Helicobacter pylori is not a Cause of Anaemia amongst People Living with HIV and AIDS in Tanzania.

Objectives: Helicobacter pylori is the most common infection worldwide. Several reports have indicated an association between H. pylori infection and anaemia. The aim of the study was to determine the prevalence of H. pylori co-infection with HIV and its correlation with anaemia and CD4 cell counts. Methods: A cross sectional study of 77 people infected with human immunodeficiency virus at SHIDEPHA+ Post Test Club Mwananyamala in Dar-es-Salaam, were assessed for Helicobacter pylori infection using 13C urea breath tests, immune integrity by use of CD4 cell count and anaemia using Beckman Coulter Counter. Results: Of the 77 subjects who were HIV positive 31 (40%) were H. pylori positive, compared to 14 out of 25 (56%) H. pylori positive amongst HIV negative controls. The mean (SD) haemoglobin level in H. pylori negative subjects was 11.7 (1.6) g/dl, compared to 11.4 (1.75) g/dl amongst those who were H. pylori positive (unpaired t test, p=0.43). Of the 15 subjects with CD4 counts below 200/ml, 4 (26%) were H. pylori positive, compared to 27/62 (48%) of those with CD4 counts above 200/ml (Chi squared, p<0.005). Conclusion: Our data demonstrates that H. pylori colonization is unlikely to contribute to anaemia amongst HIV positive subjects studied. Although this suggests that H. pylori colonization does not lead to significant problems in this population, both adequate nutrition and treatment of problems such as iron deficiency remain important components of the management of HIV positivity and AIDS throughout Africa.

Micronutrient dietary supplements--a new fourth approach

Currently the three main widely used strategies to control micronutrient deficiencies are food diversification, fortification, and consumption of medicinal supplements. In Tanzania a fourth strategy has been evaluated in school children, and is to be studied in pregnant and lactating women. The dietary supplement comes in the form of a powder used to prepare a fruit flavored drink. Children consumed for six months 25 grams per school day attended, the powder being added to 200 ml of water. The dietary supplement provides between 40 and 100 percent of the RDA of 10 micronutrients, which includes iron, vitamin A and iodine. Unlike medicinal supplements it provides the multiple vitamins and minerals in physiologic, not megadoses. In a well conducted randomized double blind placebo controlled trial, a dietary supplement in the form of a fortified powder fruit drink produced statistically significant differences not only in vitamin A and iron status, but also in the growth of young school age children.