Knowledge of final year undergraduate nursing students about HIV and AIDS in Eswatini

Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are overwhelming health issues globally. They have caused many devastating and draining health issues, which have escalated a critical need for a well-trained and sustainable healthcare workforce in order to meet the needs of people living with HIV and AIDS (PLWHA). Health science students are the future healthcare providers who will implement proper preventive measures, as well as health educational and promotional sessions to promote information and knowledge among the public regarding HIV and AIDS in Eswatini. Methods: A quantitative cross-sectional study was conducted on 140 final-year undergraduate nursing students in three nursing universities in Eswatini. A questionnaire adapted from Othman and Ali in Malaysia with closed-ended questions was modified and used to collect data. The questionnaire consisted of questions on the virus structure, transmission, prevention and management of HIV and AIDS. Statistical Package for the Social Sciences (SPSS) version 20 was utilised to analyse the data. Results: The level of knowledge about HIV and AIDS was high, as evidenced by a mean score and standard deviation of (91.02 ± 5.00). However, there were low scores on questions related to the transmission of the disease. Conclusion: Across all three universities in Eswatini, there were good nursing education programs on HIV and AIDS, evidenced by the high knowledge level about HIV and AIDS. However, there are still some knowledge gaps on HIV and AIDS transmission and management that need to be attended to contribution: This study contributed by providing knowledge of undergraduate nursing students' HIV and AIDS training and management of PLWHA.

Experiences of grandmothers caring for female adolescents living with HIV in rural Manzini, Eswatini: a caregiver stress model perspective

The HIV pandemic has immense effects on the Eswatini population. The burden of caregiving rests on women, typically grandmothers who are elderly and dealing with chronic diseases themselves. The purpose of this study was to explore and describe the experiences of grandmothers in Eswatini caring for female adolescents living with HIV. The study draws on phenomenological fieldwork of six case studies of grandmother­granddaughter pairs who were purposively sampled. Data were collected through in-depth individual interviews that commenced with broad questions: "How is it for you to care for a female adolescent living with HIV?" for the grandmothers, and "How is it for you to live with HIV?" for female adolescents. Data were transcribed verbatim and analysed thematically following the elements of the caregiver stress theory. Drawing on the caregiver stress model, grandmothers and female adolescents experienced input stimuli of financial difficulties related to daily provisions for food and transport fare. Control processes experienced by grandmothers and female adolescents related to feelings of loss, grief, fear, hopelessness and isolation along with suicidal ideation for female adolescents. Regarding output stimuli, grandmothers and female adolescents developed psychological unrest related to difficulty accepting the HIV diagnosis and concerns about the future. Grandmothers experienced ill health due to the demands of the caregiving role. It is recommended that family, financial and psychological support be made available for grandmothers to lighten the duty of caregiving

Patient satisfaction with directly observed treatment and multidrug-resistant tuberculosis injection administration by lay health workers in rural Eswatini

Background: The human resources for health crisis in rural Eswatini led to a novel community-based multidrug-resistant tuberculosis (MDR-TB) treatment strategy based on task-shifting, that is delegation of directly observed treatment (DOT) and administration of MDR-TB injections, traditionally restricted to professional nurses, to lay community treatment supporters (CTSs). Aim: This study assessed the level of patient satisfaction with receiving community-based MDR-TB care from a CTS. Setting: The study was conducted at three MDR-TB-treating facilities in the mostly rural Shiselweni region. Methods: A cross-sectional survey of a purposive sample of 78 patients receiving DOT and intramuscular MDR-TB injections from CTSs was carried out in 2017. Descriptive statistics and regressions were calculated. Results: A high overall general patient satisfaction score for receiving community-based MDR-TB care from a CTS was observed. Adherence counselling, confidentiality, provider selection and treatment costs significantly (p < 0.05) influenced satisfaction. A large majority (n = 62; 79.5%) of patients indicated that they would likely recommend their significant others to receive MDR-TB care from a CTS. Respondents identified the need to provide CTSs with adequate training, regular supervision and sufficient incentives and also to broaden the scope of their services. Conclusion: This study observed that task-shifting of DOT and MDR-TB injection administration to CTSs was supported from a patient perspective. However, adherence counselling, confidentiality, provider selection and treatment costs should be taken into account in community-based MDR-TB care programming. Further to the patients, community-based tuberculosis care could be enhanced by improving CTSs' training, supervision and incentives, and broadening the scope of their services

