Malabsorption in wasting HIV disease: diagnostic and management issues in resource-poor settings

Isaac, Rita; Alex, Reginald; Knox, Tamsin A.

doi:10.1258/td.2008.080087

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…; Isaac et al . ; WHO ). Further, hand hygiene is essential for disease control in commercial and domestic food preparation as well as in health care, day care, educational and occupational settings (Roberts et al .…”

Section: Introductionmentioning

confidence: 99%

Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects

Freeman

Stocks

Cumming

et al. 2014

Tropical Med Int Health

400

372

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Abstractobjective To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature.methods Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta-regression for risk estimates.results From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children's excreta). Meta-regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53-0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32-1.86).conclusions Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits.

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Section: Introductionmentioning

confidence: 99%

Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects

Freeman

Stocks

Cumming

et al. 2014

Tropical Med Int Health

400

372

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“…[2], [3]. Diarrheal disease may lead to intestinal malabsorption so that PLHIV on antiretrovirals (ARVs) are not acquiring their essential nutrients and therapeutic dosages of medications [4], [5], [6].…”

Section: Introductionmentioning

confidence: 99%

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia

et al. 2012

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BackgroundUnsafe drinking water presents a particular threat to people living with HIV/AIDS (PLHIV) due to the increased risk of opportunistic infections, diarrhea-associated malabsorption of essential nutrients, and increased exposure to untreated water for children of HIV-positive mothers who use replacement feeding to reduce the risk of HIV transmission. This population may particularly benefit from an intervention to improve water quality in the home.Methods and FindingsWe conducted a 12-month randomized, controlled field trial in Zambia among 120 households with children <2 years (100 with HIV-positive mothers and 20 with HIV-negative mothers to reduce stigma of participation) to assess a high-performance water filter and jerry cans for safe storage. Households were followed up monthly to assess use, drinking water quality (thermotolerant coliforms (TTC), an indicator of fecal contamination) and reported diarrhea (7-day recall) among children <2 years and all members of the household. Because previous attempts to blind the filter have been unsuccessful, we also assessed weight-for-age Z-scores (WAZ) as an objective measure of diarrhea impact. Filter use was high, with 96% (596/620) of household visits meeting the criteria for users. The quality of water stored in intervention households was significantly better than in control households (3 vs. 181 TTC/100 mL, respectively, p<0.001). The intervention was associated with reductions in the longitudinal prevalence of reported diarrhea of 53% among children <2 years (LPR = 0.47, 95% CI: 0.30–0.73, p = 0.001) and 54% among all household members (LPR = 0.46, 95% CI: 0.30–0.70, p<0.001). While reduced WAZ was associated with reported diarrhea (−0.26; 95% CI: −0.37 to −0.14, p<0.001), there was no difference in WAZ between intervention and control groups.ConclusionIn this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was highly effective in improving drinking water quality, and was protective against diarrhea.Trial RegistrationClinicaltrials.gov NCT01116908

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“…), and co‐infections and disease progression among people living with HIV/AIDS (Isaac et al . ; Filteau ). Other benefits include more school attendance as a result of fewer episodes of illness (Bowen et al .…”

Section: Lives Saved By Handwashing With Soap Children 1–59 Monthsmentioning

confidence: 99%

“…Hand hygiene could further reduce mortality from hospitalacquired infections and maternal sepsis (Seale et al 2009;World Health Organisation 2009). In addition to saving lives, a plethora of other health benefits has been attributed to handwashing with soap, including reductions in healthcare-associated infections (World Health Organisation 2009), puerperal sepsis (Luby et al 2001), skin infections (Luby et al 2005), eye infections (Montessori et al 1998), including trachoma (the latter health improvements come from face washing combined with antibiotic usage) (Ejere et al 2012), and co-infections and disease progression among people living with HIV/AIDS (Isaac et al 2008;Filteau 2009). Other benefits include more school attendance as a result of fewer episodes of illness (Bowen et al 2007;Freeman et al 2011;Talaat et al 2011) and possible improvements in child growth and development as a result of improved nutritional status (hypothesised to be mediated via reduction in diarrhoea and environmental enteropathy) (Pr€ uss-€ Ust€ un et al 2008;Bowen et al 2012).…”

mentioning

confidence: 99%

Editorial: Can we afford to overlook hand hygiene again?

Greenland

Cairncross

Cumming

et al. 2013

Tropical Med Int Health

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L'accès à l'eau potable et fiable et à l'assainissement, Objectif 7 du Millénaire pour le Développement, cible 7c, est essentiel pour la santé et le bien‐être et est reconnu comme un droit humain. L'hygiène offre de nombreux avantages pour la santé, liés à l'eau et à l'assainissement et pourtant elle est encore absente des Objectifs du Millénaire pour le Développement. En 2013, l'Assemblée Générale des Nations Unies se réunira pour convenir des objectifs et cibles de développement durable postérieurs à 2015. La santé ne devrait pas être mise à l’écart de ce processus.

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Malabsorption in wasting HIV disease: diagnostic and management issues in resource-poor settings

Cited by 8 publications

References 20 publications

Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects

Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia

Editorial: Can we afford to overlook hand hygiene again?

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