The impact of HIV on mortality during in-patient rehabilitation of severely malnourished children in Malawi
Chinkhumba, J.; Tomkins, A.; Banda, T.; Mkangama, C.; Fergusson, P.
Transactions of the Royal Society of Tropical Medicine and Hygiene 102(7): 639-644
2008
ISSN/ISBN: 0035-9203 PMID: 18534649 DOI: 10.1016/j.trstmh.2008.04.028Document Number: 201548
A prospective cohort study measured mortality during nutritional rehabilitation among HIV-infected and uninfected children, aged 6-59 months, with severe acute malnutrition (SAM). Children were tested for HIV and CD4% on admission to the nutrition rehabilitation unit (NRU). Mortality was assessed by following children to 4 months post discharge from the NRU or death if earlier. Overall mortality was 14.8% (67/454) and HIV prevalence was 17.4% (79/454). HIV-infected children were significantly more likely to die than uninfected children [35.4% (28/79) vs. 10.4% (39/375), P<0.001], and 85.7% of deaths occurred in children with a CD4% less than 20. Forty percent (18/45) of HIV-infected children with a CD4% <20 died, in contrast to 15% (3/20) of HIV-infected children with a CD4% >20 (P=0.05). Routine testing and treatment for HIV among all malnourished children is necessary to improve quality of care and reduce mortality among children with SAM.
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