolated from stools of patients with diarrhoea and 30 strains isolated from stools of healthy individuals were collected between March 1996 and May 1997. The E. coli isolates were characterized by serotyping, antimicrobial susceptibility testing, and adherence patterns. Polymerase chain reaction (PCR) was performed to determine the presence of the genes-encoding virulence factors. PCR showed that 59 (32.6%) of the E. coli isolates carried eaeA genes, 6 (3.3%) possessed bfpA genes, 4 (2.2%) CNF1, and 2 (1.1%) carried labile toxin and Stx2 genes. The eae genes were more prevalent in strains isolated from patients than in those from the control group (p < 0.001). Forty-eight (26.5%) strains belonged to enteropathogenic E. coli (EPEC) O serogroups and 14 (7.7%) to Shiga toxin-producing E. coli (STEC) O157 serotype. A high percentage (28.2%) of atypical EPEC strains possessing the eaeA but not the bfpA genes was isolated. Most isolates were susceptible to commonly-used antimicrobial agents. The adherence of the E. coli strains to HeLa cells was identified more in patients (69.4%) than in the control group (60%) and was more dominant in infants than in adults. PCR and tissue culture assays were shown to be useful techniques for the epidemiological study of E. coli where this organism is a major cause of diarrhoea.