Response to Conventional Nutritional Treatment of Severely Malnourished Hospitalized Children in the Context of HIV Infection at Yekatit 12 Hospital, Addis Ababa, Ethiopia
Science Journal of Clinical Medicine
Volume 2, Issue 6, November 2013, Pages: 176-182
Received: Oct. 22, 2013;
Published: Nov. 20, 2013
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Tesfaye Taye Gelaw, Department of Pediatrics and child health, Bahir Dar University, Bahir Dar, Ethiopia
Amha Mekasha Wondemagegn, Department of Pediatrics and child health, AAU, Addis Ababa, Ethiopia
Background: The aim of this study was to describe the response to nutritional treatment of severely malnourished hospitalized children in relation to HIV infection Methods: The study was conducted in the paediatric wards of Yekatit 12 hospital, which is situated in Addis Ababa, Ethiopia serving as a referral hospital for clinics, health centers and hospitals situated in and out of Addis Ababa. It also serves as a teaching hospital for AAU Medical students and Residents. We studied 300 severely malnourished children (presence of oedema, weight for age < 60% on HC and/ or weight-for-height <70%). At admission, HIV serology was confirmed by ELISA, for children >18 months of age, and PCR (DBS) was performed for those <18 months and CD4+ cells were measured for those who turned out to be positive. Complete blood count (CBC), including differential counts, was determined using a Coulter counter and/or manually. The study is a prospective observational analytic cohort study. Result: Of the 300 children, 75 were HIV Positive (cases) and the remaining 225 were controls (1:3 ratio). There was no significant difference by sex, age group, site of residency, family in come, family educational status, medical illness, hematologic profiles, immune category and presence or absence of edema in the treatment out come of HIV infected children compared to uninfected once. Among HIV infected forty three (43/75) failed to respond to the nutritional intervention when compared to those who are not infected (225/38) (Adjusted OR = 6.61, 95%CI = 0.053, 0.423). Conclusion: HIV infection is a major challenge in addressing nutritional intervention for those children who are severely malnourished admitted in Yekatit 12 hospital. An intervention to alleviate the challenge in managing the problem has to be designed based on further interventional studies.
Tesfaye Taye Gelaw,
Amha Mekasha Wondemagegn,
Response to Conventional Nutritional Treatment of Severely Malnourished Hospitalized Children in the Context of HIV Infection at Yekatit 12 Hospital, Addis Ababa, Ethiopia, Science Journal of Clinical Medicine.
Vol. 2, No. 6,
2013, pp. 176-182.
Susan Thurstans: HIV prevalence in severely malnourished children admitted to nutrition rehabilitation units in Malawi: Geographical & seasonal variations a cross-sectional Study; BMC Pediatrics 2008, 8:22
The USA President’s emergency plan for AIDS relief, Report on food & nutrition for PLWHA, May 2006.
Stephen M. Arpadi, Growth failure in HIV infected children, WHO, department of nutrition for health & development, 2005.
Action against hunger UK, Research: Developing Therapeutic Nutritional Care for HIV-Affected Children.
FMOH-ETHIOPIA, Protocol for the management of severe acute malnutrition, 2007.
Exceler JL: Malnutrition and HIV infection in children in a hospital milieu in Burundi: Pediatrie. 1987; 42:9:715-8.
Fajardo-Rodriguez A, Lara del Rivero-Vera CM; Nutritional intervention in HIV/AIDS: practical guide for its implementation and follow-up; Gac Med Mex. 2001 Sep-Oct; 137: 5:489-500.
The ICAP Pediatric clinical manual, 2005.
Kessler L.; Daley H.; Malenga G.; Graham S. The impact of HIV type 1 on the management of severe malnutrition in Malawi; Ann.trop.paed; 20:1, 1 March 2000, pp. 50-56(7)
Hanifa Bachou; Severe malnutrition with and without HIV-1infection in hospitalized children in Kampala, Uganda; Nutrition Journal 2006. 5:27
London Peter Moszynski; AIDS and malnutrition inextricably Linked; BMJ 2006; 333:64 (8 July).
Schewenk A, Buger B, Wessel D, Stutzer H, Ziegenhagen D, Diehl V, Schrape M; Clinical risk factors for malnutrition in HIV-1-infected patients; AIDS. 1993, 7: 1213-1219.
NI Paton, S Sangeetha, A Earnest and R Bellamy; The impact of malnutrition on survival & the CD4 count response in HIV-infected Patients starting ART; HIV Medicine 2006, 7, 323–330
WHO, Regional Office for the Western Pacific; HEALTH RESEARCH METHODOLOGY, A Guide for Training in Research Methods; Second Edition; Manila, 2001.
Neil Pearce ; A Short Introduction to Epidemiology; Second Edition; 2005.
Kenneth F Schulz, David A Grimes; Epidemiology series; The Lancet; 2002; 359:9303: 341-345.
WHO, Management of severe malnutrition: a manual for physicians and other senior health workers, Geneva 1999.
WHO, WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children, 2006, GENEVA.
Buford Nichols; Treatment of severe malnutrition in developing countries, Uptodate version 15.3
Rebecca T Kirkland; Etiology and evaluation of failure to thrive in children younger than two years; Uptodate version 15.3
Tindyebwa D, Kayita J, Mosoke P, et al, eds. 2006. Handbook on Paediatric AIDS in Africa. Uganda: African Network for the Care of Children Affected by AIDS, ANNECA.
Michael Golden; The management of severe acute malnutrition; A manual for Ethiopia; UNICEF, 2002.
Fawzi WW, Msamanga GI, Spiegelman D et al. (2004) "Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality" New England Journal of Medicine 351:23-32.
Shorr IJ. How to weigh and measure children: assessing the nutritional status of young children in household surveys. New York: Department of Technical Co-operation for Development and Statistical Office, United Nations, 1986.