Human Immunodeficiency Virus in Children With Severe Acute Malnutrition (SAM) at Ola During Children’s Hospital Freetown, Sierra Leone

International Journal of Medical Science

© 2019 by SSRG - IJMS Journal

Volume 6 Issue 7

Year of Publication : 2019

Authors : Lucy Eberechi Yaguo-ide, Nsirimobu Ichendu Paul

10.14445/23939117/IJMS-V6I7P106

How to Cite?

Lucy Eberechi Yaguo-ide, Nsirimobu Ichendu Paul, "Human Immunodeficiency Virus in Children With Severe Acute Malnutrition (SAM) at Ola During Children’s Hospital Freetown, Sierra Leone," SSRG International Journal of Medical Science, vol. 6,  no. 7, pp. 28-34, 2019. Crossref, https://doi.org/10.14445/23939117/IJMS-V6I7P106

Abstract:

Background:
Human Immunodeficiency Virus (HIV) occurring in Children with Severe Acute Malnutrition (SAM) constitute two key health problems in sub-Saharan Africa. Where these coexist, disease severity is worse and outcome is poorer. The study looked at the prevalence of HIV in children with SAM and its associated risk factors.
Methodology:
This was a descriptive cross-sectional study carried out in 2018 at the therapeutic feeding center (TFC) of the Ola During children’s hospital in Freetown, Sierra Leone. A non-probability sampling method (opportunistic sampling) was used to recruit children for the study. Children were admitted into TFC, if they met the WHO criteria for SAM. A written consent was obtained from the parents or caregivers of these children. A structured questionnaire was used to collect data on the sociodemographic characteristics, clinical and laboratory data of the children and mother. Obtained data was analyzed using Epi-info version 7 and are presented in prose and tables. A test of statistical significance at 95% confidence interval was p<0.05.
Result:
Males represented 103(62.8%) while females constituted 60 (36.6%) of the study participants giving a male female ratio of 1.7:1. Forty eight (29.3%) of the mothers had no formal education while 76 (46.3%) had only primary education. Traders and students constituted 89 (54.3%) and 26 (15.9%) of the mothers occupation respectively. Thirty six of the children were found to be HIV positive giving a prevalence of 22%. Among the mothers of children who were HIV positive, 23 (63.9%) had primary education while 9 (25.0%) had no formal education, nearly half (44.4%) of these mothers were petty traders while a quarter (25.0%) were students and this was statistical significant p < 0.05. Among the SAM children who were HIV positive, 34 (94.4%) presented with fever while had diarrhoea, There was no statistically significant relationship between fever, diarrhoea and HIV status of the children (p=0.924).
Conclusion:
The HIV prevalence of 22% found in this study is high. Also, HIV was commoner among the mothers who were less educated, who were students and petty traders. We recommend; education on HIV risk factors and preventive methods targeted at the less educated and populations of the lower socioeconomic class, screening of all children with SAM for HIV to ensure proper treatment which will improve their outcome, free or augmented female education up to at least secondary level and welfare economic support for economically disadvantaged women by the government.

Keywords:

Severe Acute Malnutrition, HIV, Children

References:

