Your search found 8 Results
Prevalence of Malnutrition and Associated Factors among Hospitalized Patients with Acquired Immunodeficiency Syndrome in Jimma University Specialized Hospital, Ethiopia.
Ethiopian Journal of Health Sciences. 2016 May; 26(3):217-26.BACKGROUND: HIV/AIDS predisposes to malnutrition. Malnutrition exacerbates HIV/AIDS progression resulting in increased morbidity and mortality. The magnitude of malnutrition in HIV/AIDS patients has not been well studied in Ethiopian setup. Our objective was to assess the prevalence of malnutrition and associated factors among HIV/AIDS patients admitted to Jimma University Specialized Hospital (JUSH). METHOD: A cross-sectional study was conducted to assess the nutritional status of 109 HIV/AIDS patients admitted from November 2013 to July 2014. Cohort design was also used for outcome assessment. Serum levels of hemoglobin, albumin and CD4 counts were determined. Data were organized, coded, cleaned, entered into a computer and analyzed using SPSS version 16.0. Descriptive analysis was done initially. Those variables in the bivariate analysis with P-value < 0.25 were then considered as candidates to be included in the multivariable logistic regression model. A P-vale of < 0.05 was considered as statistically significant. RESULTS: The mean age of the patients was 32.7+/-8.12 with male to female ratio of 1:1.9. Patients were in either clinical stage, 3(46.8%), or stage, 4(53.2%). Forty nine (45%) of the respondents had a CD4 count of < 200 cells/microL. The overall prevalence of malnutrition was 46.8% (BMI<18.5kg/m2) and 44.1% (MUAC= 20cm). Eighty four (77.1%) of the patients had a serum albumin level of =3.5g/dl while 76 (69.6%) of the patients had anemia (Hg<12g/dl). CONCLUSION: The prevalence of malnutrition was found to be high. WHO Stage 4 disease and CD4 count <200cells/microl were independent predictors of malnutrition.
Comparison of previous and present World Health Organization clinical staging criteria in HIV-infected Malawian children.
AIDS. 2009 Sep 10; 23(14):1913-6.In many settings, HIV infected children are looked after with limited access to CD4 cell count or viral load. The decision to initiate antiretroviral therapy (ART) is made clinically, based on the WHO paediatric staging criteria, which were revised in 2006. Results of using new and old criteria were compared. Of 694 children, 626 (90.2%) fulfilled criteria to start ART when applying the new WHO staging guidelines, whereas 330 (47.6%) children were eligible for ART when using the old WHO criteria. This signifies a marked rise in the number of paediatric patients qualifying for ART on clinical grounds.
Journal of Tropical Pediatrics. 2008 Dec; 54(6):364-9.AIM: To assess the clinical outcomes of a combined approach to the treatment of severe acute malnutrition in an area of high HIV prevalence using: (i) an initial inpatient phase, based on WHO guidelines and (ii) an outpatient recovery phase using ready-to-use therapeutic food. METHODS: An operational prospective cohort study implemented in a referral hospital in Southern Malawi between May 2003 and 2004. Patient outcomes were compared with international standards and with audits carried out during the year preceding the study. RESULTS: Inpatient mortality was 18% compared to 29% the previous year. Programme recovery rate was 58.1% compared to 45% the previous year. The overall programme mortality rate was 25.7%. Of the total known HIV seropositive children, 49.5% died. CONCLUSIONS: Inpatient mortality and cure rates improved compared to pre-study data but the overall mortality rate did not meet international standards. Additional interventions will be needed if these standards are to be achieved.
London, United Kingdom, ACF International Network, . 80 p. (Hunger Watch Publication)This report documents the findings of Local Voices, a six month qualitative research project that provided HIV orphans, vulnerable children and their carers with the opportunity to discuss and document the difficulties they face providing food, water and healthcare for their families. Through meetings, detailed interviews and discussions the project initiated and developed an ongoing dialogue with 20 families in four areas of the Kitwe district in the Copperbelt province of Zambia: Chimwemwe, Kwacha, Chipata and Zamtan. The discourse that developed over the course of the project has given Action Against Hunger (ACF-UK) and CINDI insight in two key areas. Firstly, the research has added a household perspective to existing ideas and analysis of food security in an HIV/AIDS context. Secondly, the project highlights the knowledge and learning that can be gained when people living with a positive HIV diagnosis are seen as 'experts' and their experiences are used to help identify and address the problems they face. Through the voices of the project's participants, the testimonies and images that are the core of this document explore the social and economic impact HIV/AIDS has on families affected by the disease. ACF-UK and CINDI pioneered this work because we believe HIV/AIDS can no longer be seen as just a medical issue. Within this report we demonstrate that HIV/AIDS has a direct impact on the economic and social well-being of both households and communities; and as such it must be tackled using an integrated approach where food, livelihoods and social protection are highlighted as solutions alongside access to medical care. This report opens with statistics that outline current rates of HIV/AIDS and poverty in Zambia, focusing specifically on the Copperbelt province and the Kitwe district. The testimonies that form the centrepiece of this report are introduced by a summary of the key social and economic issues that HIV orphans, vulnerable children and their carers face, together with a synopsis of government and community based organisation (CBO) responses. These topics have been selected as they cover the core issues that were raised during the Local Voices project. The document ends with a brief conclusion and the report recommendations.