Navigating intimate sexual partnerships in an era of HIV: dimensions of couple relationship quality and satisfaction among adults in Eswatini and linkages to HIV risk

Couple relationship functioning impacts individual health and well-being, including HIV risk, but scant research has focused on emic understandings of relationship quality in African populations. We explored relationship quality and satisfaction in Eswatini (formerly Swaziland) using data from 148 in-depth interviews (117 life-course interviews with 28 adults and 31 interviews with 29 marriage counselors and their clients) and 4 focus group discussions. Love, respect, honesty, trust, communication, sexual satisfaction, and sexual faithfulness emerged as the most salient characteristics of good relationships, with both men and women emphasising love and respect as being most important. Participants desired relationships characterised by such qualities but reported relationship threats in the areas of trust, honesty, and sexual faithfulness. The dimensions of relationship quality identified by this study are consistent with research from other contexts, suggesting cross-cultural similarities in conceptions of a good relationship. Some relationship constructs, particularly respect, may be more salient in a Swazi context

Determinants of risky sexual behaviours among adolescents in Central African Republic, Eswatini and Ghana: evidence from multi-indicator cluster surveys

Despite the declining HIV/AIDS prevalence globally, nearly half of all new HIV infections still occur among youth, especially in sub-Saharan Africa. While determinants of risky sexual behaviour have received copious attention in the literature, we still lack multi-country studies that track regional changes in sexual risk among youth in sub-Saharan Africa. This study seeks to fill part of this gap by identifying the determinants of risky sexual behaviours among adolescents in Ghana, Central African Republic (CAR) and Eswatini (formerly Swaziland). We used nationally representative sample data from the Multi Indicator Cluster survey, round four (MICS4). Results of the descriptive analysis show that overall consistent condom use is still extremely low in sub-Saharan Africa. In Ghana, only 8.5% of male youth and 7% of female youth consistently use condoms. In CAR this figure is 8% and 4% in male youth and female youth respectively. In Eswatini, with one of highest HIV prevalence in the world, the prevalence of consistent condom use is at 29% in males and 20% in females, higher than both in Ghana and CAR. Results of hierarchical models show that age at first sex does not predict risky sexual behaviour in Ghana, but it does predict risky sexual behaviour in CAR although only among young males. In Swaziland, age at first sex predicts risky sexual behaviour in both male and female youth but the relationship is not in the expected direction. Low socio-economic status predicts inconsistent condom use in all the three countries, but only among young females. This paper provides relevant policy lessons and recommendations

A situational analysis of eye care services in Swaziland

Compared to other African countries, Swaziland performs the worst in terms of providing eye health care services. A priority goal of the World Health Organization (WHO) is to alleviate childhood blindness, particularly in low-income countries such as Swaziland, where many people live in poverty, which is a contributor to poor health outcomes. A mixed method approach that entailed a document review, key informant interviews and clinical facility assessment questionnaires was used. Hospitals and mission clinics offering ophthalmic services were identified through the website of the Ministry of Health and verified during key informant interviews. A saturated sampling procedure was applied due to the few facilities that offer eye care services. Six framework components from the WHO for analysing health systems were utilised in an eye health care service context: leadership and governance, eye health services, eye health workforce, eye health financing systems, eye health medical supplies and technologies, and eye health information systems. Poor management, lack of accountability, poor monitoring and evaluation mechanisms, weak coordination and ineffective private-public sector regulations were identified as factors that lead to poor eye care in the country. The optometrists indicated that refractive services are the most rendered ophthalmic services. The exodus of healthcare practitioners has contributed to the downfall of the public health sector in the country. Five government eye care facilities, 3 government hospitals, 1 non-governmental organization (NGO) and a church mission clinic were included in this analysis. The eye services distribution favors the more affluent areas, particularly the more urban Hhohho Region, which is also where most of the eye health professionals are located. No campaigns have been conducted to prevent childhood blinding diseases or create awareness about getting children's eyes tested for refractive correction. The burden of eye diseases among children in Swaziland remains unknown. More eye health care personnel and equipped facilities are needed throughout the country, and the eye health care program needs to be adopted

Linfoma primario de ano en un paciente con virus de la inmunodeficiencia humana/sida / Primary lymphoma of anus in a patient with human immunodeficiency virus/AIDS

Se presenta el caso clínico de un paciente de 47 años de edad con seropositividad del virus de inmunodeficiencia humana/sida desde hacía 5 años, quien acudió a la consulta de Cirugía en el Hospital Gubernamental de Mbabane en Suazilandia, por presentar un tumor anal; se diagnosticó hemorroides, pero el tumor continuó aumentando de tamaño, unido a sangrado e intenso dolor. Se realizó una biopsia por incisión que indicó la presencia de un linfoma de alto grado de malignidad. Posteriormente el paciente fue evaluado en la consulta de Oncología, donde se le indicaron los exámenes complementarios necesarios, los que revelaron que la neoplasia se encontraba en estadio IE; de manera que fue remitido a Sudáfrica para recibir quimioterapia combinada, con la cual desapareció la lesión maligna y se controló la enfermedad

The case report of a 47 years patient with the human immunodeficiency virus/AIDS for 5 years is presented. He went to the Surgery Service in the Government Hospital of Mbabane in Swaziland, due to an anus malignancy; hemorrhoids was diagnosed, but its size continued increasing, along with bleeding and acute pain. An incision biopsy that indicated the presence of a high grade lymphoma malignancy was carried out. Later on the patient was evaluated in the Oncology Service, where the necessary complementary exams were indicated, revealing that neoplasm was in IE stage; so he was referred to South Africa to receive combined chemotherapy, with which the malignant lesion disappeared and the disease was controlled

Enfermedad de Paget de la mama en una paciente suazí / Paget´s disease of the breast in a suazi patient

Se describe el caso clínico de una paciente de 63 años de edad, quien acudió a la consulta de Oncología del Hospital Gubernamental de Mbabane, en Suazilandia, por presentar una lesión ulcerada en el pezón de la mama izquierda desde hacía 1 año. Luego de realizarle una biopsia por escisión, que reveló la presencia de la enfermedad de Paget, clasificada en el estadio 0 según los resultados de los exámenes complementarios, se decidió remitirla al Servicio de Cirugía donde le practicaron una mastectomía simple. La paciente mostró buena evolución clínica y se mantenía estable hasta la última consulta en que fuera asistida

The case report of a 63 years patient who went to the Oncology Service of the Government Hospital of Mbabane, in Swaziland is described, due to an ulcerated lesion in the nipple of the left breast for 1 year. After carrying out an excision biopsy that revealed the presence of the Paget´s disease, classified in the stage 0 according to the results of the complementary tests, she was referred to the Surgery Service where a simple mastectomy was carried out. The patient showed good clinical course and she remained stable until the last appointment when she was assisted

Love matters: exploring conceptions of love in Rwanda and Swaziland and relationship to HIV and intimate partner violence

Health risks such as intimate partner violence (IPV) and HIV infection often occur within intimate sexual relationships, yet the study of love and intimacy is largely absent from health research on African populations. This study explores how women and men in Rwanda and Swaziland understand and represent love in their intimate sexual partnerships. In Rwanda, 58 in-depth interviews with 15 couples, 12 interviews with activists, and 24 focus group discussions were carried out during formative and evaluative research of the Indashyikirwa programme, which aims to reduce IPV and support healthy couple relationships. In Swaziland, 117 in-depth, life-course interviews with 14 women and 14 men focused on understanding intimate sexual partnerships. We analysed these qualitative data thematically using a Grounded Theory approach. Participants described love as being foundational to their intimate sexual partnerships. Women and men emphasised that love is seen and expressed through actions and tangible evidence such as gifts and material support, acts of service, showing intentions for marriage, sexual faithfulness, and spending time together. Some participants expressed ambivalent narratives regarding love, gifts, and money, acknowledging that they desired partners who demonstrated love through material support while implying that true love should be untainted by desires for wealth. IPV characterised many relationships and was perceived as a threat to love, even as love was seen as a potential antidote to IPV. Careful scholarship of love is critical to better understand protective and risk factors for HIV and IPV and for interventions that seek to ameliorate these risks

Constrained relationship agency as the risk factor for intimate partner violence in different models of transactional sex

