Abstract
Infant malnutrition in sub-Saharan Africa is a public health priority and a challenge in high HIV prevalence areas. The Drug Resources Enhancement Against AIDS and Malnutrition program, with multiple medical centers in Sub-Saharan Africa, developed an innovative intervention for the surveillance and control of malnutrition. In a pilot initiative, 36 HIV-exposed children were evaluated at baseline upon presentation for malnutrition and at six months post- treatment. Parameters included HIV-free survival, nutritional status and change in diet. Food diary data was entered and processed using the Nutrisurvey (WHO) software. At 6 months post-intervention, a significant improvement in anthropometric parameters was noted. Slowing of linear growth was observed in patients with malaria with a mean gain in centimetres of 4.4 ± 1.7 as compared to 5.6 ± 1.7 in children with no malaria, p < 0.048 (CL 95%: −2.32, −0.01). Dietary diversity scores increased from 5.3 ± 1.9 to 6.5 ± 1.3, p < 0.01 at 6 months. A significant increase (+25%, p < 0.02) in the number of children eating fish meals was noted. Our pilot data describes positive outcomes from a rehabilitative nutritional approach based on use of local foods, peer education, anthropometric and clinical monitoring in areas of high food insecurity. The relationship between malaria and linear growth retardation requires further investigation.
Highlights
The treatment of infant malnutrition in sub-Saharan Africa is a public health priority and represents a challenge in areas with high HIV/AIDS prevalence [1,2,3,4]
Our primary objective in this pilot project was to assess the impact of a health-driven, growth monitoring intervention coupled to health education and food supplementation on the diet and nutritional status of malnourished HIV-exposed infants
Our findings demonstrate that both nutritional status and diet improved significantly over the course of a short observation period
Summary
The treatment of infant malnutrition in sub-Saharan Africa is a public health priority and represents a challenge in areas with high HIV/AIDS prevalence [1,2,3,4]. In Malawi, HIV and malnutrition are the two major causes of infant morbidity and mortality [5,6]. Malnourished children who do not quickly break away from the vicious cycle of infectious disease and growth failure are vulnerable to irreversible cognitive damage [7]. Educational interventions have proven to be effective in changing the behavior of caregivers with respect to the care of malnourished children [10,11]. There is a strong association between maternal education and reduction of infant mortality with positive public health outcomes [12]
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