title: Nutritional rehabilitation of HIV-exposed infants in Malawi: results from the drug resources enhancement against AIDS and malnutrition program.
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.
authors.affiliation: Department of Public Health, Tor Vergata University, Via Montpellier, Rome 00133, Italy.
authors.forename: Ersilia
authors.initials: E
authors.lastname: Buonomo
authors.forename: Simona
authors.initials: S
authors.lastname: de Luca
authors.forename: Dyna
authors.initials: D
authors.lastname: Tembo
authors.forename: Paola
authors.initials: P
authors.lastname: Scarcella
authors.forename: Paola
authors.initials: P
authors.lastname: Germano
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Doro Altan
authors.forename: Leonardo
authors.initials: L
authors.lastname: Palombi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liotta
authors.forename: Karin
authors.initials: K
authors.lastname: Nielsen-Saines
authors.forename: Fulvio
authors.initials: F
authors.lastname: Erba
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Marazzi
mesh_terms: D015658:HIV Infections / Q000150:complications / Q000178:diet therapy* / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D008295:Malawi; D044342:Malnutrition / Q000150:complications / Q000178:diet therapy* / Q000534:rehabilitation*