The effect of hiv on growth of malnourished children under five years during follow-up at mulago hospital in kampala, uganda

Abstract

Introduction Globally, of the 2.3 million children living with HIV/AIDS under 15 years, two thirds (63%) live in sub-Saharan Africa. In Uganda, approximately 100,000 children < 15 years are living with HIV/AIDS, which is 10% of all people living with HIV. On average, stunting (a deficit in height for age) and wasting (a deficit in weight for height) affects over 40% and 10% of under-5-year children, respectively in developing countries. Studies have shown that the HIV prevalence in malnourished children is high. However, it is not clear whether the management of malnutrition in HIV infected children should be different from that of malnourished HIV non-infected children. Objective To determine the effect of HIV on growth of malnourished children under five years during follow-up at Mulago hospital, Kampala Methods The study design was a retrospective cohort employing quantitative methods of data collection and was conducted at Mwanamugimu Nutrition Unit, Mulago Hospital by reviewing medical records between January 2007 and March 2008. Malnourished children under five years during follow-up were eligible for the study with HIV positive children as the exposed group and HIV negative children as the non-exposed group. All children with complete records meeting the eligibility criteria were included in the study. Baseline parameters were documented at discharge into the Supplementary Feeding Centre and follow-up parameters at one-month follow-up visit. The outcome variables were weight gain, change in weight for height, and weight gain velocity. The extraneous variables were Illnesses at discharge and at one month follow-up visit, age, sex and immunization status.

Results One hundred and eight children treated for malnutrition were enrolled in this study. Thirty eight (35.2%) children were HIV positive and the rest were HIV negative. Fifty five (50.9%) were male while 53 (49.1%) were female. On average HIV positive children gained less mean body weight (0.58 kg) and had a less weight gain velocity (3.15 g/kg/day) compared to 0.65 kg and 3.18 g/kg/day respectively for HIV negative children. Although the difference in mean weight gain and mean weight gain velocity between malnourished HIV positive children and HIV negative children was statistically significant, the difference in change in weight for height which is a better measure of wasting (than weight gain and weight gain velocity) was not statistically significant.

Conclusion and recommendation HIV does not affect growth of under five malnourished children in the first one month of follow-up after discharge. The current Ministry of Health policy on nutritional management of under five malnourished children which does not provide for special management of malnourished HIV positive children during follow-up should be maintained. Introduction Globally, of the 2.3 million children living with HIV/AIDS under 15 years, two thirds (63%) live in sub-Saharan Africa. In Uganda, approximately 100,000 children < 15 years are living with HIV/AIDS, which is 10% of all people living with HIV. On average, stunting (a deficit in height for age) and wasting (a deficit in weight for height) affects over 40% and 10% of under-5-year children, respectively in developing countries. Studies have shown that the HIV prevalence in malnourished children is high. However, it is not clear whether the management of malnutrition in HIV infected children should be different from that of malnourished HIV non-infected children. Objective To determine the effect of HIV on growth of malnourished children under five years during follow-up at Mulago hospital, Kampala Methods The study design was a retrospective cohort employing quantitative methods of data collection and was conducted at Mwanamugimu Nutrition Unit, Mulago Hospital by reviewing medical records between January 2007 and March 2008. Malnourished children under five years during follow-up were eligible for the study with HIV positive children as the exposed group and HIV negative children as the non-exposed group. All children with complete records meeting the eligibility criteria were included in the study. Baseline parameters were documented at discharge into the Supplementary Feeding Centre and follow-up parameters at one-month follow-up visit. The outcome variables were weight gain, change in weight for height, and weight gain velocity. The extraneous variables were Illnesses at discharge and at one month follow-up visit, age, sex and immunization status.

Results One hundred and eight children treated for malnutrition were enrolled in this study. Thirty eight (35.2%) children were HIV positive and the rest were HIV negative. Fifty five (50.9%) were male while 53 (49.1%) were female. On average HIV positive children gained less mean body weight (0.58 kg) and had a less weight gain velocity (3.15 g/kg/day) compared to 0.65 kg and 3.18 g/kg/day respectively for HIV negative children. Although the difference in mean weight gain and mean weight gain velocity between malnourished HIV positive children and HIV negative children was statistically significant, the difference in change in weight for height which is a better measure of wasting (than weight gain and weight gain velocity) was not statistically significant.

Conclusion and recommendation HIV does not affect growth of under five malnourished children in the first one month of follow-up after discharge. The current Ministry of Health policy on nutritional management of under five malnourished children which does not provide for special management of malnourished HIV positive children during follow-up should be maintained.