Women who engage in transactional sex are more likely to experience intimate partner violence (IPV) and are at higher risk of HIV. However, women engage in transactional sex for a variety of reasons and the precise mechanism linking transactional sex and IPV is not fully understood. We conducted a behavioural survey with a cross-sectional sample of 401 women attending 1 rural and 1 urban public antenatal clinic in Swaziland between February and June 2014. We used structural equation modelling to identify and measure constrained relationship agency (CRA) as a latent variable, and then tested the hypothesis that CRA plays a significant role in the pathway between IPV and transactional sex. After controlling for CRA, receiving more material goods from a sexual partner was not associated with higher levels of physical or sexual IPV and was protective against emotional IPV. CRA was the single largest predictor of IPV, and more education was associated with decreased levels of constrained relationship agency. Policies and interventions that target transactional sex as a driver of IPV and HIV may be more successful if they instead target the broader social landscape that constrains women's agency and drives the harmful aspects of transactional sex

Predictors of survival among HIV-positive children on ART in Swaziland

The objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively. The results reveal that the median survival time for children was 78 months (95% CI: 77­79). Children who were initiated early on ART had higher survival probability over time (HR: 0.35 [95% CI: 0.21­0.57], p < 0.001) compared to those whose ART initiation was delayed. Children within the age group of <1 years had higher hazard (HR = 1.55 [95% CI: 1.16­2.08], p < 0.001) of death than children within the age group of 1­14 years. Children who were nourished had 88% lower hazard of death (HR: 0.12 [95% CI: 0.07­0.19], p < 0.001) than severely malnourished children. The study demonstrates that ART paediatric services are effective in increasing survival among HIV infected children and early initiated children have high survival probability. Active tuberculosis (TB), malnutrition, and delayed ART initiation remain predictors of poor survival among children living with HIV

A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland

HIV/AIDS remains one of the leading causes of death among children under 5 years old in Swaziland. Although studies have shown that early initiation of infants and children diagnosed with HIV on antiretroviral therapy (ART) significantly reduces mortality, many children do not initiate ART until the later stages of disease. This study was designed to collect qualitative data from mothers and caregivers of HIV-positive children to identify the barriers to ART initiation. Focus group discussion (FGD) sessions were conducted in siSwati between July and September 2014 among caregivers of aged children 2­18 months in Swaziland who did or did not initiate ART between January 2011 and December 2012 after HIV DNA PCR-positive diagnosis of the infants. Denial, guilt, lack of knowledge, tuberculosis (TB)/HIV co-infection, HIV-related stigma, lack of money, and distance to clinics were reported by the participants as barriers to ART initiation. The findings further revealed that non-initiation on ART was not linked to a negative perception of the treatment. Findings suggest a need to improve sensitivity among healthcare workers as well as education and counselling services that will facilitate the ART initiation process

Legal responses to HIV and AIDS: lessons from Swaziland

Since 1999, the HIV and AIDS epidemic in Swaziland has been declared a national disaster, and today HIV and AIDS still pose a great threat to the survival and development of Swaziland and its people. The impact of the pandemic necessitated a multi-faceted response from the government. This paper critically evaluates the Swaziland legal response to HIV and AIDS. The objective is to assess whether and to what extent Swazi law addresses human rights issues related to HIV and AIDS. Through the application of a human rights based theory, the paper analyses the domestication of Swaziland's treaty commitments, and the constitutional and the statutory frameworks. The paper advances the importance of "law" as a tool that can create an enabling environment for a national response to HIV and AIDS. It analyses how the government has successfully crafted the normative framework so as to make it responsive to the fight against HIV and AIDS, and the shortcomings of the Swaziland legal system in this fight. The paper argues that even though a credible legal and policy environment is in place, some laws still need to be supplemented, reviewed and amended so that the legal system adequately addresses the human rights issues related to HIV and AIDS. The paper suggests improvements to the legal system which mainly relate to aligning the legal framework with the Constitution of Swaziland and international conventions to which Swaziland is party

