Outcome of Severely Malnourished HIV Infected And uninfected Children in Mwanamugimu Nutrition Unit in Uganda - Abstract
Background: The prevalence of severe malnutrition among people under five years of age worldwide is 11% and 7% in Uganda, while the prevalence of HIV infection among these children is high (29-48%). Objectives: To establish the pattern of weight gain and duration of hospital stay among severely malnourished HIV-infected and uninfected individuals admitted to the Mwanamugimu Nutrition Unit (MNU). Methods: A cohort of severely malnourished children was followed at MNU-Mulago Hospital until death or discharge. HIV tests, blood and urine cultures, and electrolyte and chest X-ray analyses were also performed. Children received standard management of severe malnutrition. Results: Fifty-two of the 140 children (37.1%) were HIV positive. The overall mean weight gain in the MNU group during the study was 11.73 g/kg/day. HIV-infected children gained weight poorly (9.300 g/kg/day, SD = 6.66; 12.77 g/kg/day, SD = 7.40) for HIV negative patients (p = 0.023). Urinary tract infection associated with convulsions was a predictor of poor weight gain (p = 0.006). Oral thrush (p=0.003) and marasmus (p=0.04) were associated with prolonged hospital stays. Mortality was greater among HIV-infected children (RR = 2.940, Cl 1.53–9.42, p=0.003). Conclusions: HIV positive children gained weight poorly and had higher mortality than HIV negative children did. Given the high prevalence of HIV and the excess mortality, severely malnourished children, through their caretakers, should be offered voluntary counseling and testing for HIV.