Thursday, February 10, 2011

Malnutrition and HIV in Ugandan Children

I recently read a Nutrition Journal study from 2006 on severely malnourished children with and without HIV. It was a very interesting study on an extremely important topic. I am not only particularly interested in the subject of malnourishment but I’m also particularly interested in Uganda, a country where I have visited with my wife who did some of her health professional training (in Occupational Therapy from the University of Toronto) at a hospital in Mbarara.

There is no doubt that both HIV and malnourishment are very serious problems. The study looked at children with severe malnourishment in Uganda and compared those with and without HIV. This was an important study and some of its results were not at all surprising:

The group of children with HIV had lower white blood cell counts and lower lymphocyte counts. The main sentence from the conclusions is also not surprising: “Severe protein energy malnutrition is associated with the depletion of the haematological and lymphocyte subsets, and this depletion is exacerbated by the presence of HIV-1 infection”

However, the more surprising stuff is found in their data:

The children in this study suffered from many problems. What I found the most surprising was that there was very little difference between the rates at which the children suffered from additional problems when comparing those with and without HIV.

Both groups of kids were severely malnourished and divided into two groups: HIV and no HIV. The two groups exhibited almost the same rates for all of these problems: pneumonia, diarrhea, urinary tract infection and bacteraemia (presence of bacteria in the blood). Based on the frequency of these kids suffering from these extra problems, the authors found “no significant difference with regard to [children’s] HIV status”.

The implication would appear to be that severe malnourishment is playing a major role in exacerbating the rates of these problems (pneumonia, diarrhea, urinary tract infection and bacteraemia).

Here's to hoping for a better future, where everyone gets an adequate supply of food.

Jacob Levman, PhD