HIV prevention needs for men who have sex with men in Swaziland

Men who have sex with men (MSM) have a high HIV burden and also often face multiple other challenges accessing HIV services, including legal and social issues. Although Swaziland recently started responding with interventions for MSM, significant gaps still exist both in information and programming. This study aimed to explore the HIV prevention needs of MSM in Swaziland, including factors elevating their risks and vulnerabilities to HIV infection; to find out what HIV prevention strategies exist; and to determine how best to meet the prevention needs of MSM. A total of 50 men who reported anal sex with other men in the past 12 months were recruited through simple respondent driven sampling. They completed either a structured quantitative survey (n = 35) or participated in a semi-structured qualitative interview (n = 15). Both quantitative and qualitative findings indicated perceived and experienced stigma among MSM. This predominantly manifested as internalised stigma, which may lead to alcohol abuse and sexual risky behaviours. At least 83% (29/35) of the quantitative sample had been labelled with derogatory terms because of their sexual orientation, while 66% (23/35) had experienced being avoided. There was limited knowledge of risk practices: When asked, 54% (19/35) of quantitative respondents reported that vaginal and anal sex carry an equal risk of HIV infection. Participants also had little knowledge on new HIV prevention methods such as pre-exposure prophylaxis (PrEP) and rectal microbicides. MSM needs included safe spaces in form of drop-in centres and non-hostile HIV services. Although Swaziland recently started interventions for key populations, including MSM, there is still a general lack on information to inform managers and implementers on the HIV prevention needs of MSM in Swaziland. Such information is crucial for designers of official and HIV programmes. Research is needed to increase knowledge on the HIV prevention needs for key populations, including MSM

Gendered childcare norms ­ evidence from rural Swaziland to inform innovative structural HIV prevention approaches for young women

Addressing discriminatory gender norms is a prerequisite for preventing HIV in women, including young women. However, the gendered expectation that women will perform unpaid childcare-related labour is rarely conceptualised as influencing their HIV risk. Our aim was to learn from members of a rural Swazi community about how gendered childcare norms. We performed sequential, interpretive analysis of focus group discussion and demographic survey data, generated through participatory action research. The results showed that gendered childcare norms were firmly entrenched and intertwined with discriminatory norms regarding sexual behaviour. Participants perceived that caring for children constrained young women's educational opportunities and providing for children's material needs increased their economic requirements. Some young women were perceived to engage in "transactional sex" and depend financially on men, including "sugar daddies", to provide basic necessities like food for the children they cared for. Our results suggested that men were no longer fulfilling their traditional role of caring for children's material needs, despite women's traditional role of caring for their physical and emotional needs remaining firmly entrenched. The results indicate that innovative approaches to prevent HIV in young women should incorporate structural approaches that aim to transform gendered norms, economically empower women and implement policies guaranteeing women equal rights

Mixed results: the protective role of schooling in the HIV epidemic in Swaziland

Swaziland has the highest HIV prevalence in the world. It is recognised that young women, especially adolescents, are particularly vulnerable to HIV infection and bear a disproportionate burden of HIV incidence. The HIV data from Swaziland show the location of the epidemic, which is particularly high among adolescent girls and young women. This paper is based on research in Swaziland, commissioned because of the perception that large numbers of children were dropping out of the school. It was assumed that these "dropouts" had increased risk of HIV exposure. This study carried out a detailed analysis using the Annual Education Census Reports from 2012 to 2014 produced by the Ministry of Education. In addition, this topic was explored, during fieldwork with key informants in the country. While HIV prevalence rises rapidly among young women in Swaziland, as is the case across most of Southern Africa, the data showed there were few dropouts. This was the case at all levels of education ­ primary, junior secondary and senior secondary. The major reason for dropping out of primary school was family reasons; and in junior and senior secondary, pregnancy was the leading cause. Swaziland is doing well in terms of getting its children into school, and, for the most part, keeping them there. This paper identifies the students who face increased vulnerability: the limited number of dropouts; repeaters who consequently were "out-of-age for grade"; and orphans and vulnerable children (OVC). The learners who were classified as repeaters and OVC greatly outnumbered the dropouts. We argue, on the basis of these data, for re-focussed attention and the need to develop a method for tracking children as they move across the vulnerable groups. We acknowledge schooling is protective in reducing children's vulnerability to HIV, and Swaziland is on the right track in education, although there are challenges

"I will take ARVs once my body deteriorates": an analysis of Swazi men's perceptions and acceptability of Test and Start

