Dietary intake among paediatric HIV-positive patients initiating antiretroviral therapy in Johannesburg, South Africa

Musakwa, Nozipho; Feeley, Alison; Magwete, Mmapula; Patz, Sharon; McNamara, Lynne; Sanne, Ian; Long, Lawrence; Evans, Denise

doi:10.1080/17450128.2019.1668581

Cited by 5 publications

(4 citation statements)

References 20 publications

(12 reference statements)

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“…Those who did not get nutritional counseling were about four-time thinner than those who get nutritional counseling. This was similar to the research conducted among Children on Follow Up in Amhara Region Referral Hospitals, Ethiopia [13] and among adult HIV/AIDS patients receiving ART in Dilla University Referral Hospital, Dilla, Southern Ethiopia [19] and among pediatric HIV-positive patients initiating antiretroviral therapy in Johannesburg, South Africa [22] This shows nutritional counseling help ART patient to select the appropriate diet and nutritional problem can aggravate the disease and decrease immunity.…”

Section: Prevalence Of Thinnesssupporting

confidence: 85%

Undernutrition and Associated Factors Among Young Patients on Anti-retroviral Therapy in North Shoa, Oromia, Etiopia,2022. A Facility- Based Cross-sectional Study

Nigussie¹,

Sahlu²,

Gizaw³

2023

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Background Undernutrition and the Human Immunodeficiency Virus (HIV) are related in a complex and harmful way and are both exceedingly prevalent throughout the world, particularly in sub-Saharan Africa. In Ethiopia, the prevalence of undernutrition ranged from 12.3–43% and the prevalence of stunting and thinness among HIV-infected adolescents were 39%) and 14% respectively. There is no study among young patients living with Human Immunodeficiency Virus and ART. Therefore, this study aims to assess the prevalence of undernutrition and its associated factor among young infected with HIV and following ART clinics at the north Shoa health facilities in Oromia, Ethiopia. Methods A facility-based cross-sectional study was conducted. A probability-proportional sampling method was used to select 387 participants and pretested, interview-administered questionnaires were used to collect the data. The information was entered into EpiData and analyzed with SPSS. A 95% confidence interval and a P-value less than 0.05 were used to identify predictor variables, and an adjusted odds ratio (AOR) was used to assess the strength of the association. Result The prevalence of stunting and thinness in the study was 37% (95% CI: 32.0,41.9) and 13.4% (95%, CI:10.3, 16.9) respectively. Being male (AOR 1.5, 95%CI: 1.0,2.4), educational level of caregiver(AOR 7.8, 95%CI: 3.5, 17.2), and having a family income ≤ 1500 ETB (AOR 7.8,95%CI:3.5,17.2) were significantly associated with stunting while being male (AOR = 2.59,95% CI: 1.25,5.40), nutritional counseling (AOR 4.05,95% CI:1.64,10.02), Skipping meal (AOR 4.97,95%CI:2.08,11.9) and educational level of caregiver (AOR 4.18,95% CI:1.82,9.60) were significantly associated with thinness. Conclusion The prevalence of stunting and thinness among HIV-infected adolescents and youth in the study area was consistent with EDHS and higher than the EDHS report respectively. Sex, skipping a meal, nutritional counseling, and family size were significantly associated with thinness and Sex, educational level of the caregiver, and family income was significantly associated with stunting.

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Section: Prevalence Of Thinnesssupporting

confidence: 85%

Undernutrition and Associated Factors Among Young Patients on Anti-retroviral Therapy in North Shoa, Oromia, Etiopia,2022. A Facility- Based Cross-sectional Study

Nigussie¹,

Sahlu²,

Gizaw³

2023

Preprint

View full text Add to dashboard Cite

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“…The data were collected in a different era of ART and much has been done to improve initiation age and clinical management of CLHIV; however, there exists an increasing need for dietary counselling and the provision of nutritional education or supplementation at ART initiation in order to improve growth and development as well as health outcomes. 43 More research is needed to determine the impact of nutrition interventions, especially at early stages of improper weight gain, in order to assess the effect on ART success. Improved monitoring of growth in CLHIV according to a HIV-specific reference could help to optimise the response to ART.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Weight gain in children from birth to 10 years on antiretroviral treatment

