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HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis

Fergusson, P. and Tomkins, A. (2009) 'HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 103, Issue 6, pp. 541-548.

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Abstract

This systematic review and meta-analysis explored HIV prevalence and mortality in children undergoing treatment for severe acute malnutrition (SAM) in sub-Saharan Africa. It included all studies reporting on HIV infection within a sample of children with SAM where HIV status was assessed using a blood test and SAM was defined using the WHO, Gomez, Wellcome or Waterlow definitions. Children from 17 studies were included in the analysis (n = 4891), of whom 29.2% were HIV-infected. HIV-infected children were significantly more likely to die than HIV-uninfected children (30.4% vs. 8.4%; P < 0.001; relative risk = 2.81, 95% CI 2.04-3.87). HIV-negative children treated within community-based therapeutic care (CTC) programmes had tower mortality (4.3%) than those treated within an inpatient nutrition rehabilitation unit (NRU) (15.1%). There was no significant difference in mortality for HIV-infected children with SAM treated in the CTC (30.0%) or NRU (31.3%) settings. HIV prevalence is high in children with SAM in sub-Saharan Africa, and HIV-infected children are at significantly increased risk of mortality. There is an urgent need to integrate HIV testing and treatment into care for children with SAM in regions of high HIV prevalence. (C) 2008 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Item Type: Article
Additional Information: Fergusson, Pamela Tomkins, Andrew
Uncontrolled Keywords: HIV; Malnutrition; SAM; CD4; Africa; Review
Subjects: WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 130 In childhood
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.41 General coverage
WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 115 Nutritional requirements. Nutrition disorders
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
Faculty: Department: Groups (2002 - 2012) > Disease Control Strategy Group
Digital Object Identifer (DOI): doi.10.1016/j.trstmh.2008.10.029
Depositing User: Tina Bowers
Date Deposited: 02 Jul 2010 10:08
Last Modified: 06 Feb 2018 12:59
URI: http://archive.lstmed.ac.uk/id/eprint/266

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