[1] Jesson, S. konmakpai, N. R Diagne et al Effect of age at antiretroviral therapy initiation on catch-up growth within the first 24months among HIV infected children in the leDEA. West Africa Pediatric Cohort. Pediatr Infect Dis J 2015; 34:el 159-68
[2] J. Jesson and V. Leny. Challenges of malnutrition care among HIV-infected children on antiretroviral treatment in Africa Med Mal Infect 2015; 45 : 149-56
[3] UNICEF 2016 HIV/AIDS Global and Regional Trends Available at http:// data unicef org/nutrition/malnutrition.html. Accessed September 14. 2016
[4] UNICEF 2016: Malnutrition: Current Status and Progress.Available at http://data.unicef.org/nutrition/malnutrition.html. Acessed September 14 2016.
[5] Sierra Leone demographic and health survey 2013
[6] S. Duggal, T. D. Chugh and A.K. Duggal. HIV and malnutrition: effects on immune system Clin Dev Immunol 2012; 2012: 784740
[7] J. Jesson, D. Masson, A. Adonon et al Prevalence of malnutrition among HIV infected children in central and West Africa HIV care programmes supported by growing Up Programme in 2011 : a crosssectional study BMC: Infect Dis 2015;15:216
[8] A. M. Rose, C. S. Hall and N. Martenez-Alier. Aetiology and management of malnutrition in HIV positive children Arch Dis Child 2014;99: 546-51
[9] G. Anabwani and P. Navario. Nutrition and HIV/AIDS in sub-Saharan Africa: an overview. Nutrition. 2005;21(1):96–9.
[10] J. Chinkhumba, A. Tomkins, T. Banda, C. Mkangama and P. Fergusson. The impact of HIV on mortality during in-patient rehabilitation of severely malnourished children in Malawi. Trans R Soc Trop Med Hyg. 2008;102(7):639–44.
[11] WHO. Training Course on Child Growth Assessment. Module B: Measuring a child’s growth. Geneva, Switzerland: WHO. 2008. Available at: [http:// www.who.int/childgrowth/training/module_b_measuring_growth.pdf
[12] WHO Child Growth standards and the identification of severe acute malnutrition in infants and children. A joint statement by the World Health Organisation and the United Nations Children’s funds.
[13] J. Chinkhumba, A. Tomkins, T. Banda et al. The impact of HIV on mortality during in-patient rehabilitation of severely malnourished children in Malawi. Trans R Soc Trop Med Hyg 2008 ; 102 : 639 – 44
[14] T. Maayer and H. Saloojee. Clinical outcomes of severe malnutrition in a high tuberculosis and HIV setting. Archives of Disease in Childhood. 2011 DOI: 10.1136/adc.2010.205039 · Source: PubMed
[15] B. Amadi, P. Kelly, M. Mwiya, E. Mulwazi, S. Sianongo, F. Changwe et al. Intestinal and systemic infection, HIV, and mortality in Zambian children with persistent diarrhea and malnutrition. J Pediatr Gastroenterol Nutr 2001 ; 32 : 550 – 4 .
[16] WHO/HIV/2017.59. Sierra Leone HIV country profile: 2016 Available at https://www.who.int/hiv/data/Country_profile_Sierra_Leone.pdf
[17] Global information and education on HIV and AIDS in South Africa. Available at https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa
[18] Global information and education on HIV and AIDS in Zambia. Available at https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zambia
[19] P. D. Smith, T. C. Quinn, W. Strober, E. N. Janoff and H. Masur. “Gastrointestinal infections in AIDS,” Annals of Internal Medicine. 1992; 116 (1): 63–77.
[20] C. O. Enwonwu, “Complex interactions between malnutrition, infection and immunity: relevance to HIV/AIDS infection, “Nigerian Journal of Clinical and Biomedical Research. 2006; 1 (1): 6–14.
[21] N. S. Scrimshaw, C. E. Taylor and J. E. Gordon. “Interactions of nutrition and infection,” World Health Organization, World Health Organization, Geneva, Switzerland, 1968
[22] M. Janssen, J. de Wit, W. Stroebe and F. V. Griensven. Educational Status and Risk of HIV in Young Gay Men. Journal of Health Psychology. 2000; 5(4):487-99. DOI:10.1177/135910530000500407
[23] E.H. Johnson, L. Gant, Y. A. Hinkle, D. Gilbert, C. Willie and T. Hoopwood. Do African-American men and women differ in their knowledge about AIDS, attitudes about condoms, and sexual behaviors? J Natl Med Assoc. 1992;84:49–64. [PMC free article] [PubMed] [Google Scholar]
[24] L. K. Brown, K. J. Lourie, P. Flanagan and P. High. HIV-related attitudes and risk behavior of young adolescent mothers. AIDS Educ Prev. 1998;10:565–73. [PubMed] [Google Scholar]
[25] E. J. Essien, G. O. Ogungbade, D. Ward, E. Ekong, M. W. Ross, A. Meshack et al. Influence of educational status and other variables on HIV risk perception among military personnel: A large cohort finding. Mil Med. 2007 Nov; 172(11): 1177–1181. PMCID: PMC2137161 NIHMSID: NIHMS27973 PMID: 18062392
[26] A. Sikira and E. P. Mamuya. Risk behavior and HIV/AIDS spread among petty traders in Namanga border (Tanzania and Tenya border) International Journal of Asian Social Science, 2016, 6(7): 418-429
[27] W. R. Beisel. Nutrition and immune function: Overview. J Nutr. 1996; 126: 2611S-5S.