Scholtz

Ellis²,

Kruger³

2022

Southern African Journal of HIV Medicine

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Background: Inadequate weight gain could indicate clinical deterioration in infants and children living with HIV (CLHIV). The World Health Organization’s (WHO) weight-for-age z-score (WAZ) growth standards and reference charts are currently used in South Africa to assess weight gain in CLHIV on antiretroviral treatment (ART).Objectives: To assess weight gain patterns of infants and children initiated on ART and to compare weight gain patterns between the WHO WAZ growth standards and population-specific curves constructed from data of CLHIV on ART.Method: A quantitative, retrospective and descriptive-comparative design was used. The weight gain patterns of 98 infants and children from birth to 10 years old during the 24-month period following ART initiation were recorded and assessed using two different growth charts.Results: The children’s rate of weight and length gain improved significantly over 24 months since ART initiation, but complete catch-up growth was never achieved. Most (69%) of the children had increased weight gain according to the WAZ growth standard and reference charts versus only 16% according to the HIV-specific weight gain curves.Conclusion: Antiretroviral treatment improved weight and height gain in CLHIV, but the interpretations of weight gain differed significantly between the WHO chart and HIV-specific weight gain curves. Population- and treatment-specific references could improve weight monitoring in CLHIV and assist in the timeous identification of malnutrition.

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“…Significantly less temporary employment and borderline lower permanent employment among household breadwinners of children with low iron stores and HIV+ children, respectively, also suggest potentially lower household income which could adversely affect household food security and dietary diversity. In Johannesburg, South Africa, poor dietary diversity was recently described among 1 to 10-year-old HIV+ children [ 52 ], while a previous study comparing 5 to 9-year-old HIV+ and HIV-ve children revealed similar borderline-low dietary diversity scores in both groups [ 53 ]. Of concern is the lower intake of muscle protein/heme iron by the HIV+ children.…”

Section: Discussionmentioning

confidence: 99%

Examining Associations of HIV and Iron Status with Nutritional and Inflammatory Status, Anemia, and Dietary Intake in South African Schoolchildren

et al. 2021

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The etiology of multifactorial morbidities such as undernutrition and anemia in children living with the human immunodeficiency virus (HIV) (HIV+) on antiretroviral therapy (ART) is poorly understood. Our objective was to examine associations of HIV and iron status with nutritional and inflammatory status, anemia, and dietary intake in school-aged South African children. Using a two-way factorial case-control design, we compared four groups of 8 to 13-year-old South African schoolchildren: (1) HIV+ and low iron stores (inflammation-unadjusted serum ferritin ≤40 µg/L), n = 43; (2) HIV+ and iron sufficient non-anemic (inflammation-unadjusted serum ferritin >40 µg/L, hemoglobin ≥115 g/L), n = 41; (3) children without HIV (HIV-ve) and low iron stores, n = 45; and (4) HIV-ve and iron sufficient non-anemic, n = 45. We assessed height, weight, plasma ferritin (PF), soluble transferrin receptor (sTfR), plasma retinol-binding protein, plasma zinc, C-reactive protein (CRP), α-1-acid glycoprotein (AGP), hemoglobin, mean corpuscular volume, and selected nutrient intakes. Both HIV and low iron stores were associated with lower height-for-age Z-scores (HAZ, p < 0.001 and p = 0.02, respectively), while both HIV and sufficient iron stores were associated with significantly higher CRP and AGP concentrations. HIV+ children with low iron stores had significantly lower HAZ, significantly higher sTfR concentrations, and significantly higher prevalence of subclinical inflammation (CRP 0.05 to 4.99 mg/L) (54%) than both HIV-ve groups. HIV was associated with 2.5-fold higher odds of iron deficient erythropoiesis (sTfR >8.3 mg/L) (95% CI: 1.03–5.8, p = 0.04), 2.7-fold higher odds of subclinical inflammation (95% CI: 1.4–5.3, p = 0.004), and 12-fold higher odds of macrocytosis (95% CI: 6–27, p < 0.001). Compared to HIV-ve counterparts, HIV+ children reported significantly lower daily intake of animal protein, muscle protein, heme iron, calcium, riboflavin, and vitamin B12, and significantly higher proportions of HIV+ children did not meet vitamin A and fiber requirements. Compared to iron sufficient non-anemic counterparts, children with low iron stores reported significantly higher daily intake of plant protein, lower daily intake of vitamin A, and lower proportions of inadequate fiber intake. Along with best treatment practices for HIV, optimizing dietary intake in HIV+ children could improve nutritional status and anemia in this vulnerable population. This study was registered at clinicaltrials.gov as NCT03572010.

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Dietary intake among paediatric HIV-positive patients initiating antiretroviral therapy in Johannesburg, South Africa

Cited by 5 publications

References 20 publications

Undernutrition and Associated Factors Among Young Patients on Anti-retroviral Therapy in North Shoa, Oromia, Etiopia,2022. A Facility- Based Cross-sectional Study

Undernutrition and Associated Factors Among Young Patients on Anti-retroviral Therapy in North Shoa, Oromia, Etiopia,2022. A Facility- Based Cross-sectional Study

Weight gain in children from birth to 10 years on antiretroviral treatment

Examining Associations of HIV and Iron Status with Nutritional and Inflammatory Status, Anemia, and Dietary Intake in South African Schoolchildren

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