Swaziland has the highest HIV prevalence in the world. To mitigate the spread and devastation caused by HIV and to improve the wellbeing of people living with HIV, the country has adopted the latest available HIV prevention campaigns, including "Test and Start". Because evidence from randomised controlled trials has demonstrated a significant risk reduction in HIV transmission when HIV-positive people start antiretroviral therapy (ART) early, Swaziland aims to find these people and link them to treatment. This study presents findings regarding the perceptions of this promising HIV-prevention intervention among men aged 17­69 years. A combination of qualitative methods including focus group discussions (12), in-depth interviews (17), informal conversations and participant observation (21) were used to collect data in two peri-urban communities in 2013­2014. Findings illustrate that men still fear taking an HIV test because of a relatively high probability of a positive test which some still interpret as a death sentence. Other potential barriers to the effectiveness of Test and Start programmes include lack of hospitality in hospitals, fear of starting treatment early related to side effects of ART, poverty, and lack of trust in the financial stability of the Swazi government. We argue that several social factors need to be considered for the Test and Start programme to be more effective

Carcinoma basocelular invasivo de vulva en una adulta / Basal cellular invasive vulvar carcinoma in an adult woman

Se presenta el caso clínico de una fémina de 32 años con seropositividad del virus de inmunodeficiencia humana desde hacía 2 años, quien acudió a la consulta de Ginecología del Hospital Gubernamental de Mbabane, en Suazilandia, por presentar una lesión en el labio mayor derecho de la vulva, unido a prurito y adenopatías en la región inguinal derecha. La paciente fue evaluada en la consulta de Oncología, donde se le diagnosticó un carcinoma basocelular invasivo de vulva, clasificado en estadio III luego de realizar los exámenes complementarios necesarios; posteriormente fue remitida a Sudáfrica para recibir radioterapia y quimioterapia combinadas.

The case report of a 32 years female patient is presented with seropositivity of the human immunodeficiency virus for 2 years who came to the Gynecology Service of Mbabane Government Hospital, in Swaziland, due to a lesion in the right major lip of the vulva, together with pruritus and adenopathies in the right inguinal region. The patient was examined in the Oncology Service, where a basal cellular invasive vulvar carcinoma was diagnosed. It was classified in stage III after carrying out the necessary laboratory exams; later on she was transferred to South Africa to receive combined radiotherapy and chemotherapy.

Melanoma lentiginoso acral en una mujer suazí / Acral lentiginous melanoma in a suazi woman

Se presenta el caso clínico de una fémina de 58 años de edad, de raza negra, quien acudió a la consulta de Cirugía del Hospital Gubernamental de Mbabane en Suazilandia por presentar una lesión pigmentada y ulcerada en el talón del pie derecho, donde se le practicó una biopsia por escisión cuyo resultado fue un melanoma lentiginoso acral invasivo. Posteriormente fue evaluada en la consulta de Oncología y luego de realizarle los exámenes complementarios necesarios, la neoplasia se clasificó en estadio IIC. La paciente fue remitida a Sudáfrica para recibir tratamiento con citosinas inmunomoduladoras, factor estimulante de colonias de granulocitos y macrófagos o inhibidores del gen BRAF.

The case report of a 58 years black woman is presented. She went to the Surgery Service of Mbabane Government Hospital in Suaziland due to a pigmented and ulcerated injury in her right foot heel, where she had an excisional biopsy whose result was an invasive acral lentiginous melanoma. Later on she was evaluated in the Oncology Service and after carrying out the necessary complementary tests, the neoplasm was classified in stage IIC. The patient was referred to South Africa to receive treatment with immunomodulatory cytokines, stimulating factor of granulocytes and macrophages colonies or BRAF gene inhibitors.

Nutritional aspects of children and adolescents with epidermolysis bullosa: literature review

Epidermolysis Bullosa is a genetic disorder that affects mainly the skin, however, all others systems are influenced. The nutritional care of children and adolescents with Epidermolysis Bullosa is a key treatment strategy, since the energy needs are increased due to the disease's metabolism, burdening the immune system and cicatrization process, symptoms caused by the disease hinder the intake and adequate absorption of nutrients, which may result in inadequate growth and development. Because this is a rare disease, there are few professionals who know the characteristics of both the clinical evolution and nutritional and dietary treatments. This literature review discusses the latest knowledge on energy and specific nutrient requirements to the dietary treatment and monitoring of children and adolescents with Epidermolysis Bullosa.