Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: Anthropometric and dietary profile

Dannhauser, A; Staden, Anna M. Van; Ryst, Elna van der; Nel, Mariëtte; Marais, Nalize; Erasmus, Elizabeth; Attwood, E.M.; Barnard, H. C.; Roux, G D le

doi:10.1038/sj.ejcn.1600691

Cited by 53 publications

(25 citation statements)

References 40 publications

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“…Our findings were similar to rates of under nutrition among HIV-infected adults reported from other parts of Ethiopia and Africa. The prevalence of wasting, defined as body mass index (BMI) <18.5 kg/m 2 , in adults with HIV infection in Sub-Saharan Africa was in the range 20-40% (15,16,17). However, the findings of this study were lower than those reported among HIV infected individuals in Asia, which was in the range 60 to 68% for wasting.…”

Section: Discussioncontrasting

confidence: 55%

“…Thus, wasting may occur despite individuals maintaining their usual food intake after acquiring HIV and during all stages of the disease. Besides, through reduction of food intake, impairment of digestion, malabsorption and food insecurity, HIV progressively impairs nutrition status (6,7,8).…”

Section: Discussionmentioning

confidence: 99%

“…Low body mass index (BMI) was a strong independent predictor of mortality and treatment outcome among people infected with HIV (15,16). A low BMI at start of ART was an independent predictor of early mortality (i.e.…”

Section: Introductionmentioning

confidence: 97%

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Under Nutrition and Its Use in Prediction of Immunodeficiency in Adults Infected with Human Immunodeficiency Virus in Addis Ababa-Ethiopia

Hussien¹

2015

IJNFS

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HIV infection and poor nutrition status are interlinked. HIV infected individuals are more vulnerable to under nutrition than the general population. Despite major advances in HIV treatment and survival outcomes, weight loss and wasting remain of significant health concern in people living with HIV. Poor nutritional status in HIV infected individuals is associated with disease progression, increased morbidity and reduced survival even when antiretroviral treatment (ART) is available. HIV and malnutrition have a cumulative effect in weakening the immune system and worsening nutrition status. The objective of this study was to assess the prevalence of under nutrition (wasting) among HIV infected, antiretroviral naïve adults, and the utility of wasting in predicting immunosuppression in Addis Ababa, Ethiopia, 2014. Institution based, cross sectional study was done on a sample of 395 antiretroviral naïve adults attending chronic HIV care programs. Study participants were selected by systematic random sampling. Data was collected using a structured interview questionnaire and anthropometric measurements (weight and height) were taken from all study participants. CD4 cell count was done using standard laboratory method and used as a proxy indicator of immune status. Body mass index (BMI) was correlated with CD4 cell count and receiver operating characteristic curves plotted. Under nutrition was of critical health concern among HIV infected antiretroviral naïve adults. The study showed a 27% prevalence of wasting with significantly variation by sex. More women were malnourished than men. There was significant association between wasting and immune suppression. However, the sensitivity and specificity of wasting to predict stages of immune suppression was low. HIV infected individuals need special attention for nutrition monitoring, counselling and support.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Under Nutrition and Its Use in Prediction of Immunodeficiency in Adults Infected with Human Immunodeficiency Virus in Addis Ababa-Ethiopia

Hussien¹

2015

IJNFS

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“…The apparent lack of influence of poor environmental conditions (poor housing, water supply, sanitation and refuse clearance) on the nutritional status of children in this study was also indicated in 11-month-old children in an urban Brazilian study (Huttly et al, 1991), and in 12 -72-month-old children in a rural South African district (Dannhauser et al, 1996). With the data thus not pointing to poor environmental conditions as primary determinants of growth failure in the study population, it is speculated that the difference between the two groups was determined by the quality of care that was received by the children in these unfavourable conditions.…”

Section: Discussionmentioning

confidence: 76%

Determinants of growth failure in 12–24-month-old children in a high-density urban slum community in East London, South Africa

