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Int. J. Environ. Res. Public Health 2016, 13(7), 666; doi:10.3390/ijerph13070666

Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival

1
Department of Biomedicine and Prevention University of Rome Tor Vergata, via Montpellier, Rome 00133, Italy
2
Rainbow Project Association Pope John 23rd, 5656 Chinika Road, Ndola 10101, Zambia
3
Ndola District Health Office, 1307 Naidu Close, Ndola 10101, Zambia
4
Department of Pediatrics, David Geffen UCLA School of Medicine, Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 22 April 2016 / Revised: 20 June 2016 / Accepted: 27 June 2016 / Published: 1 July 2016
(This article belongs to the Special Issue Pediatric Infectious Diseases)
View Full-Text   |   Download PDF [1259 KB, uploaded 1 July 2016]   |  

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. View Full-Text
Keywords: child malnutrition; community-based management of malnutrition; HIV; child survival; supplementary feeding programs; Zambia child malnutrition; community-based management of malnutrition; HIV; child survival; supplementary feeding programs; Zambia
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Moramarco, S.; Amerio, G.; Ciarlantini, C.; Chipoma, J.K.; Simpungwe, M.K.; Nielsen-Saines, K.; Palombi, L.; Buonomo, E. Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival. Int. J. Environ. Res. Public Health 2016, 13, 666.

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