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HIV and mortality in severe malnutrition in Malawi

HIV and mortality in severe malnutrition in Malawi . P Fergusson, J Chinkhumba, A Tomkins. Research Objective. To investigate the relationship between CD4%, mortality and HIV in severely malnourished children. . Study setting and characteristics.

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HIV and mortality in severe malnutrition in Malawi

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  1. HIV and mortality in severe malnutrition in Malawi P Fergusson, J Chinkhumba, A Tomkins

  2. Research Objective To investigate the relationship between CD4%, mortality and HIV in severely malnourished children.

  3. Study setting and characteristics • 3 Nutrition Rehabilitation Units in Lilongwe district • 2 rural • 1 urban • Therapeutic feeding and medical management Sample characteristics: • 507 mother/child pairs recruited • 454 child/mother pairs HIV status available • HIV : 17.4% • Mortality: 14.8%

  4. HIV and risk of mortality HIV infected children relative risk of mortality: RR= 3.41 (CI 2.24 – 5.19)

  5. Urban Rural divide Urban children were significantly more likely than rural children to be HIV infected RR = 3.54

  6. Recommendations and conclusions • HIV infected severely malnourished children in Malawi are clustered in urban environments – resource implications • Small proportion of deaths occurring in NRU • Better integration between paeds and NRU • Training on severe malnutrition protocols for paeds staff • Defining criteria for appropriate referral to paeds • CD4% cut offs for initiation of ART should be more clearly defined

  7. Thank you • The participating families Donors • National AIDS Council of Malawi • UNICEF • ACF Paris Partners • KCH, St. Gabriels, Mitundu hospitals • MOH Malawi • UNC Labs • CICH AAH London, Madrid and Malawi

  8. Questions?

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