ABSTRACT
Weight loss is a major complication in children infected with HIV. Very few studies have focused on the nutritional management of malnourished HIV-positive children, particularly in developing countries, although there have been some studies in adults. Therefore, the aim of this retrospective study was to evaluate, as a function of HIV status, the effect of a nutritional rehabilitation program on the mortality of malnourished children in an Ivory Coast nursery. We studied 193 malnourished children over the age of 15 months from January 1 1994 to December 31 1996; 41 % of these children (80 of 193) were HIV-positive. The nutritional rehabilitation program was introduced in 1995. It had a beneficial effect in HIV-negative children because the setback rate (the number of deaths and transfers x 1,000/the number of child-months at risk) decreased significantly over the three years of the study (1994: 130; 1995: 113; 1996: 26; p < 0.05). The rate in HIV-positive children did fall slightly, but this decrease was not statistically significant. These results demonstrate the difficulties involved in the nutritional management of malnourished HIV-positive children. However, recent studies have suggested that nutritional rehabilitation (by mouth) combined with total vitamin and mineral supplementation may be more effective. Given the frequency of malnutrition in HIV-positive children, clinical studies aimed at improving the nutritional management of these children should be a priority in developing countries.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Child Nutrition Disorders/mortality , Nutritional Physiological Phenomena , Acquired Immunodeficiency Syndrome/mortality , Child Nutrition Disorders/rehabilitation , Child, Preschool , Cote d'Ivoire , Female , HIV Seropositivity/complications , HIV Seropositivity/mortality , HIV-1 , HIV-2 , Humans , Infant , Infant Nutrition Disorders/mortality , Infant Nutrition Disorders/rehabilitation , Male , Weight LossABSTRACT
This study, conducted in a health centre in Abidjan for malnourished children, shows that there were more girls than boys among children admitted who were HIV seropositive whereas there were more boys than girls among seronegative children. Reasons for this gender bias are investigated.
Subject(s)
Child Nutrition Disorders/complications , HIV Seronegativity , HIV Seropositivity/complications , HIV Seropositivity/epidemiology , HIV Seroprevalence , Cote d'Ivoire/epidemiology , Female , Humans , Infant , Male , Retrospective Studies , Risk Factors , Sex Distribution , Sex Factors , Urban HealthABSTRACT
Stunting and weight-loss are common complications of HIV infection in children. The aim of this study was to assess whether stunting, assessed using a height-for-age index, is a discriminating factor for HIV in malnourished children. This is a retrospective study of 66 children, all older than 15 months, with marasmus-type malnutrition. They were studied at a nursery in the Côte d'Ivoire from 1994 to 1995. Forty-five percent of the children were HIV-positive. The anthropometric indices (weight-for-age, weight-for-height, height-for-age and body mass index) were lower in seropositive than in seronegative children, but the difference was not significant. The rate of stunting was similar in the two groups, with 66% of seropositive and 58% of seronegative children stunted. Thus, stunting was not a discriminating factor for HIV infection. Studies aimed at increasing our understanding of nutritional disorders associated with HIV are necessary to improve the nutritional management of these children, especially in Africa where malnutrition is endemic.
Subject(s)
Body Height , Body Weight , Growth Disorders/physiopathology , HIV Infections/physiopathology , Nutrition Disorders/physiopathology , Age Factors , Anthropometry , Body Mass Index , Cote d'Ivoire , Endemic Diseases , Growth Disorders/etiology , HIV Infections/complications , HIV Seronegativity , HIV Seropositivity , Humans , Infant , Infant Nutritional Physiological Phenomena , Nutrition Disorders/complications , Nutrition Disorders/therapy , Nutritional Support , Protein-Energy Malnutrition/complications , Protein-Energy Malnutrition/physiopathology , Retrospective Studies , Weight LossABSTRACT
A combination of diarrhoea and malnutrition frequently occurs in HIV seropositive children and constitutes a bad prognosis factor. The impact of dehydration induced by diarrhoea in these children has not as yet been assessed and constitutes the aim of this study. This retrospective analysis was conducted on 121 malnourished children monitored in 1994 at an infant home in Cöte d'lvoire. 46.2% of the children were HIV seropositive and their mortality rate was significantly higher than that observed among seronegative children (42.8% vs. 15.3%; p < 0.01). Among the various pathologies observed in these children, diarrhoea and oral candidosis were discriminating factors in seropositive children. Besides, the findings confirmed the effect of dehydration on the mortality of malnourished children as a whole. Studies allowing a better understanding of factors involved in diarrhoea or dehydration among HIV seropositive malnourished children appears to be essential to improve the management of these children.
