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INTL/TUE/01 IMPACT OF HIV ON NUTRITIONAL RECOVERY IN SEVERELY MALNOURISHED CHILDREN IN MALAWI

1P Fergusson, 2J Chinkhumba, 3A Tomkins. 1University of Chester, Chester, UK; 2Action Against Hunger, Lilongwe, Malawi; 3UCL Centre for International Health and Development, London, UK

Aims: To determine the impact of HIV on nutritional recovery in severely malnourished children in Malawi.

Methods: A cohort of 454 severely malnourished children aged 6 months to 5 years was selected from three, hospital-based, nutrition rehabilitation units. Children received therapeutic feeding (according to national guidelines) until achieving nutritional recovery (defined as 85% weight for height and no oedema) and were followed up at home on a programme of supplementary feeding for 4 months.

Results: 17.4% (79/454) of children were HIV infected. HIV-infected children had significantly lower weight for height (−2.74 v −2.29 Z scores; p = 0.007) than HIV-uninfected children. Overall mortality in the children was 14.8% (67/454); 35.4% (28/79) in HIV-infected children v 10.4% (39/375) in HIV-uninfected children (p<0.001). While in the nutritional recovery unit (NRU), HIV-infected children gained significantly more weight than uninfected children (1.45 kg v 1.21 kg; p<0.03). Although HIV-infected children had a significantly longer stay in the NRU (28.8 days v 24.3 days; p<0.03), their rate of weight gain was actually quicker than in uninfected children. HIV-infected children gained an average of 8.9 g/kg per day v 8.0 g/kg per day (NS) in HIV-uninfected children. Data on appetite during 4 months community follow-up was available for 344 children. Only 3/344 (0.9%) children had poor appetites. Also, only 3/344 children required re-admission to the NRU after discharge home. At follow-up, the mean weight for height Z score was −0.67 (−0.85 HIV infected v −0.64 HIV uninfected, NS).

Conclusion: HIV-infected severely malnourished children gain and maintain weight as well as HIV-uninfected children.

INTL/TUE/02 TEACHING CHILD HEALTH IN THE OCCUPIED PALESTINIAN TERRITORIES: AN INTERNATIONAL MODEL?

1T Waterston, 2M Rudolf. 1University of Newcastle, Newcastle upon Tyne, UK; 2 …

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