Dar es Salaam, Tanzania, Research on Poverty Alleviation [REPOA], 2007. 26 p. (Special Paper 07.25)The intention of this paper is to highlight the key issues of children and vulnerability in Tanzania. The paper states that a national framework for social protection must be established to address these overwhelming facets of insecurity and vulnerability for children in Tanzania. The framework needs to reduce vulnerability, strengthen capabilities and must therefore put priority on improving the rural economy and rural conditions of life, and on improving health care and other services in rural areas to reduce the toll of ill-health on children and their caregivers. According to the paper pre-natal and obstetric care must be improved so that at birth babies and their mothers are provided health services which minimise their risk of death. Moreover, individuals who require special support may be identified through a combination of community and local government systems, with strengthened organised community groups to care for the most vulnerable. The paper further states that the level of support provided by several programmes to a relatively small number of children, for clothing, for example, is far in excess of the average expenditures by the majority of households on their children. The challenge is to provide support mechanisms which are not stigmatising, nor discriminatory, but which ensure that all children, no matter what their circumstances, benefit from and contribute to their own development and that of the nation to their fullest capacity. In conclusion the paper emphasises that the implications of this analysis suggest that investments are most critically needed to ensure that there is equitable access to quality health care, and that much more serious attention is needed towards the social attitudes towards children and young people and practices of caring for children, not only as infants, but also as older children.
Antiretroviral therapy for HIV infection in infants and children: towards universal access. Recommendations for a public health approach.
Geneva, Switzerland, WHO, 2007.  p.These stand-alone treatment guidelines serve as a framework for selecting the most potent and feasible first-line and second-line ARV regimens as components of expanded national responses for the care of HIV-infected infants and children. Recommendations are provided on: diagnosing HIV infection in infants and children; when to start ART, including situations where severe HIV disease in children less than 18 months of age has been presumptively diagnosed; clinical and laboratory monitoring of ART; substitution of ARVs for toxicities. The guidelines consider ART in different situations, e.g. where infants and children are coinfected with HIV and TB or have been exposed to ARVs either for the prevention of MTCT (PMTCT) or because of breastfeeding from an HIV-infected mother on ART. They address the importance of nutrition in the HIV-infected child and of severe malnutrition in relation to the provision of ART. Adherence to therapy and viral resistance to ARVs are both discussed with reference to infants and children. A section on ART in adolescents briefly outlines key issues related to treatment in this age group. (excerpt)
As Niger's emergency eases, another crisis looms. [Niger : la situation d'urgence ne s'apaise que pour faire place à une autre crise]
Lancet. 2005 Sep 24; 366(9491):1065-1066.The influx of international aid into Niger and the pending harvest has eased the plight of 3 million people at risk of starvation. But as the crisis recedes in the Sahel region, the UN has sounded the alarm about the deadly combination of drought, poverty, and HIV/AIDS in southern Africa. The UN estimates that up to 10 million people in Lesotho, Malawi, Mozambique, Swaziland, Zimbabwe, and Zambia will need assistance during the next 6 months. Aid groups such as CARE International warn that the scale and complexity of the southern African crisis will dwarf that of the Sahel. Zimbabwe is particularly at risk because of the accelerating economic and agricultural collapse, compounded by President Robert Mugabe’s recent clampdown on shack dwellers and street traders, which left some 700 000 people without a home or a job. The UN forecasts that up to 4 million people may need aid but has been unable to launch an appeal for funds because the government refuses to acknowledge the emergency. (excerpt)
Vitamin A deficiency and increased mortality among human immunodeficiency virus-infected adults in Uganda.
Nutrition Research. 2003 May; 23(5):595-605.The specific aims of the study were to determine the prevalence of vitamin A deficiency and to examine the relationship between vitamin A deficiency and mortality among human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa. A prospective cohort study was conducted at the outpatient clinic of Mulago Hospital, Kampala, Uganda, among HIV-infected adults enrolled in the placebo arms of a randomized clinical trial to prevent Mycobacterium tuberculosis infection. Of 519 subjects at enrollment, 186 (36%) had serum vitamin A concentrations consistent with deficiency (<1.05 µmol/L). During follow-up (median 17 months), the mortality among subjects with and without vitamin A deficiency at enrollment was 30% and 17%, respectively (P = 0.01). In a multivariate model adjusting for CD4+ lymphocyte count, age, sex, anergy status, body mass index, and diarrhea, vitamin A deficiency was associated with a significantly elevated risk of death [relative risk (RR) = 1.78, 95% confidence interval (CI) 1.2-2.6]. Vitamin A deficiency is common among HIV-infected adults in this sub-Saharan population and is associated with higher mortality. (author's)