Penda Calixte Ida, Moukoko Else Carole Eboumbou, Nolla Nicolas Policarpe, Evindi Nadia Olivia Abomo, Ndombo Paul Koki
Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
HIV Care and Treatment Centre, Laquintinie Hospital of Douala, Cameroon.
Pan Afr Med J. 2018 May 31;30:91. doi: 10.11604/pamj.2018.30.91.15832. eCollection 2018.
The aim of this study was to assess the prevalence of malnutrition among HIV infected children under five years of age followed up at the Laquintinie Hospital Douala (LHD).
Medical records of children aged 13 days-59 months enrolled at initiation of antiretroviral treatment in the Day Care Unit/LHD, were reviewed for a period of 14 years (from 2002 to 2015). We used standard Z-scores, with cut-off point of <-2 SD to define low height-for-age (HAZ), low weight-for-height (WHZ) and low weight-for-age (WAZ). Factors associated with malnutrition were assessed according to World Health Organization (WHO) criteria.
Overall, 217 medical records were included and 52.5% were records of boys. The median weight, height and age of the children was 9.5 kg (range: 2.5-20), 76 cm (range: 46- 117) and 22 months (range: 0.03-59), respectively. The overall prevalence of malnutrition among HIV-infected children was 68.7%; 63.6% were stunted (HAZ<-2), 37.8% were underweight (WAZ<-2) and 18.4 % were wasted (WHZ<-2). Severe and advanced immunological stages of HIV according to WHO were found in 42.4%, (39/92) and 17.4%, (16/92) of children respectively, and most of them (21.7%) were aged 12-36 months. The overall prevalence of anemia, oropharyngeal candidiasis and pulmonary tuberculosis were 34.6%, 12% and 8.8%, respectively. Oropharyngeal candidiasis was a risk factor independently associated with severe underweight and wasting (OR = 4.9, 95% CI: 1.8-13.5, p = 0.002) and (OR = 5.1, 95% CI: 1.5-17.1, p = 0.007).
HIV infection negatively affects the nutritional status of children under five years of age. Early detection of malnutrition is necessary and adequate nutrition should be integrated into the management of pediatric HIV.
本研究旨在评估在杜阿拉拉昆蒂尼医院（LHD）接受随访的5岁以下感染艾滋病毒儿童的营养不良患病率。
回顾了在日间护理单元/LHD开始抗逆转录病毒治疗时登记的13天至59个月大儿童的14年（2002年至2015年）医疗记录。我们使用标准Z评分，以<-2标准差为切点来定义年龄别身高低（HAZ）、身高别体重低（WHZ）和年龄别体重低（WAZ）。根据世界卫生组织（WHO）标准评估与营养不良相关的因素。
总体而言，纳入了217份医疗记录，其中52.5%是男孩的记录。儿童的体重、身高和年龄中位数分别为9.5千克（范围：2.5 - 20）、76厘米（范围：46 - 117）和22个月（范围：0.03 - 59）。感染艾滋病毒儿童的总体营养不良患病率为68.7%；63.6%发育迟缓（HAZ<-2），37.8%体重不足（WAZ<-2），18.4%消瘦（WHZ<-2）。根据WHO标准，分别在42.4%（39/92）和17.4%（16/92）的儿童中发现了艾滋病毒的严重和晚期免疫阶段，其中大多数（21.7%）年龄在12至36个月之间。贫血、口腔念珠菌病和肺结核的总体患病率分别为34.6%、12%和8.8%。口腔念珠菌病是与严重体重不足和消瘦独立相关的危险因素（OR = 4.9，95%CI：1.8 - 13.5，p = 0.002）和（OR = 5.1，95%CI：1.5 - 17.1，p = 0.007）。
艾滋病毒感染对5岁以下儿童的营养状况有负面影响。早期发现营养不良很有必要，应将充足的营养纳入儿科艾滋病毒的管理中。
