[The effect of nutritional management on the mortality of malnourished children, uninfected and infected with the human immunodeficiency virus].
Weight loss is a major complication in children infected with HIV. Very few studies have focused on the nutritional management of malnourished HIV-positive children, particularly in developing countries, although there have been some studies in adults. Therefore, the aim of this retrospective study was to evaluate, as a function of HIV status, the effect of a nutritional rehabilitation program on the mortality of malnourished children in an Ivory Coast nursery. We studied 193 malnourished children over the age of 15 months from January 1 1994 to December 31 1996; 41 % of these children (80 of 193) were HIV-positive. The nutritional rehabilitation program was introduced in 1995. It had a beneficial effect in HIV-negative children because the setback rate (the number of deaths and transfers x 1,000/the number of child-months at risk) decreased significantly over the three years of the study (1994: 130; 1995: 113; 1996: 26; p < 0.05). The rate in HIV-positive children did fall slightly, but this decrease was not statistically significant. These results demonstrate the difficulties involved in the nutritional management of malnourished HIV-positive children. However, recent studies have suggested that nutritional rehabilitation (by mouth) combined with total vitamin and mineral supplementation may be more effective. Given the frequency of malnutrition in HIV-positive children, clinical studies aimed at improving the nutritional management of these children should be a priority in developing countries.
Beau
J P
JP
IRD, 04 BP 293, Abidjan 04, Côte d'Ivoire.
Imboua-Coulibaly
L
L
Du Lou
A D
AD
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000401:mortality; D015362:Child Nutrition Disorders / Q000401:mortality* / Q000534:rehabilitation; D002675:Child, Preschool; D007560:Cote d'Ivoire; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000401:mortality; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000401:mortality / Q000534:rehabilitation; D008297:Male; D009747:Nutritional Physiological Phenomena; D015431:Weight Loss