Browsing by Author "Nathoo, Kusum J"

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    Hospitalization for severe malnutrition among HIV-infected children starting antiretroviral therapy
    (Wolters Kluwer Health, 2011) Prendergast, Andrew; Mutsa, F; Bwakura-Dangarembizi; Cook, Adrian D; Bakeera-Kitaka, Sabrina; Natukunda, Eva; Ntege, Patricia Nahirya; Nathoo, Kusum J; Karungi, Christine; Lutaakome, Joseph; Kekitiinwa, Adeodata; Gibb, Diana M
    HIV and malnutrition overlap and interact in resourcelimited settings [1]. There is high HIV prevalence among children with severe malnutrition, and mortality in these children is approximately three-fold higher than in HIV-uninfected children with severe malnutrition [2]. Similarly, malnutrition is a major risk factor for mortality in HIV-infected children. Studies from resource-limited settings, in which the majority of HIV-infected children have severe immunosuppression and poor nutritional status at presentation, consistently report 5–10% early mortality among HIV-infected children starting antiretroviral therapy (ART) [3,4]. Severe malnutrition presents as two main clinical syndromes: nonoedematous malnutrition (marasmus) and oedematous malnutrition (kwashiorkor and marasmic kwashiorkor) [5]. Although several studies report that HIV-infected children are more likely to present with nonoedematous malnutrition [6,7], there are anecdotal reports of oedematous malnutrition occurring soon after ART initiation in sub-Saharan Africa (J. Bunn, B. Amadi, personal communication); however, no study has described the frequency of this clinical observation. To better understand the interaction between malnutrition and HIV in children starting ART, we describe the frequency of hospital admissions for severe malnutrition and assess the impact of severe malnutrition on early mortality in a cohort of ART-treated children in Uganda and Zimbabwe.