MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
Trop Med Int Health. 2010 Apr;15(4):414-22. doi: 10.1111/j.1365-3156.2010.02476.x. Epub 2010 Feb 17.
To assess the nutritional status of children in a rural community with high HIV prevalence in rural Uganda and to examine the impact of HIV infection at the individual and population level. Methods Cross-sectional population-based survey of children aged 0-12 in a cohort comprising the residents of 25 neighbouring villages in rural southwest Uganda. Anthropometric indicators of nutritional status (height for age, weight for age and weight for height) were assessed in relation to children's HIV serostatus, maternal HIV serostatus and maternal vital status. Children with a Z score of <-2 were defined as undernourished, with a Z score <-2 for weight for age defining underweight, for height for age defining stunting and for weight for height defining wasting.
Of 5951 children surveyed, 91% underwent anthropometric measurement: 30% were underweight, 42% stunted and 10% wasted. HIV seroprevalence among children aged 2-12 was 0.7%. The prevalence of underweight was significantly higher in HIV-positive than in HIV-negative children (52%vs. 30%), as was the prevalence of stunting (68%vs. 42%), but there was no significant difference in the prevalence of wasting (4%vs. 9%). There were no significant differences in the prevalences of indicators of undernutrition in children classified by maternal HIV and vital status.
Chronic childhood undernutrition is common in this rural community. HIV infection had a direct effect in worsening children's nutritional status, but no indirect effect in terms of maternal HIV infection or maternal death. The population-level impact of childhood HIV infection on nutritional status is limited on account of the low HIV prevalence in children. The response to undernutrition in children in Africa requires action on many fronts: not only delivering community-wide HIV and nutritional interventions but also addressing the many interacting factors that contributed to childhood undernutrition before the HIV era and still do so now.
评估乌干达农村一个高艾滋病毒流行地区农村社区儿童的营养状况，并研究艾滋病毒感染对个人和人群层面的影响。方法：在乌干达西南部农村的一个包含 25 个相邻村庄居民的队列中，对 0-12 岁儿童进行了基于人群的横断面调查。将营养状况的人体测量指标（年龄别身高、年龄别体重和身高别体重）与儿童的艾滋病毒血清阳性状态、产妇艾滋病毒血清阳性状态和产妇存活状况联系起来进行评估。Z 分数<-2 的儿童被定义为营养不良，Z 分数<-2 的体重与年龄之比定义为消瘦，Z 分数<-2 的身高与年龄之比定义为发育迟缓，Z 分数<-2 的体重与身高之比定义为消瘦。结果：在所调查的 5951 名儿童中，有 91%接受了人体测量：30%体重不足，42%发育迟缓，10%消瘦。2-12 岁儿童的艾滋病毒血清阳性率为 0.7%。与艾滋病毒阴性儿童相比，艾滋病毒阳性儿童体重不足的比例显著更高（52%对 30%），发育迟缓的比例也显著更高（68%对 42%），但消瘦的比例无显著差异（4%对 9%）。根据产妇艾滋病毒和存活状况对儿童进行分类，其营养不良指标的流行率无显著差异。结论：在这个农村社区，慢性儿童营养不良很常见。艾滋病毒感染直接影响儿童的营养状况，使其恶化，但通过产妇艾滋病毒感染或产妇死亡，并无间接影响。儿童艾滋病毒感染对营养状况的人群层面影响有限，因为儿童艾滋病毒感染率较低。非洲儿童营养不良问题的应对措施需要从多个方面入手：不仅要在社区范围内开展艾滋病毒和营养干预，还要解决在艾滋病毒时代之前和现在导致儿童营养不良的许多相互作用的因素。
