Both acculturation and poverty have roles in children's diets and in household food insufficiency. Culturally specific public health and nutrition education should complement efforts to improve the financial security of low-income households.
BackgroundThe mental health of caregivers has been shown to be important for improving HIV prevention and treatment. Household food insecurity affects hundreds of millions of individuals in Sub-Saharan Africa, a region that experiences a disproportionate burden of the HIV pandemic. Both maternal HIV diagnosis and household food insecurity may be linked with maternal stress. This in turn may lead to unhealthy coping behaviors. We examined the independent associations of HIV, persistent household food insecurity and the synergistic effect of both on maternal stress.MethodsGhanaian women recruited prenatally from hospitals offering voluntary counseling and testing (VCT) were followed for 12 months after childbirth (N = 232). A locally adapted 7-item version of the US Household Food Security Survey Module was applied at four time points postpartum. We dichotomized participant households as being persistently food insecure (i.e., food insecure at each time point) or not (i.e., food secure at any time point). We dichotomized participant women as not perceiving vs. perceiving stress at 12 months postpartum in reference to the median sample score on the 4-item Cohen’s stress scale. Binary multivariate logistic regression models were used to assess the independent and interactive effects of maternal HIV and persistent household food insecurity on maternal stress.ResultsThe proportion of HIV-positive women that lived in severe food insecure households increased over time. By contrast, the HIV-negative group living in severely food insecure households experienced a steady decline across time. HIV-infection (AOR = 2.31, 95% CI 1.29-4.12) and persistent household food insecurity (AOR = 3.55, 95% CI 1.13-11.13) were independently associated with maternal stress in a multivariate model. Being both HIV-positive and persistently food insecure strongly and synergistically increased the risk for maternal perceived stress (AOR = 15.35, 95% CI 1.90-124.14).ConclusionIn agreement with syndemic theory there is a powerful synergism between maternal HIV diagnosis and household food insecurity on maternal stress. Comprehensive multi-dimensional intervention studies are needed to better understand how to reduce stress among HIV-positive women living in persistently food insecure households and how to reduce the likelihood of food insecurity in HIV-affected households in Sub-Saharan Africa.
HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place young infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n=492) were recruited from 3 antenatal clinics; mothers and infants were followed for 12 mo postpartum. Diarrheal incidence was 0.6 episodes/100-d at risk. More HIV-P than HIV-N and HIV-U women tended to report PND symptoms (P=0.09). PND symptoms increased the risk of infantile diarrhea only for HIV-P and HIV-U but not HIV-N women (interaction term, P=0.02). Health care providers should be aware of the increased risk of infantile diarrhea when both maternal HIV and PND symptoms are present and take preventive action to reduce morbidity.
Children of HIV-infected mothers experience poor growth but not much is understood about the extent to which such children are affected. The Research to Improve Infant Nutrition and Growth (RIING) Project used a longitudinal study design to investigate the association between maternal HIV status and growth among Ghanaian infants in the first year of life. Pregnant women in their third trimester were enrolled into three groups: HIV Negative (HIV-N, n=185), HIV-positive (HIV-P, n=190) and HIV-unknown (HIV-U, n=177). Socioeconomic data were collected. Infant weight and length were measured at birth and every month until 12 months of age. Weight-forage (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) z-scores were compared using analysis of covariance. Infant HIV status was not known as most mothers declined to test their children's status at 12 months. Adjusted mean WAZ and LAZ at birth were significantly higher for infants of HIV-N compared to infants of HIV-P mothers. The prevalence of underweight at 12 months in the HIV-N, HIV-P and HIV-U were 6.6%, 27.5% and 9.9%(p<0.05) respectively. By 12 months, the prevalence of stunting was significantly different (HIV-N=6.0%, HIV-P=26.5% and HIV-U=5.0%, p<0.05). The adjusted mean±SE LAZ (0.57±0.11 vs. −0.95±0.12; p < 0.005) was significantly greater for infants of HIV-N mothers than infants of HIV-P mothers. Maternal HIV is associated with reduce infant growth in weight and length throughout the first year of life.
Children of HIV-P mothers living in socioeconomically deprived communities need special support to mitigate any negative effect on growth performance.
Aim of the study Assessment of the revitalization process and achievement of the treatment effects intended in the process Material and methods The author carried out selected tests and performed a process evaluation along with other results from research laboratories. The research concerned measurements of bottom sediment thickness, water transparency and selected physicochemical analyzes of quality parameters of water from the reservoir during the revitalization process. Results and conclusions The obtained results are very satisfactory, as a high level of reduction of bottom sediments was achieved, at some measuring points by over 1 m. There was an improvement in water transparency; physical and chemical parameters did not show deterioration of water quality during the intensive biodegradation process of the organic fraction deposited in bottom sediments. Based on the results presented in the article, it can be stated that the microbiological revitalization processes carried out are very effective methods of purifying surface water pollution.
HIV seropositive women living in low-income communities may have difficulty meeting the increased energy requirements that are associated with both lactation and HIV infection. Data on household food security and maternal socio-demographic characteristics, perceived stress, anthropometry, reported illness, dietary intakes and preferences, and exposure to nutrition education were collected from 70 lactating women (16 seropositive (HP), 27 seronegative (HN), and 27 who refused to be tested and had unknown HIV status (HU)). Diet was assessed with three 24-hr recalls (one market day, one weekend day, and one non-market weekday). Data were collected at 8.4 (SD=4.7) months postpartum. Most women (74.3%) reported being in good health at the time of study.
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