title: Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival.
abstract: (1) BACKGROUND: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) METHODS: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) RESULTS: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1-6.8), HIV infection (3.1; 1.7-5.5), and WAZ <-3 (3.1; 1.6-5.7) as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) CONCLUSIONS: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children.
authors.affiliation: Department of Biomedicine and Prevention University of Rome Tor Vergata, via Montpellier, Rome 00133, Italy. stefania.moramarco@gmail.com.|Rainbow Project Association Pope John 23rd, 5656 Chinika Road, Ndola 10101, Zambia. stefania.moramarco@gmail.com.
authors.forename: Stefania
authors.initials: S
authors.lastname: Moramarco
authors.affiliation: Rainbow Project Association Pope John 23rd, 5656 Chinika Road, Ndola 10101, Zambia. giulia.amerio@gmail.com.
authors.forename: Giulia
authors.initials: G
authors.lastname: Amerio
authors.affiliation: Rainbow Project Association Pope John 23rd, 5656 Chinika Road, Ndola 10101, Zambia. clarice.ciarlantini@gmail.com.
authors.forename: Clarice
authors.initials: C
authors.lastname: Ciarlantini
authors.affiliation: Ndola District Health Office, 1307 Naidu Close, Ndola 10101, Zambia. jeankasengele@gmail.com.
authors.forename: Jean Kasengele
authors.initials: JK
authors.lastname: Chipoma
authors.affiliation: Ndola District Health Office, 1307 Naidu Close, Ndola 10101, Zambia. mkakungusimpungwe@yahoo.co.uk.
authors.forename: Matilda Kakungu
authors.initials: MK
authors.lastname: Simpungwe
authors.affiliation: Department of Pediatrics, David Geffen UCLA School of Medicine, Los Angeles, CA 90095, USA. knielsen@mednet.ucla.edu.
authors.forename: Karin
authors.initials: K
authors.lastname: Nielsen-Saines
authors.affiliation: Department of Biomedicine and Prevention University of Rome Tor Vergata, via Montpellier, Rome 00133, Italy. leonardo.palombi@gmail.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Palombi
authors.affiliation: Department of Biomedicine and Prevention University of Rome Tor Vergata, via Montpellier, Rome 00133, Italy. ersilia.buonomo@uniroma2.it.
authors.forename: Ersilia
authors.initials: E
authors.lastname: Buonomo
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology; D000067576:Child Health; D015362:Child Nutrition Disorders / Q000453:epidemiology* / Q000628:therapy*; D002675:Child, Preschool; D003141:Communicable Diseases; D019587:Dietary Supplements; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000628:therapy; D009752:Nutritional Status; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014480:United Nations; D015024:Zambia / Q000453:epidemiology
keywords: HIV; Zambia; child malnutrition; child survival; community-based management of malnutrition; supplementary feeding programs