Assessment of nutritional status and the variables affecting the nutritional status of human immunodeficiency virus positive children in antiretroviral therapy centre of J. A. group of hospitals, Gajra Raja medic

Authors

  • Priya Gogia Department of Pediatrics, Government Medical College and Hospital, Chandigarh
  • Ravi Ambey Department of Pediatrics, Gajra Raja Medical College, Gwalior, Madhya Pradesh
  • Saumya Sahu MBBS, Gajra Raja Medical College, Gwalior, Madhya Pradesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20163515

Keywords:

ART center, HIV positive children, Nutritional status of children, Stunting, Underweight, Wasting

Abstract

Background:HIV-infected children are undernourished; an improvement in their nutritional status may significantly decrease their morbidity. Thus, determining the etiology and temporal course of malnutrition in children with HIV infection will be important for early intervention and development of re-feeding regimens. This cross-sectional study describes the nutritional status and the variables affecting it, among the children made vulnerable by HIV/AIDS. The objective of this study was to assess the nutritional status of the HIV positive children, and to study the variables affecting the nutritional status of HIV positive children.

Methods: The study involved 84 HIV positive children of 18 months - 18 years age group in the ART centre of J. A. group of hospital, Gajra Raja medical college, Gwalior, Madhya Pradesh. Anthropometric measurements, birth and maternal characteristics, socio-economic and immunization profile, past illness were recorded. Z-scores were generated using WHO standards as indicators of nutritional status and variables were assessed by suitable statistical test.

Results:Prevalence of under nutrition is very high particularly moderate and severe stunting (76.19%), moderate and severe underweight (71.42%), and moderate and severe wasting (38.09%) in under five years HIV positive children. While low height for age was observed in 60.31%, low weight for age in 34.92%, and low BMI for age was recorded in 20.63%, in 6-18 years age group. Besides HIV status, other significant determinants of nutritional outcomes include child factors, birth related factors, maternal level factors, socio-economic and past history of illness.

Conclusions:This study documents poor nutritional status among HIV positive children of 18 months-18 years age group. HIV is an independent and non-modifiable risk factor for poor nutritional outcomes in those who are already infected but an improvement in their nutritional status may significantly decrease their morbidity. Early pediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children with integration of other child survival interventions like immunization, community participation may improve their nutritional status and survival.

 

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References

Bachou H, Tylleskar T, Downing R, Tumwine J. Severe malnutrition with and without HIV-1 infection in hospitalized children in Kampala, Uganda. Nutr J. 2006;5:27.

Sunguya B, Koola J, Atkinson S. Infection associated with severe malnutrition among hospitalized children in East Africa. Tanzania Health Res Bull. 2006;8(3):189-92.

Heikens GT, Bunn J, Amadi B, Manary M, Chhagan M, Berkley JA, et al. case management of HIV-infected severely malnourished children: challenges in the area of highest prevalence. Lancet. 2008;371(9620):1305-7.

Ashworth A, Jackson A, Khanum S, Schofield C. Ten steps to recovery. Child Health Dialogue. 1996;3-4:10-2.

Collins S, Dent N, Binns P, Bahwere P, Sadler K, Hallam A. Management of severe acute malnutrition in children. Lancet. 2006;368(9551):1992-2000.

Ndondoki C, Dabis F, Namale L, Bacquet R, Ekouev D, Bosse-Amani C, et al. Survival, clinical and biological outcomes of HIV-infected children treated by antiretroviral therapy in Africa: Systematic review, 2004-2009. La Presse Medicale. 2011;40(7):e338-57.

UNICEF. Committing to child survival: a promise renewed progress report 2013. New York: UNICEF; 2013.

Fergusson P, Tomkins A, Kerac M. Improving survival of children with severe acute malnutrition in HIV-prevalent settings. Hum Res Dev. 2009;1:10-6.

Saloojee H, De Maayer T, Garenne M, Kahn K. What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting. Scand J Public Health Suppl. 2007;69:96-106.

Normén L, Chan K, Braitstein P, Anema A, Bondy G, Montaner J, et al. Food insecurity and hunger are prevalent among HIV-positive individuals in British Columbia, Canada. J Nutr. 2005;135(4):820-5.

Mpontshane N, Van den Broeck J, Chhagan M, Luabeya KK, Johnson A, Bennish ML. HIV infection is associated with decreased dietary diversity in South African children. J Nutr. 2008;138(9):1705-11.

Hien NN, Kam S. Nutritional status and the characteristics related to malnutrition in children under five years of age in Nghean, Vietnam. J Prev Med Public Health. 2008;41(4):232-40.

Sunguya BF, Poudel KC, Otsuka K, Yasuoka J, Mlunde LB, Urassa DP, et al. Under nutrition among HIV positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough. BMC Pediatr. 2011;11:869.

Weng S, Bulterys M, Chao A, Stidley CA, Dushimimana A, Mbarutso E, et al. Perinatal human immunodeficiency virus-1 transmission and intrauterine growth: a cohort study in Butare, Rwanda. Pediatrics. 1998;102(2):e24.

Department of health: National HIV and syphilis antenatal seroprevalence survey in South Africa: 2007. Pretoria: Depart of Health; 2008.

Bulterys M, Chao A, Munyemana S, Kurawige JB, Nawrocki P, Habimana P, et al. Maternal human immunodeficiency virus 1 infection and intrauterine growth: a prospective cohort study in Butare, Rwanda. Pediatr Infect Dis J. 1994;13(2):94-100.

Linnemayr S, Alderman H, Ka A. Determinants of malnutrition in Senegal: individual, household, community variables, and their interaction. Econ hum Biol. 2008;6(2):252-63.

Kimani-Murage EW, Norris SA, Pettifor JM, Tollman SM, Klipstein-Grobusch K, Gomez-Olive XF, et al. Nutritional status and HIV in rural South African children. BMC Pediatr. 2011;11:23.

Magadi MA. Cross-national analysis of risk factors of child malnutrition among children made vulnerable by HIV/AIDS in sub-Saharan Africa: evidence from the DHS. Trop Med Internat Health. 2011;16:570-8.

Assis AM, Barreto ML, Santos LM, Fiaccone R, da Silva Gomes GS. Growth faltering in childhood related to diarrhea: a longitudinal community based study. Eur J Clin Nutr. 2005;59(11):1317-23.

Kapavarapu PK, Bari O, Perumpil M, Duggan C, Dinakar C, Krishnamurthy S, et al. Growth and nutritional status of orphaned HIV-infected children living in an institutional facility in India.

Gomber S, Kaushik JS, Chandra J, Anand R. Profile of HIV infected children from Delhi and their response to antiretroviral treatment. Indian Pediatr. 2010;48:703-7.

Shet A, Mehta S, Rajagopalan N, Dinakar C, Ramesh E, Samuel N, et al. Anemia and growth failure among HIV-infected children in India: a retrospective analysis. BMC Pediatr. 2009;9:37.

Ram M, Gupate N, Nayak U, Kinikar AA, Khandave M, Shankar AV, at al. Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India. BMC Pediatr. 2012;12:282.

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Published

2016-12-22

How to Cite

Gogia, P., Ambey, R., & Sahu, S. (2016). Assessment of nutritional status and the variables affecting the nutritional status of human immunodeficiency virus positive children in antiretroviral therapy centre of J. A. group of hospitals, Gajra Raja medic. International Journal of Contemporary Pediatrics, 3(4), 1227–1231. https://doi.org/10.18203/2349-3291.ijcp20163515

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Original Research Articles