HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis

Fergusson, Pamela; Tomkins, Andrew

doi:10.1016/j.trstmh.2008.10.029

Cited by 126 publications

(125 citation statements)

References 36 publications

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“…The prevalence of HIV/AIDS among severely malnourished children in this study was 11.3% and similar findings were reported from South West Ethiopia with a prevalence of 13.8% [18]. But it was found to be lower when compared to studies done in Malawi, 21.6% [19], Zambia, 30% [11], Uganda, 38.6% [12] and recent systematic review and meta-analysis, 29.2% [13]. This could be due to the general decreasing trend in the prevalence of HIV/AIDS in Ethiopia.…”

Section: Discussionsupporting

confidence: 84%

Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

Gebremichael¹,

Bezabih²,

Tsadik³

2014

OALib

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Background: Despite presence of clinical management protocols for treating severe acute malnutrition, its case fatality rate remains high in health facilities from developing countries. Objectives: To assess treatment outcomes and associated risk factors for death of children aged 6 -59 months with complicated severe acute malnutrition. Methods: A cohort of 469 children aged 6 -59 months with complicated severe acute malnutrition admitted to nutritional rehabilitation units of Mekelle City were followed retrospectively. Data on nutritional status, socio-demographic factors, admission medical conditions and management characteristics were collected. Median test, Chi-square test and Cox's proportional hazard regression were used for statistical analysis. Results: Overall case fatality rate was 12.8%. The median length of stay and median weight gain was 17 days and 12.1 g/kg/day, respectively. Two third of the deaths occurred during the first week of admission. Diarrhea (HR: 2.45, 95% CI: 1.23 -4.89), IV antibiotic (HR: 5.87, 95% CI: 1.73 -19.87), blood transfusion (HR: 3.05, 95% CI: 1.51 -6.17) and IV infusion (HR: 2.52, 95% CI: 1.25 -5.07) were found to be associated with time to death. Conclusion: Unacceptably high case fatality rate was observed at the therapeutic feeding units of Mekelle City. Diarrhea, IV antibiotic, blood transfusion and IV infusion were the risk factors for death of severely malnourished under five children. Appropriate clinical management of severe acute malnutrition in the first week of inpatient stay with frequent monitoring for signs associated with clinical deterioration of children hospitalized with complicated SAM is most critical to the survival of the children.

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Section: Discussionsupporting

confidence: 84%

Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

Gebremichael¹,

Bezabih²,

Tsadik³

2014

OALib

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“…Sub-Saharan African countries have the highest case fatality rate due to malnutrition. Chronic diseases like tuberculosis and HIV/AIDS have made the situation of malnutrition severe while in a middle of inadequate inpatient care [4] [9].…”

Section: Introductionmentioning

confidence: 99%

Outcome and Effectiveness of Inpatient Care of Malnourished under Five Children in District Hospitals of Mwanza Region, North Western Tanzania

Ngallaba¹,

Makerere²,

Kapesa³

et al. 2014

OJPM

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Background: Malnutrition is a disease affecting commonly children from 0 to 5 years of age. In Tanzania it is still a problem with a prevalence of 36% and 28% mortality. Objective: This study aimed to compare the outcome and effectiveness of therapeutic regimes used by different district hospitals in the management of malnutrition of under five years old children in Mwanza Region. Methods: Patient charts were reviewed collecting social demographic attributes, diagnosis, type of therapeutic regimen given and treatment outcome. Results: The prevalence of malnutrition was found to be 30% with case fatality rate (CFR) of 8.8%, for the health facilities using WHO regime while 29% CFR for those using traditional regimen. The use of recommend malnutrition screening tests was generally poor. Conclusion: Malnutrition is still a public health problem with high mortality rate in Tanzania which is mainly caused by failure to use the WHO regimen. There is a need to use the available screening methods and recommended regimens to avert this.

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“…The most common commercial brand of RUTF is Plumpy'nut [17], which was designed for pediatric use and is the only one that has been clinically tested in several different studies [3,[18][19][20][21][22]. In wasted adults, a number of factors have been shown to reduce compliance with Plumpy'nut including the taste of this pediatric formulation [23].…”

Section: Introductionmentioning

confidence: 99%

Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Dibari

Bahwere

Huerga³

et al. 2013

Nutrition

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Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods Objective: To develop a method for determining the acceptability and safety of ready-to-use therapeutic foods (RUTF) before clinical trialing. Acceptability was defined using a combination of three consumption, nine safety, and six preference criteria. These were used to compare a soy/ maize/sorghum RUTF (SMS-RUTFh), designed for the rehabilitation of human immunodeficiency virus/tuberculosis (HIV/TB) wasted adults, with a peanut-butter/milk-powder paste (P-RUTF; brand: Plumpy'nut) designed for pediatric treatment. Methods: A cross-over, randomized, controlled trial was conducted in Kenya. Ten days of repeated measures of product intake by 41 HIV/TB patients, >18 y old, body mass index (BMI) 18-24 kg$m À2 , 250 g were offered daily under direct observation as a replacement lunch meal. Consumption, comorbidity, and preferences were recorded. Results: The study arms had similar age, sex, marital status, initial BMI, and middle upper-arm circumference. No carryover effect or serious adverse events were found. SMS-RUTFh energy intake was not statistically different from the control, when adjusted for BMI on day 1, and the presence of throat sores. General preference, taste, and sweetness scores were higher for SMS-RUTFh compared to the control (P < 0.05). Most consumption, safety, and preference criteria for SMS-RUTFh were satisfied except for the average number of days of nausea (0.16 versus 0.09 d) and vomiting (0.04 versus 0.02 d), which occurred with a higher frequency (P < 0.05). Conclusion: SMS-RUTFh appears to be acceptable and can be safely clinically trialed, if close monitoring of vomiting and nausea is included. The method reported here is a useful and feasible approach for testing the acceptability of ready-to-use foods in low income countries. MSF Field Research

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HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis

Cited by 126 publications

References 36 publications

Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

Outcome and Effectiveness of Inpatient Care of Malnourished under Five Children in District Hospitals of Mwanza Region, North Western Tanzania

Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

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