Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study

BMC Infectious Diseases

Valériane Leroy⁵  Gustave Gougouyor⁴  Andrée Bassuka¹  Akossiwa Kpade²  Philemon Saina³  Abdoulaye Nimaga⁷  Tiefing Konate^1,13  Edith Sare⁶  Rosine Kwayep⁹  Goreth Serurakuba^1,11  Sophie Desmonde⁵  Léoncie Nicimpaye^1,14  Réjane Zio^1,12  Capitoline Habarugira^1,10  Caroline Tran^1,12  Arsène Adonon⁸  David Masson^1,12  Julie Jesson⁵ 

[1]EVT (Espoir Vie Togo), Lomé, Togo

[2]AMC (Aide Médicale et Charité), Lomé, Togo

[3]ADN (Association Djenandoum Naasson), Moundou, Tchad

[4]CRIPS (Centre de Recherche de d’Information Pour la Santé ) - Togo, Lomé, Togo

[5]Centre de Recherche Inserm U897, Institut de Santé Publique, d’Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen Case 11, 146 rue Léo Saignat, Bordeaux, 33076, Cedex, France

[6]CSAS (Centre Solidarité Action Sociale), Bouaké, Ivory Coast

[7]AKS (Association Kenedougou Solidarité ), Sikasso, Mali

[8]RACINES (Recherches Actions Communautaires Initiatives pour un Nouvel Espoir), Cotonou, Bénin

[9]SWAA Littoral (Society for Women against AIDS in Africa), Douala, Cameroon

[10]ANSS (Association Nationale de Soutien aux Séropositifs et malades du Sida), Bujumbura, Burundi

[11]SWAA (Society for Women against AIDS in Africa ) - Burundi, Bujumbura, Burundi

[12]Growing Up Programme - Sidaction & Initiative Développement, Paris, France

[13]ARCAD (Association de Recherche, de Communication et d’Accompagnement à Domicile des personnes vivant avec le VIH et le sida), Bamako, Mali

[14]APECOS (Association de Prise en Charge des Orphelins du Sida ), Bujumbura, Burundi

关键词: Africa;    Nutritional support;    Malnutrition;    Children;    HIV;   

Others  :  1229538
DOI  :  10.1186/s12879-015-0952-6

 received in 2014-05-29, accepted in 2015-05-18,  发布年份 2015

【 摘 要 】

Background

The burden of malnutrition among HIV-infected children is not well described in sub-Saharan Africa, even though it is an important problem to take into account to guarantee appropriate healthcare for these children. We assessed the prevalence of malnutrition and its associated factors among HIV-infected children in HIV care programmes in Central and West-Africa.

Methods

A cross-sectional study was conducted from September to December 2011 among the active files of HIV-infected children aged 2–19 years old, enrolled in HIV-care programmes supported by the Sidaction Growing Up Programme in Benin, Burundi, Cameroon, Côte d’Ivoire, Mali, Chad and Togo. Socio-demographics characteristics, anthropometric, clinical data, and nutritional support were collected. Anthropometric indicators, expressed in Z-scores, were used to define malnutrition: Height-for-age (HAZ), Weight-for-Height (WHZ) for children < 5 years and BMI-for-age (BAZ) for children ≥5 years. Three types of malnutrition were defined: acute malnutrition (WHZ/BAZ < -2 SD and HAZ ≥ -2 SD), chronic malnutrition (HAZ < -2 SD and WHZ/BAZ ≥ -2 SD) and mixed malnutrition (WHZ/BAZ < -2 SD and HAZ < -2 SD). A multinomial logistic regression model explored associated factors with each type of malnutrition.

Results

Overall, 1350 HIV-infected children were included; their median age was 10 years (interquartile range [IQR]: 7–13 years), 49 % were girls. 80 % were on antiretroviral treatment (ART), for a median time of 36 months. The prevalence of malnutrition was 42 % (95 % confidence interval [95% CI]: 40-44 %) with acute, chronic and mixed malnutrition at 9 % (95% CI: 6–12 %), 26 % (95% CI: 23–28 %), and 7 % (95% CI: 5–10 %), respectively. Among those malnourished, more than half of children didn’t receive any nutritional support at the time of the survey. Acute malnutrition was associated with male gender, severe immunodeficiency, and the absence of ART; chronic malnutrition with male gender and age (<5 years); and mixed malnutrition with male gender, age (<5 years), severe immunodeficiency and recent ART initiation (<6 months). Orphanhood and Cotrimoxazole prophylaxis were not associated with any type of malnutrition.

Conclusions

The prevalence of malnutrition in HIV-infected children even on ART remains high in HIV care programmes. Anthropometric measurements and appropriate nutritional care of malnourished HIV-infected children remain insufficient and a priority to improve health care of HIV-infected children in Africa.

【 授权许可】

   
2015 Jesson et al.; licensee BioMed Central.

【 图 表 】

Fig. 1.

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