title: HIV prevalence and impact on renutrition in children hospitalised for severe malnutrition in Niger: an argument for more systematic screening.
abstract: BACKGROUND
  In developing countries, malnutrition is a contributing factor in over 50% of child deaths. Mortality rates are higher in underweight children, and HIV-infection is known to increase underweight. Our goals were to evaluate the prevalence of HIV among children hospitalised for severe malnutrition (SM) at the Niamey national hospital (Niger), and to compare renutrition and mortality by HIV-status.
  
  
  METHODS
  Retrospective study based on all children <5 years hospitalised for SM between January 1(st) 2008 and July 1(st) 2009. HIV-prevalence was the ratio of HIV+ children on the number of children tested. Duration of renutrition and mortality were described using survival curves.
  
  
  RESULTS
  During the study period, 477 children were hospitalised for SM. HIV testing was accepted in 470 (98.5%), of which 40 were HIV+ (HIV prevalence (95% confidence interval) of 8.6% (6.2-11.5)). Duration of renutrition was longer in HIV+ than HIV- children (mean: 22 vs. 15 days; p = 0.003). During renutrition, 8 (20%) and 61 (14%) HIV+ and HIV- children died, respectively (p = 0.81).
  
  
  CONCLUSIONS
  Around 9% of children hospitalised for severe malnutrition were HIV infected, while in Niger HIV prevalence in adults is estimated at 0.8%. This pleads for wider access to HIV testing in this population.
authors.affiliation: Unité d'Epidémiologie des maladies Emergentes, Institut Pasteur, Paris, France. yoann.madec@pasteur.fr
authors.forename: Yoann
authors.initials: Y
authors.lastname: Madec
authors.forename: David
authors.initials: D
authors.lastname: Germanaud
authors.forename: Violeta
authors.initials: V
authors.lastname: Moya-Alvarez
authors.forename: Wafa
authors.initials: W
authors.lastname: Alkassoum
authors.forename: Aichatou
authors.initials: A
authors.lastname: Issa
authors.forename: Morou
authors.initials: M
authors.lastname: Amadou
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tchiombiano
authors.forename: Cecilia
authors.initials: C
authors.lastname: Pizzocolo
authors.forename: Florence
authors.initials: F
authors.lastname: Huber
authors.forename: Sanata
authors.initials: S
authors.lastname: Diallo
authors.forename: Roubanatou
authors.initials: R
authors.lastname: Abdoulaye-Mamadou
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000472:pathogenicity*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality*; D009548:Niger / Q000453:epidemiology; D015596:Nutrition Assessment; D015995:Prevalence; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult