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Malnutrition in HIV

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https://www.readbyqxmd.com/read/29150377/urgent-versus-post-stabilisation-antiretroviral-treatment-in-hospitalised-hiv-infected-children-in-kenya-push-a-randomised-controlled-trial
#1
Irene N Njuguna, Lisa M Cranmer, Vincent O Otieno, Cyrus Mugo, Hellen M Okinyi, Sarah Benki-Nugent, Barbra Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart
BACKGROUND: Urgent antiretroviral therapy (ART) among hospitalised HIV-infected children might accelerate recovery or worsen outcomes associated with immune reconstitution. We aimed to compare urgent versus post-stabilisation ART among hospitalised HIV-infected children in Kenya. METHODS: In this unmasked randomised controlled trial, we randomly assigned (1:1) HIV-infected, ART-naive children aged 0-12 years who were eligible for treatment to receive ART within 48 h (urgent group) or in 7-14 days (post-stabilisation group) at four hospitals in Kenya (two in Nairobi and two in western Kenya)...
November 14, 2017: Lancet HIV
https://www.readbyqxmd.com/read/29132283/predictors-of-survival-among-hiv-positive-children-on-art-in-swaziland
#2
Patrick Shabangu, Andy Beke, Samuel Manda, Nobuhle Mthethwa
The objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively...
December 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/29119032/cytomegalovirus-associated-duodenal-ulcer-and-duodenitis-in-a-malnourished-pediatric-patient
#3
Rachel Bernard, Ghanim Aljomah, Emily Klepper, Elizabeth McDonough
Cytomegalovirus (CMV) duodenitis is a rare occurrence, especially in pediatric patients. A thirteen-month-old female presented to the Emergency Department for a febrile seizure. She was incidentally admitted for severe malnutrition with an initial workup remarkable for only a slight elevation in her ALT at 48. The patient was found to have an oral aversion requiring nasogastric tube feeds for adequate caloric intake. She continued to fail to gain weight and underwent an EGD that demonstrated a duodenal ulcer...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29020216/outpatient-management-of-children-with-world-health-organization-chest-indrawing-pneumonia-implementation-risks-and-proposed-solutions
#4
Eric D McCollum, Amy Sarah Ginsburg
This Viewpoints article details our recommendation for the World Health Organization Integrated Management of Childhood Illness guidelines to consider additional referral or daily monitoring criteria for children with chest indrawing pneumonia in low-resource settings. We review chest indrawing physiology in children and relate this to the risk of adverse pneumonia outcomes. We believe there is sufficient evidence to support referring or daily monitoring of children with chest indrawing pneumonia and signs of severe respiratory distress, oxygen saturation <93% (when not at high altitude), moderate malnutrition, or an unknown human immunodeficiency virus (HIV) status in an HIV-endemic setting...
June 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28968393/correlates-of-multi-drug-non-susceptibility-in-enteric-bacteria-isolated-from-kenyan-children-with-acute-diarrhea
#5
Rebecca L Brander, Judd L Walson, Grace C John-Stewart, Jacqueline M Naulikha, Janet Ndonye, Nancy Kipkemoi, Doreen Rwigi, Benson O Singa, Patricia B Pavlinac
BACKGROUND: Reduced antimicrobial susceptibility threatens treatment efficacy in sub-Saharan Africa, where data on the burden and correlates of antibiotic resistance among enteric pathogens are limited. METHODS: Fecal samples from children aged 6 mos-15 yrs presenting with acute diarrhea in western Kenya were cultured for bacterial pathogens. HIV-uninfected children with identified Shigella or Salmonella species or pathogenic Escherichia coli (EPEC, ETEC, EAEC or EIEC) were included in this cross-sectional sub-study...
October 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28960594/birthweight-hiv-exposure-and-infant-feeding-as-predictors-of-malnutrition-in-botswanan-infants
#6
P Chalashika, C Essex, D Mellor, J A Swift, S Langley-Evans
BACKGROUND: A better understanding of the nutritional status of infants who are HIV-Exposed-Uninfected (HEU) and HIV-Unexposed-Uninfected (HUU) during their first 1000 days is key to improving population health, particularly in sub-Saharan Africa. METHODS: A cross-sectional study compared the nutritional status, feeding practices and determinants of nutritional status of HEU and HUU infants residing in representative selected districts in Botswana during their first 1000 days of life...
September 28, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28915813/the-relationship-between-burden-of-childhood-disease-and-foreign-aid-for-child-health
#7
J Clay Bavinger, Paul Wise, Eran Bendavid
BACKGROUND: We sought to examine the relationship between child specific health aid (CHA) and burden of disease. Based on existing evidence, we hypothesized that foreign aid for child health would not be proportional to burden of disease. METHODS: In order to examine CHA and burden of disease, we obtained estimates of these parameters from established sources. Estimates of disability adjusted life years (DALYs) in children (0-5 years) were obtained from the World Health Organization for 2000 and 2012...
September 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28903800/predicting-treatment-failure-death-and-drug-resistance-using-a-computed-risk-score-among-newly-diagnosed-tb-patients-in-tamaulipas-mexico
#8
B E Abdelbary, M Garcia-Viveros, H Ramirez-Oropesa, M H Rahbar, B I Restrepo
The purpose of this study was to develop a method for identifying newly diagnosed tuberculosis (TB) patients at risk for TB adverse events in Tamaulipas, Mexico. Surveillance data between 2006 and 2013 (8431 subjects) was used to develop risk scores based on predictive modelling. The final models revealed that TB patients failing their treatment regimen were more likely to have at most a primary school education, multi-drug resistance (MDR)-TB, and few to moderate bacilli on acid-fast bacilli smear. TB patients who died were more likely to be older males with MDR-TB, HIV, malnutrition, and reporting excessive alcohol use...
October 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28883928/cpap-impact-a-protocol-for-a-randomised-trial-of-bubble-continuous-positive-airway-pressure-versus-standard-care-for-high-risk-children-with-severe-pneumonia-using-adaptive-design-methods
#9
Andrew G Smith, Michelle Eckerle, Tisungane Mvalo, Brian Weir, Francis Martinson, Alfred Chalira, Norman Lufesi, Innocent Mofolo, Mina Hosseinipour, Eric D McCollum
INTRODUCTION: Pneumonia is a leading cause of mortality among children in low-resource settings. Mortality is greatest among children with high-risk conditions including HIV infection or exposure, severe malnutrition and/or severe hypoxaemia. WHO treatment recommendations include low-flow oxygen for children with severe pneumonia. Bubble continuous positive airway pressure (bCPAP) is a non-invasive support modality that provides positive end-expiratory pressure and oxygen. bCPAP is effective in the treatment of neonates in low-resource settings; its efficacy is unknown for high-risk children with severe pneumonia in low-resource settings...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28862176/index-tb-guidelines-guidelines-on-extrapulmonary-tuberculosis-for-india
#10
Surendra K Sharma, H Ryan, Sunil Khaparde, K S Sachdeva, Achintya D Singh, Alladi Mohan, Rohit Sarin, C N Paramasivan, Prahlad Kumar, Neeraj Nischal, Saurav Khatiwada, Paul Garner, Prathap Tharyan
Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India...
April 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28854929/transition-from-f-75-to-ready-to-use-therapeutic-food-in-children-with-severe-acute-malnutrition-an-observational-study-in-uganda
#11
Betty Lanyero, Hanifa Namusoke, Nicolette Nabukeera-Barungi, Benedikte Grenov, Ezekiel Mupere, Kim Fleischer Michaelsen, Christian Mølgaard, Vibeke Brix Christensen, Henrik Friis, André Briend
BACKGROUND: World Health Organization now recommends the transition from F-75 to ready-to-use therapeutic foods (RUTF) in the management of severe acute malnutrition (SAM). We described the transition from F-75 to RUTF and identified correlates of failed transition. METHODS: We conducted an observational study among children aged 6-59 months treated for SAM at Mulago hospital, Kampala, Uganda. Therapeutic feeding during transition phase was provided by first offering half of the energy requirements from RUTF and the other half from F-75 and then increasing gradually to RUTF as only energy source...
August 30, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28838283/exocrine-pancreatic-insufficiency-is-common-in-people-living-with-hiv-on-effective-antiretroviral-therapy
#12
Aylin Yilmaz, Lars Hagberg
OBJECTIVES: The primary aim of this prospective study was to determine the prevalence of exocrine pancreatic insufficiency (EPI) in people living with HIV (PLHIV) on suppressive antiretroviral therapy (ART). METHODS: PLHIV ≥18 years of age and on ART for >6 months and with HIV RNA <50 copies/mL plasma were included. Faecal elastase-1 measurement was performed on a single stool sample, serum markers of malnutrition were collected, and participants answered a short questionnaire about gastrointestinal symptoms...
August 25, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28793991/trial-of-ready-to-use-supplemental-food-and-corn-soy-blend-in-pregnant-malawian-women-with-moderate-malnutrition-a-randomized-controlled-clinical-trial
#13
Meghan Callaghan-Gillespie, Andrew A Schaffner, Patsy Garcia, Jocelyn Fry, Rachael Eckert, Shirin Malek, Indi Trehan, Chrissie Thakwalakwa, Kenneth M Maleta, Mark J Manary, Peggy C Papathakis
Background: Malnutrition during pregnancy in sub-Saharan Africa is associated with poor birth outcomes.Objective: This study compared maternal and offspring anthropometry for moderately malnourished pregnant women receiving ready-to-use supplemental food (RUSF), a fortified corn-soy blend (CSB+) with a daily multiple micronutrient antenatal supplement [United Nations International Multiple Micronutrient Preparation (UNIMMAP)], or standard of care comprising CSB+ and iron and folic acid (IFA).Design: A single-blind randomized controlled clinical trial was conducted in southern Malawi among 1828 pregnant women with moderate malnutrition, defined as a midupper arm circumference (MUAC) ≥20...
August 9, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28753985/new-biomarkers-and-diagnostic-tools-for-the-management-of-fever-in-low-and-middle-income-countries-an-overview-of-the-challenges
#14
REVIEW
Camille Escadafal, Christian Nsanzabana, Julie Archer, Violet Chihota, William Rodriguez, Sabine Dittrich
A lack of simple, inexpensive, and rapid diagnostic tests for febrile illnesses other than malaria leads to overtreatment with antibiotics for those who test negative for malaria, and contributes to the global rise in antimicrobial resistance. New tests for the detection of host biomarkers provide promising tools to differentiate bacterial from non-bacterial infections in febrile patients. However, most available biomarker tests are not currently used in resource-limited settings, and very few evaluations have been performed in low- and middle-income country populations with non-severe febrile illness...
July 21, 2017: Diagnostics
https://www.readbyqxmd.com/read/28748992/-screening-for-malnutrition-among-hospitalized-patients-in-a-colombian-university-hospital
#15
Viviana Cruz, Laura Bernal, Giancarlo Buitrago, Álvaro J Ruiz
BACKGROUND: On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. AIM: To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). MATERIAL AND METHODS: In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital...
April 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28736507/national-mortality-burden-due-to-communicable-non-communicable-and-other-diseases-in-ethiopia-1990-2015-findings-from-the-global-burden-of-disease-study-2015
#16
Awoke Misganaw, Tilahun N Haregu, Kebede Deribe, Gizachew Assefa Tessema, Amare Deribew, Yohannes Adama Melaku, Azmeraw T Amare, Semaw Ferede Abera, Molla Gedefaw, Muluken Dessalegn, Yihunie Lakew, Tolesa Bekele, Mesoud Mohammed, Biruck Desalegn Yirsaw, Solomon Abrha Damtew, Kristopher J Krohn, Tom Achoki, Jed Blore, Yibeltal Assefa, Mohsen Naghavi
BACKGROUND: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. METHODS: GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries...