Villiers

Senekal

2002

Eur J Clin Nutr

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Objective: The study's main objectives were the identification of determinants of growth failure in 12 -24-month-old children from an urban slum community attending a day hospital as well as the identification of focus areas for intervention. Design: The research was executed as a case -control study with a one-to-two design. A hypothetical causal model was developed for the undernutrition situation in Duncan Village. A questionnaire to assess the direct and underlying causes of growth failure in the study population was developed from this model. Subjects: One-hundred and fifty children were selected for the study, with 100 children in the control group and 50 children in the growth-failure group. Each child in the growth-failure group was matched with two children in the control group based on age and sex. The children were chosen according to anthropometric indices and p-albumin levels. Setting: The research was conducted at a primary health care centre in Duncan Village, an overpopulated urban slum area in East London, a small city on the east coast of South Africa. Results: No significant differences were found between the two groups for the occurrence of disease and infection. Dietary intake seemed to be generally poor in all the children. No significant differences were found between the two groups for the indicators of household food security, health service utilization and environmental conditions. The most important underlying determinants of growth failure that were identified in the study population seem to be related to the caring capacity, and the resultant caring behaviours of mothers. The risk for growth failure is increased when a child has a mother who is not the head of the household (relative risk) (RR ¼ 4.3), who is not involved with the discipline of her children (RR ¼ 2.2), who is not the guardian of the child (RR ¼ 8), who was not born in Duncan Village or in a city (RR ¼ 2.16), who is not able to write (RR ¼ 2.7) or read Xhosa (RR ¼ 2.53), who has a school education of grade 9 (RR ¼ 2.9), who did not receive nutrition education (RR ¼ 2.2), who smokes (RR ¼ 10) and drinks beer regularly (RR ¼ 10), who has a BMI < 25 (RR ¼ 2.7), who was subjectively judged to show little interest in her child (RR ¼ 4) as well as an inadequate caring attitude towards her child (RR ¼ 3.61), and whose clothing was dirty (RR ¼ 2.7) and not tidy (RR ¼ 2.9). Further determinants included the following: a child who weighed < 2500 g at birth (RR ¼ 4.96), who had not received supplemental milk while still breast-fed (RR ¼ 2.00), who did not receive baby cereal as first food (RR ¼ 2.6), whose clothes (RR ¼ 2.7) were dirty and whose hands were infrequently washed (RR ¼ 10). Conclusions: The results of this research suggest that initiatives to address the problem of growth failure in 12 -24-month-old children attending the Duncan Village Day Hospital should focus mainly on improving the caring capacity of mothers in the study area.

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“…This could possibly be related to poor nutritional status. There is an established relationship of wasting 10 , micronutrient deficiencies 11 and oxidative stress 12 with progression of HIV/AIDS. The World Health Organization and the Food and Agriculture Organization of the United Nations recognised the importance of nutrition in people living with HIV/AIDS and produced a manual on nutritional care for infected people and caregivers 16 .…”

mentioning

confidence: 99%

The nutritional status of asymptomatic HIV-infected Africans: directions for dietary intervention?

Vorster

Kruger

Margetts

et al. 2004

Public Health Nutr.

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Objective: To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIVuninfected subjects, to gain more information on the appropriate diet for HIV-infected persons at an early stage of infection. Design: Cross-sectional population-based survey. Setting: North West Province, South Africa. Subjects: Two hundred and sixteen asymptomatic HIV-infected and 1550 HIVuninfected men and women volunteers aged 15 years and older, recruited as 'apparently healthy' subjects from 37 randomly selected sites. Outcome measures: Food and nutrient intakes, measured with a validated foodfrequency questionnaire, and nutritional status indicated by anthropometric and biochemical variables, measured by a standardised methodology. Results: The prevalence of HIV infection in the study population was 11.9%. The anthropometric indices and nutrient intakes of HIV-infected and uninfected subjects did not differ significantly, indicating that these 216 HIV-infected subjects were at an early stage of infection. Of the biochemical nutritional status variables, high-density lipoprotein cholesterol and total cholesterol, haemoglobin, albumin and triglycerides were significantly lower in infected subjects. They also had higher globulin and liver enzyme levels than uninfected subjects. In infected subjects, serum albumin correlated significantly with serum lipids, serum vitamin A, serum vitamin E, serum iron, total iron-binding capacity and haemoglobin. The significant positive correlations of the liver enzymes with serum lipids, albumin, vitamin A and iron, observed in HIV-uninfected subjects, disappeared in the infected subjects. Polyunsaturated fat intake showed significant positive correlations with the increased liver enzymes in infected subjects. A principal components analysis indicated that, in infected subjects, increased liver enzymes correlated with higher consumption of maize meal and lower consumption of meat and vegetables. Conclusions and recommendations: This survey indicated that asymptomatic HIVinfected subjects who followed a diet rich in animal foods had smaller decreases in serum albumin, haemoglobin and lipid variables, and smaller increases in liver enzymes, than those who consumed a diet based on staple foods. This suggests that animal foods are associated with improved nutritional status in HIV-infected persons. These results should be confirmed with intervention studies before dietary recommendations for asymptomatic HIV-infected individuals can be made.

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Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: Anthropometric and dietary profile

Cited by 53 publications

References 40 publications

Under Nutrition and Its Use in Prediction of Immunodeficiency in Adults Infected with Human Immunodeficiency Virus in Addis Ababa-Ethiopia

Under Nutrition and Its Use in Prediction of Immunodeficiency in Adults Infected with Human Immunodeficiency Virus in Addis Ababa-Ethiopia

Determinants of growth failure in 12–24-month-old children in a high-density urban slum community in East London, South Africa

The nutritional status of asymptomatic HIV-infected Africans: directions for dietary intervention?

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