Severe Acute Malnutrition in Children Infected with Acquired Immunodeficiency Virus in Souro Sanou University Hospital of Bobo-Dioulasso (Burkina Faso)

Assétou ZONGO, Makoura BARRO, Bintou SANOGO, Fatimata Sahoura NACRO, Raymond CESSOUMA, Boubacar NACRO

Abstract



ABSTRACT
Objective. To compare the profile of acute malnutrition among HIV positive and HIV negative children. Methods. This was a retrospective transversal analytic study concerning 231 severely malnourished children aged 0-5 years hospitalized from January 1st, 2008 to June 30th, 2009 (18 months) in the pediatrics department and monitored in educational and nutritional rehabilitation centre of the department. Our data of interest were epidemiology, clinical and therapeutic features and issue. Results. We did not notice any significant difference between age and serology. Also, there was no statistically significant difference between gender and serology nor with the type of malnutrition. Urban –born children were more exposed to HIV infection (79.6% vs 57%; p=0,000). The percentage of HIV infected children was 44,6% of which 94,2% of the serotype HIV1 and almost 80% of the infected children were severely immunodepressed (rate of CD4 inferior to 25%). Marasmus was the most noticeable type of malnutrition to infected children combined with Candida and cutaneous lesions. The non infected children had more edema. Blood transfusion concerned more the non infected children and the latter had a good nutritional rehabilitation with the new national protocol. The infected children were more inclined to die than the non infected children. Conclusion. The nutritional monitoring of infected children, the rapid acess to ARV are measures which will permit to reduce the occurrence of acute malnutrition among these children and reduce the high mortality rate that we noticed.
RÉSUMÉ
Objectif. Comparer de la malnutrition aiguë sévère chez l’enfant infecté et celui non infecté par le VIH. Méthodes.  Étude transversale analytique rétrospective concerne 231 enfants malnutris sévères âgés de 0-5 ans hospitalisés du 1er janvier 2008 au 30 juin 2009 (18 mois) dans le département de pédiatrie et suivis au centre d’éducation et de récupération nutritionnel du département. Nos paramètres d’interet étaient les aspects épidémiologiques, cliniques, thérapeutiques et évolutifs. Résultats. On ne notait pas de différence significative entre l’âge et la sérologie, le sexe et la sérologie et non plus avec le type de malnutrition. Les enfants provenant du milieu urbain étaient les plus exposés à l’infection par le VIH (79,6% contre 57% ; p=0,000). Le pourcentage d’enfants infectés par le VIH était de 44,6% dont 94,2% du séro-type VIH1 et près de 80% de ces enfants infectés étaient sévèrement immunodéprimés (taux de CD4 inférieur à 25%). Le marasme était la forme de malnutrition la plus observée chez les enfants infectés associé à des lésions candidosiques et cutanées. Les enfant non infectés présentaient plus d’œdèmes. La transfusion a davanatge concerné les enfants non infectés et ces derniers avaient une bonne récupération nutritionnelle avec le nouveau protocole. Le risque de décès était plus élevé chez les enfants infectés. Conclusion. Le suivi nutritionnel des enfants infectés, l’accès rapide aux ARV sont des mesures qui permettront de réduire la survenue de la malnutrition sévère chez ces enfants et réduire la forte mortalité observée.

Keywords


acute malnutrition/HIV/ nutritional monitoring/ Burkina Faso

Full Text:

PDF

References


Malnutrition in HIV-infected children: Knowing how to detect it. No. 14 Nutrition. April 2009 Available on http: //www.grandir. sidaction.org/.

World Health Organization. Report (Nutrition and HIV / AIDS) available at: http: //www.Who .int.

UN. AIDS: HIV, Food Security and Nutrition; General policy. May 2008.

Somé KJ-F. Itinerary of children admitted for malnutrition in rehabilitation and nutrition education centers of Ouagadougou. Med thesis: University of Ouagadougou. 1999; 26.

Beautiful J.P., Emboua-Coulbaly L. Malnutrition and HIV infection1: Why a lower seroprevalence in kwashiorkor. Ivory Coast. Health Papers 1997; 7: 236-8.

Bachou H, Tylleskär T, Downing R, Tumwine KJ. Risk factors in hospital deaths in Kampala, Uganda. BMC Paediatrics 2006; 6: 7.

Ashraf H, Ahmed T, Hossain MI, Alam NH, Mahmud R, Kamal SM et al. Day-care management of children with severe malnutrition in an urban health clinic in Dhaka, Bangladesh. J Too Pediatr 2007; 53: 171-8.

Tiendrebéogo S. Evaluation of the management of severe acute malnutrition in the pediatric ward of the Yalgado Ouedraogo University Hospital Center. Thesis Med: No. 36 University of Ouagadougou. 2009.

Sanon T. Epidemiological, clinical and progressive aspects of malnutrition associated with HIV infection in pediatric settings in Bobo-Dioulasso. Thesis Med: University of Ouagadougou.1991; 17.

O. Mbaye Ngagne, Diouf S, Camara B, Sall M.G, Ndiaye A, Becker B. Fall M, Fall B, Law. Coll-Secka.M. Mboup S. Malnutrition and HIV infection in pediatric settings at Dakar University Hospital, Senegal. 1994.

David R Brewster. Critical appraisal of the management of severe malnutrition: Journal of Paediatrics and Child Health 42 (2006) 583-593.

Bachou H, Tumwine KJ, Mwadime RKN, Tylleskär T. Severe malnutrition with and without HIV-1 infection in hospitalized children in Kampala, Uganda: differences in clinical features, haematological findings and CD4 + cell counts. Nutrition Journal 2006; 5:27.

World Health Organization. Management of severe malnutrition: Manual for use by doctors and other health personnel in managerial positions. Geneva: World Health Organization; 2000.

Burkina Faso Directorate of Nutrition. National protocol for the management of acute malnutrition. Ouagadougou: Ministry of Health; 2007.

Pamela F, Jobiba C, Carlos G-E, Theresa B., Catherine M. Nutritional recovery in HIV infected and uninfected children with severe acute malnutrition. BMJ Publishing Group Ltd. & Royal College of Paediatrics and Child Health 2008; 10: 1136.

Jobiba C; Andrew T; Theresa B; Catherine M; Pamela F. The Impact of HIV on Malnutrition in Malawi. 2008 102 (7): 639-44.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

********************************************************************************************