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Nutritional Rehabilitation of HIV-Exposed Infants in Malawi: Results from the Drug Resources Enhancement Against AIDS and Malnutrition Program
Department of Public Health, Tor Vergata University, Via Montpellier, Rome 00133, Italy
Department of Nutrition, Health Education Center, Perugia University, Perugia 06100, Italy
Department of Nutrition, DREAM Program Malawi, Blantyre, Malawi
DREAM Program, Community of Sant’ Egidio, Piazza S. Egidio 3a, Rome 00153, Italy
Department of Pediatrics, David Geffen School of Medicine at UCLA, MDCC 22-442, 10833 LeConte Ave, Los Angeles, CA 90095, USA
Department of Preventive Medicine, LUMSA University (Libera Università Maria SS. Assunta), Via della Traspontina 21, Rome 00193, Italy
* Author to whom correspondence should be addressed.
Received: 19 October 2011; in revised form: 7 January 2012 / Accepted: 11 January 2012 / Published: 30 January 2012
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.
Keywords: HIV-exposed children; malaria; infant malnutrition; peer education; nutritional rehabilitation
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Buonomo, E.; de Luca, S.; Tembo, D.; Scarcella, P.; Germano, P.; Doro Altan, A.M.; Palombi, L.; Liotta, G.; Nielsen-Saines, K.; Erba, F.; Marazzi, M.C. Nutritional Rehabilitation of HIV-Exposed Infants in Malawi: Results from the Drug Resources Enhancement Against AIDS and Malnutrition Program. Int. J. Environ. Res. Public Health 2012, 9, 421-434.
Buonomo E, de Luca S, Tembo D, Scarcella P, Germano P, Doro Altan AM, Palombi L, Liotta G, Nielsen-Saines K, Erba F, Marazzi MC. Nutritional Rehabilitation of HIV-Exposed Infants in Malawi: Results from the Drug Resources Enhancement Against AIDS and Malnutrition Program. International Journal of Environmental Research and Public Health. 2012; 9(2):421-434.
Buonomo, Ersilia; de Luca, Simona; Tembo, Dyna; Scarcella, Paola; Germano, Paola; Doro Altan, Anna Maria; Palombi, Leonardo; Liotta, Giuseppe; Nielsen-Saines, Karin; Erba, Fulvio; Marazzi, Maria Cristina. 2012. "Nutritional Rehabilitation of HIV-Exposed Infants in Malawi: Results from the Drug Resources Enhancement Against AIDS and Malnutrition Program." Int. J. Environ. Res. Public Health 9, no. 2: 421-434.