Anigilaje Emmanuel Ademola, Olutola Ayodotun
Department of Paediatrics, Benue State University, Makurdi, Nigeria.
Center for Clinical Care and Clinical Research, Abuja, Nigeria.
Int J Gen Med. 2015 Mar 31;8:131-41. doi: 10.2147/IJGM.S73881. eCollection 2015.
Undernutrition is common in human immunodeficiency virus (HIV) infection and it contributes significantly to its morbidity and mortality. However, as far as we are aware, few studies have described the risk factors of undernutrition among HIV-infected Nigerian children. The study reported here aimed to determine the prevalence and risk factors of undernutrition among HIV-infected, antiretroviral therapy (ART)-naïve children aged under 5 years old in Makurdi, Nigeria.
A retrospective, cross-sectional study was undertaken at the Federal Medical Centre, Makurdi, between June 2010 and June 2011. Logistic regression modelling was used to determine the risk factors of undernutrition.
Data on 182 HIV-infected children (88 males and 94 females), aged between 6 weeks and 59 months were studied. The prevalence of undernutrition was 12.1%, 33.5%, and 54.4% for underweight, wasting, and stunting, respectively. In multivariate regression analyses, being female (adjusted odds ratio [AOR] 0.292, 95% [confidence interval] CI 0.104-0.820, P=0.019), the child's caregiver being on ART (AOR 0.190, 95% CI 0.039-0.925, P=0.04), and the absence of tuberculosis in the child (AOR 0.034, 95% CI 0.003-0.357, P=0.005) were independently protective against underweight. Subjects who were exclusively breastfed in the first 6 months of life were protected from stunting (AOR 0.136, 95% CI 0.032-0.585, P=0.007). No factor impacted significantly on wasting in multivariate analyses.
Undernutrition among HIV-infected, ART-naïve children aged under 5 years old may be reduced if programmatic interventions are guided toward early initiation of ART among eligible HIV-infected caregivers and the promotion of HIV/tuberculosis coinfection control efforts. Also, the importance of exclusive breastfeeding in reducing undernutrition cannot be overemphasized.
营养不良在人类免疫缺陷病毒(HIV)感染中很常见,并且对其发病率和死亡率有显著影响。然而,据我们所知,很少有研究描述尼日利亚感染HIV儿童中营养不良的风险因素。本文报道的这项研究旨在确定尼日利亚马库尔迪地区5岁以下未接受抗逆转录病毒治疗(ART)的HIV感染儿童中营养不良的患病率及风险因素。
2010年6月至2011年6月期间,在马库尔迪联邦医疗中心开展了一项回顾性横断面研究。采用逻辑回归模型确定营养不良的风险因素。
对182名年龄在6周龄至59月龄之间的HIV感染儿童(88名男性和94名女性)的数据进行了研究。体重不足、消瘦和发育迟缓的营养不良患病率分别为12.1%、33.5%和54.4%。在多因素回归分析中,女性(调整后的优势比[AOR]为0.292,95%置信区间[CI]为0.104 - 0.820,P = 0.019)、儿童的照料者接受ART治疗(AOR为0.190,95%CI为0.039 - 0.925,P = 0.04)以及儿童未患结核病(AOR为0.034,95%CI为0.003 - 0.357,P = 0.005)均独立地对体重不足有保护作用。在生命的前6个月纯母乳喂养的儿童可预防发育迟缓(AOR为0.136,95%CI为0.032 - 0.585,P = 0.007)。在多因素分析中,没有因素对消瘦有显著影响。
如果在符合条件的HIV感染照料者中尽早启动ART治疗,并加强HIV/结核病合并感染控制工作,那么5岁以下未接受ART治疗的HIV感染儿童中的营养不良情况可能会减少。此外,纯母乳喂养在减少营养不良方面的重要性再怎么强调也不为过。