The effect of HIV/AIDS on the treatment outcome of severe acute malnutrition in children under 5 years at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

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April 2015
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Few studies have reported on nutritional recovery, survival and growth among severely malnourished children with HIV combining both inpatient and community-based nutrition rehabilitations. This study explores treatment outcome in HIV-infected and HIV-uninfected children at the paediatric ward of the Komfo Anokye Teaching Hospital. This is a retrospective case-control study done on the paediatric ward at the Komfo Anokye Teaching Hospital. The main outcome measures were nutritional recovery/death, duration of nutritional recovery and mortality, and anthropometrics. In the sample of 141 children with severe acute malnutrition (SAM), 36% (n = 51) of children were HIV-infected; 64% (90) of children were not HIV-infected. 92.1% (47/51) of HIV-infected children recovered compared with 90.9% (80/88) in HIV-uninfected children (p=1). Thus children with HIV recovered as frequent as those without HIV (1% point difference, 95% CI, 0.6 to 1.3). Among the HIV-infected children, 8% (4/51) died, compared with 9% (8/88) in HIV-uninfected children (P=1). Children with HIV infection spent an average of 24 ± 7.5 days before discharge from the hospital compared with 20 ± 6.1days in HIV-uninfected children (P<0.005). Children with HIV infection therefore stayed longer before discharge from the hospital than children without HIV infection. HIV-infected children however, had similar weight gain to HIV-uninfected children (5.5 ± 2 vs. 4.8 ± 1.6 respectively, not statistically significant). The conclusion is that HIV infected children with SAM have similar mortality rates compared to HIV-uninfected children with SAM. Among those who survive, however, nutritional recovery is similar in HIV-infected and HIV-uninfected children. It is necessary to integrate HIV services into programmes for nutritional rehabilitation.
A thesis submitted to the Department of Population, Family and Reproductive Health College of Health Sciences, School of Public HEALTH in partial fulfillment of the requirement for the degree of Master of Public Health in Population, Family & Reproductive Health, 2015