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. 2021 Dec 14;7(1):83.
doi: 10.1186/s40795-021-00486-4.

Assessment of dietary diversity and nutritional support for children living with HIV in the IeDEA pediatric West African cohort: a non-comparative, feasibility study

Julie Jesson  1 , Ayoko Ephoevi-Ga  2 , Marie-Hélène Aké-Assi  3 , Sikiratou Koumakpai  4 , Sylvie N'Gbeche  5 , Evelyne Dainguy  6 , Karen Malateste  7 , Hugo Carrié  8 , Marcelline D'Almeida  4 , François Tanoh Eboua  3 , Elom Takassi  2 , Madeleine Amorissani-Folquet  6 , Valériane Leroy  8 ; IeDEA West African Pediatric Collaboration
Collaborators, Affiliations

Assessment of dietary diversity and nutritional support for children living with HIV in the IeDEA pediatric West African cohort: a non-comparative, feasibility study

Julie Jesson et al. BMC Nutr. .

Abstract

Background: Nutritional care is not optimally integrated into pediatric HIV care in sub-Saharan Africa. We assessed the 6-month effect of a nutritional support provided to children living with HIV, followed in a multicentric cohort in West Africa.

Methods: In 2014-2016, a nutritional intervention was carried out for children living with HIV, aged under 10 years, receiving antiretroviral therapy (ART) or not, in five HIV pediatric cohorts, in Benin, Togo and Côte d'Ivoire. Weight deficiency was assessed using two definitions: wasting (Weight for Height Z-score [WHZ] for children<5 years old or Body-Mass-Index for Age [BAZ] for ≥5 years) and underweight (Weight for Age Z-score [WAZ]) (WHO child growth standards). Combining these indicators, three categories of nutritional support were defined: 1/ children with severe malnutrition (WAZ and/or WHZ/BAZ <-3 Standard Deviations [SD]) were supported with Ready-To-Use Therapeutic Food (RUTF), 2/ those with moderate malnutrition (WAZ and/or WHZ/BAZ = [-3;-2[ SD) were supported with fortified blended flours produced locally in each country, 3/ those non malnourished (WAZ and WHZ/BAZ ≥-2 SD) received nutritional counselling only. Children were followed monthly over 6 months. Dietary Diversity Score (DDS) using a 24h recall was measured at the first and last visit of the intervention.

Results: Overall, 326 children were included, 48% were girls. At baseline, 66% were aged 5-10 years, 91% were on ART, and 17% were severely immunodeficient (CD4 <250 cells/mL or CD4%<15). Twenty-nine (9%) were severely malnourished, 63 (19%) moderately malnourished and 234 (72%) non-malnourished. After 6 months, 9/29 (31%) and 31/63 (48%) recovered from severe and moderate malnutrition respectively. The median DDS was 8 (IQR 7-9) in Côte d'Ivoire and Togo, 6 (IQR 6-7) in Benin. Mean DDS was 4.3/9 (sd 1.2) at first visit, with a lower score in Benin, but with no difference between first and last visit (p=0.907), nor by intervention groups (p-value=0.767).

Conclusions: This intervention had a limited effect on nutritional recovery and dietary diversity improvement. Questions remain on determining appropriate nutritional products, in terms of adherence, proper use for families and adequate energy needs coverage for children living with HIV.

Trial registration: PACTR202001816232398 , June 01, 2020, retrospectively registered.

Keywords: Children; Cohort; HIV; Malnutrition; Nutritional support; West Africa.

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Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
Flow-chart of the interventional study, Wadanut, 2014-2016
Fig. 2
Fig. 2
Dietary diversity by country, at first visit, for children aged more than two years at inclusion, frequencies of consumption,WADANUT, 2014-2016
See this image and copyright information in PMC

References

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