2017: Population Health Metrics
https://www.readbyqxmd.com/read/28732536/national-mortality-burden-due-to-communicable-non-communicable-and-other-diseases-in-ethiopia-1990-2015-findings-from-the-global-burden-of-disease-study-2015
#17
Awoke Misganaw, Tilahun N Haregu, Kebede Deribe, Gizachew Assefa Tessema, Amare Deribew, Yohannes Adama Melaku, Azmeraw T Amare, Semaw Ferede Abera, Molla Gedefaw, Muluken Dessalegn, Yihunie Lakew, Tolesa Bekele, Mesoud Mohammed, Biruck Desalegn Yirsaw, Solomon Abrha Damtew, Kristopher J Krohn, Tom Achoki, Jed Blore, Yibeltal Assefa, Mohsen Naghavi
BACKGROUND: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. METHODS: GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries...
July 21, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28678680/management-of-noma-practice-competence-and-knowledge-among-healthcare-workers-in-a-rural-district-of-zambia
#18
Mathilda Ahlgren, Tjede Funk, Clemence Marimo, Charlotte Ndiaye, Tobias Alfvén
BACKGROUND: Noma is an infectious but opportunistic disease that often results in severe facial disfigurements and mortality if untreated. As noma progresses quickly, early detection and treatment are important to prevent its development. OBJECTIVES: The objective of this study was to investigate primary healthcare workers' knowledge and management of noma in a rural part of Zambia. METHODS: A cross-sectional self-completed survey was conducted among 35 healthcare workers from two district hospitals and 15 rural health centres in Serenje District, Zambia...
2017: Global Health Action
https://www.readbyqxmd.com/read/28670966/malnutrition-in-hiv-infected-children-is-an-indicator-of-severe-disease-with-an-impaired-response-to-antiretroviral-therapy
#19
Maximilian Muenchhoff, Michael Healy, Ravesh Singh, Julia Roider, Andreas Groll, Chirjeev Kindra, Thobekile Sibaya, Angeline Moonsamy, Callum McGregor, Michelle Q Phan, Alejandro Palma, Henrik Kloverpris, Alasdair Leslie, Raziya Bobat, Philip S LaRussa, Thumbi Ndung'u, Philip Jr Goulder, Magdalena E Sobieszczyk, Mohendran Archary
Objectives This observational study aimed to describe immunopathogenesis and treatment outcomes in children with and without severe acute malnutrition (SAM) and HIV-infection. Design We studied markers of microbial translocation (16sDNA), intestinal damage (iFABP), monocyte activation (sCD14), T-cell activation (CD38, HLA-DR) and immune exhaustion (PD1) in 32 HIV-infected children with and 41 HIV-infected children without SAM prior to initiation of antiretroviral therapy (ART) and cross-sectionally compared these children to 15 HIV-uninfected children with and 19 HIV-uninfected children without SAM...
July 2, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28657963/maternal-hiv-infection-is-an-important-health-determinant-in-non-hiv-infected-infants
#20
María Rupérez, Raquel González, Sonia Maculuve, Llorenç Quintó, Elisa López-Varela, Orvalho Augusto, Anifa Vala, Arsénio Nhacolo, Esperança Sevene, Denise Naniche, Clara Menéndez
OBJECTIVE: To assess morbidity and mortality in HIV-exposed uninfected (HEU) children to help guiding appropriate clinical care and effective preventive interventions. DESIGN: This is a longitudinal study comparing two cohorts of children; one born to HIV-infected women and the other born to HIV-uninfected women. METHODS: We have analyzed prospectively obtained information on nutritional status, morbidity and mortality from 966 HEU and 909 HIV-unexposed infants followed up until their first 18 months of life at a referral health facility in southern Mozambique...
July 17, 2017: AIDS
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