Nutritional, immune, micronutrient and health status of HIV-infected children in care centres in Mangaung

L. Steenkamp, A. Dannhauser, D. Walsh, G. Joubert, Fj Veldman, E. Van der Walt, C. Cox, Mk Hendricks, H. Dippenaar
2009 South African Journal of Clinical Nutrition  
Nutritional, immune, micronutrient and health status of HIV-infected children in care centres in Mangaung A number of nongovernmental organisations in South Africa have been involved in the implementation of care centres for AIDS orphans. Such centres offer children access to care and support. Children are usually admitted on a semi-permanent basis. They usually visit family only during school holidays and/or weekends. At some centres, children receive day care, which includes breakfast, lunch
more » ... s breakfast, lunch as well as in-between snacks. No information is, however, available regarding the nutritional and micronutrient status of HIVinfected children in these settings. The purpose of this study was to assess the nutritional, immune, micronutrient and health status of HIV-infected children in selected care centres in Mangaung. Abstract Aim: To assess the nutritional, immune, micronutrient and health status of antiretroviral-naïve HIV-infected children. Method: A cross-sectional descriptive study was undertaken between September 2004 and March 2006 amongst HIV-infected children of which none received antiretroviral therapy, in care centres in Mangaung, Free State. Results: The study included 37 clinically stable and food-secure HIV-infected children. Their median age was 5.4 years (range 1.2-10.2 years). Fifteen children (41%) were underweight, 30 (81%) were stunted and one (3%) was wasted. The most commonly observed clinical features were lymphadenopathy (84%), skin rashes (51%), hepatomegaly (32%) and pallor (41%). Eight per cent of children had features of TB, while 19% had a lower respiratory tract infection. The median viral load of the group (n = 35) was 117 000 copies/ml, the median CD4 + cell count was 477 cells/mm3 and the median CD4 percentage was 22.5%. A significant negative correlation could be demonstrated between viral load and nutritional indicators. Children had deficient serum levels relative to normal reference values for glutathione (91% of children), albumin (78%), vitamin A (63%), vitamin D (44%), zinc (38%) and vitamin E (13%). Sixty per cent of the children were anaemic and 30% were iron deficient. Conclusion: A high prevalence of acute and chronic malnutrition and micronutrient deficiencies occurred among HIV-infected children residing in care centres. The study highlights the need to investigate early initiation of antiretroviral therapy and nutrition interventions, including aggressive supplementation, in order to improve the prognosis of these children. S Afr J Clin Nutr 2009;22(3):131-136
doi:10.1080/16070658.2009.11734234 fatcat:rzqlcn5cujewrecnizr7ilu2ny